Catastrophizing is a way of thinking called a 'cognitive distortion.' A person who catastrophizes usually sees an unfavorable outcome to an event and then decides that if this outcome does happen, the results will be a disaster.
Here are some examples of catastrophizing:
- "If I fail this test, I will never pass school, and I will be a total failure in life."
- "If I don't recover quickly from this procedure, I will never get better, and I will be disabled my entire life."
- "If my partner leaves me, I will never find anyone else, and I will never be happy again."
Doctors also call catastrophizing "magnifying," because a person makes a situation seem much worse, dire, or severe than it is.
Catastrophizing can lead to depression in some individuals. Fortunately, there are several methods to address the condition and avoid catastrophizing.
While there are several potential causes and contributors to catastrophizing, most fall into one of three categories. These are:
Ambiguity or being vague can open a person up to catastrophic thinking.
An example would be getting a text message from a friend or partner that reads, "We need to talk."
This vague message could be something positive or negative, but a person cannot know which of these it is with just the information they have. So they may start to imagine the very worst news.
Relationships and situations that a person holds in high value can result in a tendency to catastrophize. When something is particularly significant to a person, the concept of loss or difficulty can be harder to deal with.
An example would be applying for a job that a person wants. They may start to imagine the great disappointment, anxiety, and depression they will experience if they do not get the job before the organization has even made any decisions.
Fear, especially irrational fear, plays a big part in catastrophizing. If a person is scared of going to the doctor, they could start to think about all the bad things a doctor could tell them, even if they are just going for a check-up.
A person may also experience catastrophizing related to a medical condition or past event in their life.
Anxiety is closely related to catastrophizing. Anxiety is a condition where a person experiences heightened fear and preoccupation with a circumstance. Examples could be worrying about a big test coming up or being fearful of walking alone at night.
Difference between catastrophizing and anxiety
The primary difference between anxiety and catastrophizing is that anxiety can play a useful role in a person's life. For example, anxiety can be a positive emotion because it can help a person to be protective of themselves. However, catastrophizing does not usually have any benefits.
Having these catastrophic thoughts can fill a person's mind with unnecessary emotions that take time and thought away from the reality of a situation. While both anxiety and catastrophizing can be harmful, anxiety can be beneficial in some circumstances.
Link to depression
Depression, or prolonged feelings of helplessness and sadness, is also connected to catastrophizing. When a person experiences prolonged feelings of hopelessness, they may tend to catastrophize and imagine the worst will happen.
In addition to mental health conditions, such as anxiety and depression, some people may catastrophize over feelings of pain. "Pain catastrophizing" is when a person obsesses and worries about pain, feels helpless when they experience pain, and is unable to put worries or thoughts of pain aside.
According to an article in the journal Expert Review of Neurotherapeutics, catastrophizing about pain is associated with increases in narcotic usage, post-surgical pain ratings, or depression after surgery. While no person looks forward to a post-surgical or post-injury pain, an irrational fear or approach can make a recovery especially difficult.
Most people experience fear and worry at some time.
However, if a person constantly fears the worst or hears from their friends and family that they are thinking in this way, they may need to address their catastrophic thinking.
If a person has an underlying medical condition, such as depression, a doctor may prescribe antidepressant medications to help.
Examples of these include:
- Selective serotonin reuptake inhibitors (SSRI's): Examples include fluoxetine (Prozac) and paroxetine (Paxil). These medicines increase the amount of the neurotransmitter serotonin in the brain. They are often the first-line treatment for people with depression but may also be prescribed for a variety of anxiety disorders.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): Examples of these include duloxetine (Cymbalta) and venlafaxine (Effexor). These medications increase the amount of serotonin as well as norepinephrine in the brain.
- Tricyclic antidepressants (TCA's): These drugs include amitriptyline and nortriptyline (Pamelor). Doctors do not prescribe TCA's very often today because of their undesirable side effects.
- Atypical antidepressants: These medications do not fit into a particular category regarding how they work. Examples include bupropion (Wellbutrin, Aplenzin) and trazodone.
Sometimes, a doctor may initially prescribe one type of medication that may not be effective in reducing both depression and catastrophizing. In this case, the doctor may prescribe another medication.
Mental health experts often use techniques known as cognitive-behavioral therapy (CBT) to help a person address their catastrophic thinking.
These techniques require the person to be aware that they are experiencing catastrophic thinking, to recognize their actions, and to try to stop and correct their irrational thinking.
Six tips to accomplish this include remembering and making use of the following techniques. These can help to manage the condition:
- Acknowledging that unpleasant things happen: Life is full of challenges as well as good and bad days. Just because one day is bad does not mean all days will be bad.
- Recognizing when thoughts are irrational: Catastrophizing often follows a distinct pattern. A person will start with a thought, such as "I am hurting today." They will then expand on the thought with worry and anxiety, such as, "The pain is only going to get worse," or "This hurting means I'll never get better." When a person learns to recognize these thoughts, they are better equipped to handle them.
- Saying "stop!": To cease the repetitive, catastrophic thoughts, a person may have to say out loud or in their head "stop!" or "no more!" These words can keep the stream of thoughts from continuing and help a person change the course of their thinking.
- Thinking about another outcome: Instead of thinking about a negative outcome, consider a positive one or even a less-negative option.
- Offering positive affirmations: When it comes to catastrophic thinking, a person has to believe in themselves and that they can overcome their tendency to fear the worst. They may wish to repeat a positive affirmation to themselves on a daily basis.
- Practicing excellent self-care: Catastrophic thoughts are more likely to take over when a person is tired and stressed. Getting enough rest and engaging in stress-relieving techniques, such as exercise, meditation, and journaling, can all help a person feel better.
An article in the journal Expert Reviews in Neurotherapeutics defines catastrophizing as "an irrationally negative forecast of future events."
If a person finds themselves continually catastrophizing events in their life and at-home techniques do not help, they should seek help from a mental health expert.
Multiple ways exist to help a person overcome this way of thinking and live a life with less fear and anxiety.