Catastrophising – What it is and Treatment Methods

August 12, 2022

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Do you often think that the worst might happen? When organising any event, do you automatically consider the worst possible outcome, no matter how unlikely that outcome might be? Then you could be catastrophising. Catastrophising, in itself, isn’t a mental health condition but it can often be a symptom of or co-present alongside, certain mental health conditions such as anxiety. Here’s everything you need to know about catastrophic thinking and the treatment methods that can help to lessen the impact it will have on your life:

What is Catastrophising?

Catastrophising is a way of thinking that is also referred to as ‘cognitive distortion’. The root verb of the term catastrophising is ‘catastrophe’ and this is relevant because when someone catastrophises a situation, they think that it is going to be a complete disaster and they always consider the most devastating consequences of any situation. These negative outcomes are rarely, if ever, the case, but the individual who catastrophises can’t help but continue to do so. Some medical professionals refer to catastrophising as magnifying, because the patient magnifies the situation in order to make it seem much worse or more severe than it is.

Some common examples of catastrophising include:

Worrying that if you fail to pass a test or exam, you will be forced to leave school and therefore your whole future life will be ruined.
Worrying that every ache and pain could be a serious health condition and that you will be left with a permanent disability or even die.
Having a row with your partner and then worrying that they will leave you as a result, and you will be alone for the rest of your life.

Every person catastrophises from time to time. If you find that you occasionally catastrophise situations, particularly stressful or high-pressure situations, then this is not likely to be something to be concerned about. But the condition can be concerning if an individual catastrophises every experience or situation that they find themselves in. Constant catastrophising can have a serious and negative impact on your life. Not only can it make sufferers more likely to experience depression and anxiety, but a 2014 study found that catastrophising can also worsen the experience of chronic pain.

Catastrophising doesn’t have to be about big events or situations. In fact, it often escalates from very small situations and conversations. If you have an argument with your partner about what to cook for dinner, for example, catastrophising could lead you to start worrying that your partner will leave you as a result of the row: you may even imagine your divorce, or your partner remarrying someone else.

Catastrophising and Mental Illness

Catastrophising is not a mental illness in its own right, but it can be a symptom of mental illness and often presents alongside other symptoms of several common conditions. For this reason, there is a clear link between catastrophising and mental illness. The conditions that may cause you to experience catastrophising are:

Anxiety Disorders
Depression and major depressive disorder (MDD)
Attention deficit hyperactivity disorder (ADHD)
Post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorder (OCD)

Living with any of these mental conditions may make you more susceptible to experiencing catastrophic thinking. You may also have a higher risk for catastrophizing if you’ve experienced traumatic events, which is why individuals who are already suffering from post-traumatic stress disorder are predisposed to struggling with catastrophic thoughts.

Who Usually Catastrophises?

There are several causes that could lead to catastrophic thinking. If you regularly experience one of the following emotions then you are more likely to catastrophise:

Experiencing Fear. Fear is one of the biggest factors that can lead to catastrophic thinking. Irrational fear plays a huge role in catastrophising because if an individual starts to think of all the things that could go wrong in any given situation, this will quickly escalate to catastrophic thoughts. If you have a doctor’s appointment, for example, your fear could lead you to think about all the things that you could be diagnosed with (and all the things that could go wrong) even if there is no logical reason for these thoughts. Catastrophising in this way is particularly common amongst individuals that have long-term medical conditions or who suffer from health anxiety.
Being Subject to Ambiguity. If you are frequently subjected to vague and ambiguous concepts or messaging then this could make you more likely to catastrophise. If a friend tells you they’re having a bad day but doesn’t tell you why, you might wonder if they’ve been diagnosed with cancer. If your partner sends you a text message saying ‘we need to talk’ then you might think they are going to leave you. Often with ambiguous messaging the news is just as likely to be good as it is to be bad, but when you are catastrophising your thoughts will immediately go to the worst-case scenario.
Valuing Relationships. If you have relationships that are very important to you, and you value those people closest to you highly, then you may well be more prone to catastrophising events. The concept of losing someone or something significant can be harder to process, and so you will catastrophise as a way to prepare yourself for what you perceive to be the worst-case scenario. You may begin to grieve the loss of someone you love, even if they are perfectly healthy.

The Effects of Catastrophic Thinking

Catastrophic thinking can have many negative effects on your physical and mental health and wellbeing. Not only can catastrophic thinking increase your likelihood of suffering from conditions such as depression and anxiety, but from a practical point of view, it can also prevent individuals from taking action in certain situations, due to an overwhelming fear of what might happen if they do act. This is because catastrophic thoughts can be paralysing, and lead to both avoidance and isolation.

Whilst the impact of catastrophic thinking on mental health is well documented, catastrophic thinking can also have a significant impact on physical health. Many chronic pain conditions are associated with catastrophic thinking. Catastrophizing about chronic pain and its associated symptoms (by thinking such thoughts as ‘this pain is going to kill me’ or ‘I can’t take this pain anymore’) can actually negatively impact your ability to cope with the pain you are experiencing. This has been demonstrated in a wide variety of pain conditions including, but not limited to, fibromyalgia, endometriosis and Parkinson’s disease. For this reason, if you experience pain-related catastrophic thinking then it is important to get those catastrophic thoughts under control in order to better manage your pain.

Signs and Symptoms of Catastrophising

One of the main signs that you catastrophise is that you overthink situations, stress about the future, and always expect the worst-case scenario. This is a very normal and common thing for everyone to do from time to time, but if you find yourself catastrophising all the time, or it is having a negative impact on your mood or day-to-day activities, then it could indicate that you have a problem.

Understanding the signs and symptoms of catastrophising is the first step to preventing the condition. Like any other mental conditioning, catastrophising can develop quickly, and can soon completely overwhelm you. Catastrophising is a brain phenomenon that involves both memory and imagination, meaning that it can take many forms. The main signs and symptoms of catastrophising that you need to be aware of are:

You are overthinking even the most minor situation, and analysing every possible outcome.
Experiencing high levels of stress as a result of the catastrophic thoughts that you can’t control.
Common symptoms of anxiety include, but are not limited to, feeling restless and irritable, having difficulty concentrating, and sleeping problems.
Struggling with racing thoughts that you don’t feel you can turn off or control.
Experiencing higher than usual levels of fear and anger.
Feeling more prone to depression and depressive symptoms, such as feelings of unhappiness and hopelessness, feeling tired, and losing interest in the activities you would normally enjoy.
Feeling stuck in your own head and unable to escape your thoughts.
Excessive internet searching, trying to validate your catastrophic thoughts and feelings. This is especially relevant if you tend to catastrophise medical situations which are easy to research.
Frequent negative self-talk that you can’t avoid but that makes you feel worse about your negative thoughts.

If you find yourself prone to catastrophising, you will experience either one, some, or even all of the symptoms outlined above. The more of these symptoms you experience, the harder you will find it to break the cycle of catastrophising. The good news is that by reading these signs and symptoms, and recognising which of them you are experiencing, the easier you will find it to seek treatment for your condition.

Getting Help for Catastrophic Symptoms

As mentioned above, awareness that you are catastrophising is the best way to help control your catastrophic symptoms. Awareness is incredibly important because without it, you will be caught up in your thoughts and this will only lead to increased anxiety, confusion, and exhaustion.

There are two different ways in which catastrophising behaviours are treated. If your catastrophising is linked to a mental health condition such as depression or anxiety, then your doctor may recommend medication to help you control your catastrophic thoughts. Examples of the types of medications your doctor may prescribe include:

Selective serotonin reuptake inhibitors (SSRI’s). These are medicines that increase the amount of serotonin in your brain and are typically prescribed to individuals with depression or anxiety disorders. Examples of SSRIs include Prozac and Paxil.
Serotonin and norepinephrine reuptake inhibitors (SNRIs). Like SSRIs, these medications increase the serotonin in your brain. They also increase the norepinephrine in your brain. Examples of SNRIs include Cymbalta and Effexor.
Tricyclic antidepressants (TCAs). These drugs are not as commonly prescribed nowadays due to their side effects, but they include amitriptyline and nortriptyline.

If you don’t have a pre-existing condition, then it is unlikely that you will be prescribed medication to control your catastrophising. Instead, a cognitive behavioural therapy approach is likely to be recommended. Some of the treatment methods that you could try using this approach to help you keep your catastrophising symptoms under control include:

Create a mindfulness journal. You can use this to record your catastrophic thoughts, and what triggers them. After time, this may be helpful in helping you to recognise patterns in your behaviour. Revisiting your journal when you’re in a calmer frame of mind may also give you the clarity to assess your thoughts.
Mindfulness is a great technique for processing catastrophic thoughts. Taking time to breathe deeply, appreciate the sensations of the world around you, and centre yourself can all help to avoid catastrophising.
Schedule regular ‘worry sessions’ where you can review and think about your worst catastrophic thoughts and fears. Try to compartmentalize your thoughts, and don’t let yourself catastrophise situations outside of these worry sessions: gradually reduce the length of time you spend on these ‘worry sessions’ over time.
Focus on finding viable solutions to your problems, rather than on the worst-case scenarios. You could even create problem-solving strategies for what you would do in those worst-case scenarios, to lessen the impact of your catastrophic thoughts.
Talk through your thoughts and feelings with a friend or family member that you can trust.
If you cannot control your thoughts on your own, you could also consider hiring the services of a cognitive behavioural therapist, who will be able to work with you to process your catastrophic thoughts and offer more intensive techniques to help you to control them in a healthy way.