Catastrophizing is a form of thinking that can cause you to focus on the worst possible outcome. It’s something almost everyone experiences now and then, especially during stressful times. But, when catastrophic thinking takes over, you can find yourself feeling anxious, distressed, and losing sight of reality in a situation.

In and of itself, catastrophizing isn’t a medical condition. It’s a symptom that can affect people with anxiety, depression, other mental health issues, and even physical health conditions. Catastrophic thinking can exacerbate other symptoms and make you feel worse.

In this article, learn about the symptoms and types of catastrophizing, how to stop catastrophic thinking, and interventions that can help you regain control of your thoughts.

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What is catastrophizing?

Catastrophizing is when you think about the worst possible outcome of a situation. It’s a type of thinking that makes it difficult for you to look at events and situations realistically. If you’re catastrophizing, you might feel stuck, like the worst-case scenario is the only way things can turn out. But in most situations, there are many ways a situation can work out. In addition to the worst-case scenario, there are also realistic and best-case ones. But, catastrophizing has a way of giving us tunnel vision, making it tough to consider other information or possibilities.

Catastrophizing is one of several cognitive distortions or unhelpful thought patterns. Negative thoughts occur quickly and can be powerful in biasing our perspective and distorting reality. With catastrophizing, our focus narrows to the worst thing that could happen, creates strong emotions like anxiety, worry, or fear. Strong emotions can intensify our connection to those unhelpful thoughts, even if they aren’t rooted in reality.

Catastrophizing is also future-focused. For example, if you have a final exam coming up but you’re struggling to grasp the material even though you’re preparing, you might start to have thoughts like, “What if I fail the exam? And what if I can’t graduate? What if I can’t get a job?” You’ll notice a lot of “what ifs” because the thing you’re often worried about hasn’t happened yet. It’s your brain’s way of trying to consider how things could turn out but only doing so through a negative, worst-case filter.

This type of thinking differs from rumination, which is another way of thinking. Rumination involves being caught in a spiral of negative thoughts that are often based on past or present events and situations.

If you’re ruminating, your thoughts can feel negative and repetitive. For example, you might think back to a conversation you had with your loved ones and think to yourself, “Why did I say that? I can’t believe I made that comment. I must have sounded so rude.” With rumination, you might feel stuck on a specific problem, and you may notice that your negative thoughts are about the past, present, or future.

What are the symptoms of catastrophizing?

Worst-case scenario thinking can occur out of the blue or in anticipation of a coming event or situation. Anyone can have catastrophic thoughts, including children and adolescents. And they can happen fast. It may feel difficult to identify, slow, or stop these thoughts before it’s too late. Knowing the signs can help you reflect on your thinking patterns.

Here are some of the signs and symptoms of catastrophizing:

Preoccupation with the worst possible outcomes of a situation
Difficulty considering additional scenarios
Trouble examining the facts of a situation
Planning or behaving as if the worst is already happening
Overthinking
Racing thoughts
Feeling anxious or fearful
Distress
Helplessness
Negative self-talk

If you have symptoms of catastrophic thinking, talking to a healthcare professional can help you identify these types of thoughts and other cognitive distortions you experience and teach you skills to combat them.

Examples of catastrophic thinking

Let’s say you have an important presentation coming up at work. You’ve been working on it for some time, and you want to do well. At the same time, you feel anxious about it because it feels like there’s a lot at stake. The more you think about it, the more nervous you start to feel. You find yourself having thoughts like, “What if I don’t do a good job and the team reads me as incompetent?” It’s a valid question and a reflection of you wanting to be seen as an authority on your work.

Having 1 or 2 thoughts that you consider negative outcomes isn’t necessarily catastrophizing. Catastrophic thinking is persistent and often worsens the fear or anxiety you feel about a situation. In this case, that might look like, “What if I don’t perform well? If I don’t get this right, my boss won’t trust me. They’ll find a way to fire me because I can’t handle responsibility, and I won’t be able to take care of myself or my loved ones. I’ll be a complete failure.”

With catastrophic thinking, you can get stuck in seeing those negative thoughts as a predictor of the future. The reality is that you’ve been preparing, and your boss likely trusted you to make this presentation because you have some strengths in that area. Catastrophic thinking keeps you from being able to see realistic scenarios like your getting through the presentation and answering your audience’s questions. It can also keep you from seeing the potential best-case scenarios, like your team being so impressed that it leads to you getting to do more of the work you want or even a promotion.

What are the types of catastrophizing?

Anxiety disorders, like generalized anxiety disorder (GAD), are most commonly associated with catastrophic thinking. But, it can occur in people with other conditions, including:

Depression
Obsessive-compulsive disorder (OCD)
Attention-deficit/hyperactivity disorder (ADHD)
Post-traumatic stress disorder (PTSD)
Chronic pain

These conditions can be a risk factor that increases the chance you might develop catastrophic thinking. And, depending on the condition you live with, catastrophizing can look different.

Anxiety catastrophizing

People with anxiety disorders may worry excessively about the future. They often overestimate the likelihood of negative outcomes and underestimate their ability to cope. This can lead to a persistent state of worry where they catastrophize events or situations that can feel threatening or dangerous.

Catastrophizing caused by phobias

A phobia is a type of anxiety disorder that causes an irrational fear of an object or situation. Phobias can cause intense and paralyzing fear. Fear of flying is a common phobia where you may avoid flying altogether due to negative thoughts about a plane crashing.

OCD catastrophizing

Intrusive or unwanted thoughts, called obsessions, are one of the core features of OCD. These thoughts create significant distress. To cope with them, people with OCD engage in compulsions or ritualistic behaviors. Someone with OCD may worry about negative outcomes that can occur if they don’t perform the compulsion. For example, if you have contamination OCD, you may fear contracting a disease by being in an environment where you feel you could be exposed to germs.

Pain catastrophizing

Pain, especially when it’s chronic, can be mentally and physically debilitating. People with conditions that cause chronic pain, fibromyalgia, endometriosis, arthritis, and more, may catastrophize by telling themselves that their symptoms will never get better. It can look like, “I’ll never be able to manage this. No treatment will help, and I’ll never feel better.”

What causes people to catastrophize?

Ultimately, catastrophic thinking is rooted in fear.

Fear isn’t always a negative thing. In fact, fear can help us recognize danger and respond to our environment. To do so effectively, your brain needs to be able to assess the likelihood that a threat will actually come true so it can mobilize you or help you return to a state of balance. When we constantly assess negative outcomes, it feeds feelings of fear.

Other factors that can cause someone to catastrophize include:

Low self-esteem
Fear of failure
Perfectionism
Rumination
Unrealistic expectations
Adverse childhood experiences (ACEs)
Trauma

It can feel impossible to break the cycle of catastrophic thinking, but there are effective interventions.

Ways to stop catastrophic thinking

It can be challenging to prevent catastrophizing, but there are behavioral and cognitive strategies you can incorporate into your everyday life to defeat cognitive distortions, learn cognitive restructuring techniques, and reduce catastrophizing.

Identify your thoughts

It’s hard to combat catastrophic thoughts if you can’t recognize when you’re overwhelmed by them. Identifying them can help. One way to do this is by thinking about a situation from the past that made you anxious. Write down some of the thoughts you remember surfacing. Then, reflect on them and see if you can identify any patterns. If the worst that could happen is a common theme, you may be catastrophizing.

Practice mindfulness

Mindfulness is the practice of becoming aware of your thoughts and emotions without judgment. By observing your thoughts in the moment without reacting to them, you can develop more realistic and positive thought patterns, protecting yourself from catastrophizing thoughts and negative thinking.

Challenge your thoughts

When you notice you’re catastrophizing, try challenging the thought with evidence. Ask yourself, “What’s the worst thing that could happen, and how likely is it?” Then, try to think of evidence that supports or contradicts the thought. Ask yourself, “What evidence do I have that this will come true? What evidence do I have that it might not?”

Reframe negative thoughts

Reframe your negative thoughts into more positive or realistic ones. For example, if you’re catastrophizing about a work project, reframe the thought as, “I’ve faced similar challenges before, and I can handle this one too.” This is an essential coping mechanism called cognitive restructuring.

Get social support

Talking to a trusted friend or family member can help you get perspective on your thoughts and emotions. Sometimes, sharing your worries with someone else can help you feel less alone and more empowered to tackle them. This is a great tool to stop catastrophizing.

Engage in relaxation techniques

Engaging in relaxation techniques, such as deep breathing or progressive muscle relaxation, can help you reduce your stress levels and gain more control over your thoughts and emotions, making it easier for you to deal with catastrophizing. (Find 11 ideas to calm anxiety, including instructions for deep breathing.)

Practice Self-Care

Taking care of your physical and mental health can help you build resilience and cope with stressors that lead to catastrophizing. This includes getting enough sleep, eating nutritious meals, moving your body regularly, and doing activities you enjoy.

Seek professional help for anxiety or another cause of your catastrophizing

If catastrophizing persists over time and you feel like it negatively impacts your day-to-day life, you should speak with a healthcare provider. A qualified professional can help you better understand your catastrophic thinking and determine whether a mental health condition is responsible for your catastrophic thinking. If it is, anxiety therapy or mental health therapy in general, can help you learn coping skills, reframe your thought patterns, and identify triggers.

Coping and reducing catastrophic thinking is a process that takes time and practice. Be patient with yourself. Celebrate small victories along the way. If you’re struggling with catastrophic thoughts, know that there are interventions, like psychotherapy or psychiatry, that can help you reach your goals.

Professional treatment for catastrophic thinking

When catastrophic thinking is persistent, it can lead to avoidance or exacerbate pain or mental health symptoms. If catastrophic thinking is causing you distress and impacting your ability to function at home, work, school, or in your relationships, consider talking to a qualified professional who can evaluate your symptoms and work with you to develop a treatment plan.

Treatment options for catastrophizing typically involve a combination of therapies, including:

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) is a type of therapy that focuses on changing negative thought patterns and behaviors. In CBT, you learn to identify and challenge their catastrophic thoughts, replacing them with more realistic ones. CBT also helps you develop problem-solving skills.

Acceptance and commitment therapy (ACT)

Acceptance and commitment therapy (ACT) helps you develop psychological flexibility by learning to accept your thoughts and emotions without judgment. ACT can help you develop more effective coping strategies for managing your catastrophic thoughts.

Mindfulness-based cognitive therapy (MBCT)

Mindfulness-based cognitive therapy (MBCT) is a type of therapy that combines mindfulness meditation with cognitive-behavioral techniques. MBCT can help you become more aware of your thoughts and emotions, reduce stress, and develop balanced thought patterns.

Psychodynamic therapy

Psychodynamic therapy is a type of therapy that focuses on exploring unconscious patterns of thought and behavior. In psychodynamic therapy, you can gain insight into the root causes of your catastrophic thoughts and develop more effective coping strategies.

Group Therapy

Group therapy can provide a supportive environment for sharing your experiences and learning from others struggling with similar challenges. Group therapy can also let you practice new coping strategies in a safe and supportive setting.

Medication

In some cases, medication, like anxiety medication, may be prescribed to help manage symptoms of catastrophizing, especially if they’re a symptom of or contribute to anxiety or depression. Antidepressants, like Prozac or Lexapro, or anti-anxiety medications like beta blockers are commonly used to treat the symptoms of anxiety, depression, and other mental health conditions that can contribute to a tendency to catastrophize.

Treatment will depend on the severity of your symptoms and your needs. If you’re struggling with catastrophic thoughts or other mental health concerns, seeking help from a qualified professional is the best way to get an assessment of your symptoms and personalized treatment recommendations.

Put an end to catastrophizing quickly and affordably!

Get the tools you need to challenge catastrophic thinking now. Talk to a qualified mental health professional in as little as 24 hours about your anxious thoughts and techniques you can use to start feeling better.* Find a provider on Klarity Health today!

FAQS about catastrophizing and catastrophic thinking

What is catastrophizing a symptom of?: It’s not uncommon for people with different types of anxiety or other conditions like depression, OCD, or PTSD to experience catastrophic thinking. And when catastrophic thinking becomes persistent or causes distress, it can affect your mental health and lead to or exacerbate a mental health condition.
Is catastrophizing a symptom of ADHD?: People with ADHD struggle with inattention, hyperactivity, impulsivity, or a combination of features. Though not a core symptom of ADHD, people with the condition can experience anxiety. Anxiety or feelings of worry can lead to irrational thought patterns, like catastrophizing. Some individuals with ADHD struggle with problem-solving and regulating emotions, which can make catastrophizing worse.
Is catastrophizing a form of OCD?: Catastrophizing involves focusing on the worst-case scenario and imagining negative outcomes. It’s not a form of OCD, nor is it a core feature of the condition. But, it is a symptom that many people with OCD experience. People with OCD have intrusive and unwanted thoughts or obsessions. As a result, they engage in ritualistic behaviors or compulsions to alleviate feelings of anxiety or distress. In some cases, anxiety and distress can lead to catastrophic thinking.

Sources: Canadian Urological Association Journal, “It’s all in your head”: Managing catastrophizing before it becomes a catastrophe, Cox, A.R., Oct 2021, https://pmc.ncbi.nlm.nih.gov/articles/PMC8525530/

Dialogues in clinical neuroscience, Cognitive behavioral therapy of obsessive-compulsive disorder, Foa, E.B., Jun 2010, https://pmc.ncbi.nlm.nih.gov/articles/PMC3181959/

Europe’s journal of psychology, Cognitive Distortions, Humor and Styles, and Depression, Rnic, K., et al., Aug 2016, https://pmc.ncbi.nlm.nih.gov/articles/PMC4991044/

Frontiers in psychiatry, Potential Role of Pain Catastrophic Thinking in Comorbidity Patients of Depression and Chronic Pain, Chen, Y., et al., Jul 2022, https://pmc.ncbi.nlm.nih.gov/articles/PMC9309267/

Frontiers In, Understanding Pain Catastrophizing: Putting Pieces Together, Laura Petrini and Lars Arendt-Nielsen, https://pubmed.ncbi.nlm.nih.gov/33391121

StatPearls, Cognitive Behavior Therapy, Chand, S.P., et al., May 2023, https://www.ncbi.nlm.nih.gov/books/NBK470241/

StatPearls, Specific Phobia, Samra, C.K., et al., Aug 2024, https://www.ncbi.nlm.nih.gov/books/NBK499923/

The British Journal of Clinical Psychology, Understanding the experience of rumination and worry: A descriptive qualitative survey study, Joubert, A.E., Apr 2022, https://pmc.ncbi.nlm.nih.gov/articles/PMC9790473/
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If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.