Well, not to goal-post shift, but it may not have to be rumination in the classic sense that ends up causing a large shift later on.
For example, there could be particular sets of neurons that respond to specific stimuli, say for example a specific set of neurons that get activated when you see a picture of Ryan Gosling (this is actually likely the case). The brain has "gain" such so that a small change at one time can blossom into a larger change later on - but one may not be able to connect the dots.
The insignificant stimuli, or even internally generated stimuli, and the eventual significant changes in consciousness/biology (if only changed for a few days until homeostasis resets that bit) might be difficult for us to link together. As paranoia inducing as that may sound ("What random thoughts for the past few days caused my week of depression"), I'd encourage us not to read
too much into it.
Some people may be pre-disposed to flip flop up and down, such as in the case of bi-polar where there is thought to be a large genetic component (although stress certainly magnifies the risk of developing bipolar).
I'll throw this in here
"Meta-analyses examining the efficacy of CBT for bipolar disorder revealed small to medium overall effect sizes of CBT at post-treatment, with effects typically diminishing slightly at follow-up. These findings emerged from examinations of both manic and depressive symptoms associated with bipolar disorder (e.g.,
Gregory, 2010a,
2010b). There is little evidence that CBT as a stand-alone treatment (rather than as an adjunct to pharmacotherapy) is effective for the treatment of bipolar disorder.
In addition to examining CBT for attenuating symptoms of bipolar disorder, some meta-analyses focused on the efficacy of CBT for preventing relapse in bipolar patients. One study (
Beynon et al., 2008) examined the efficacy of CBT for preventing relapse and found it to be somewhat effective when comparing CBT vs. treatment as usual.
Overall, CBT for bipolar disorder was an effective method of preventing or delaying relapses (e.g.,
Lam, Burbeck, Wright, & Pilling, 2009;
Cakir & Ozerdem, 2010). Furthermore, the efficacy of CBT at preventing relapse did not seem to be influenced by the number of previous manic or depressive episodes."
So even in the case of strong genetic/biological causality, CBT can still have some uses. Pharmacotherapy for bipolar is still very important to quell aberrant neural activity (that may almost be seizure-like)
but its interesting to note that when many people take i.e. Depakote, they don't actually feel different or notice anything subjectively, even if their manic episodes are significantly reduced. So there are cases where people don't subjectively feel a drug working, but they objectively improve.
