Anxiety
20 min read
Written by Dr. Geralyn Dexter
Published: Nov 7, 2024
Medically Reviewed by Shanna Todd, LMFT
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.
Talk to a licensed, board-certified professional in 24 hours or less.* Find a provider on Klarity Health today!
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.
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:
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.
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.
Anxiety disorders, like generalized anxiety disorder (GAD), are most commonly associated with catastrophic thinking. But, it can occur in people with other conditions, including:
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.
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.
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.
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, 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.”
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:
It can feel impossible to break the cycle of catastrophic thinking, but there are effective interventions.
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.
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.
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.
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 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.
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.
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.)
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.
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.
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) 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) 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) 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 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 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.
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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.
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!
*Appointments are generally available within 24 hours. Free initial consultations are available only with select providers. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.
The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage. Not all providers on Klarity Health prescribe all medications, particularly medications that are controlled substances.
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.
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