Catastrophizing

Learn about the concept of catastrophizing, the underlying causes, signs, and symptoms of catastrophic thinking and various techniques one can use to identify and manage catastrophizing.

What is Catastrophizing

Catastrophizing is a thought process known as cognitive distortion, which refers to irrational thoughts involving worst-case scenario thinking during which individuals fixate on the worse possible outcomes.

Over-exaggeration of situations can result in individuals believing that the worst will happen to them in any circumstance.

While thinking through the consequences of a life event or decision is expected, if individuals constantly think of the worst possible outcome that is improbable, they are catastrophizing.

For instance, individuals can constantly worry about a job interview, success, or health. Recurrent negative thoughts can lead to a panic attack or other reactions to anxiety and stress.

While catastrophizing thinking is not an official diagnosis of a mental health condition, it can harm an individual’s well-being. When individuals feel like total failures, they will likely experience low self-esteem.

Catastrophic thinking is a risk factor for several common conditions, including depression, anxiety, sleep disturbances, and post-traumatic stress disorder.

Origin of the Term Catastrophizing

The founder of rational emotive behavior therapy coined the word catastrophize; psychologist Albert Ellis described catastrophizing as an “irrationally negative forecast of future events.”

Why Do People Catastrophize?

Although the exact causes of catastrophizing are unknown, it could be due to various reasons. In some individuals, it is a coping mechanism learned from other people in a person’s life. In contrast, in others, it results from their life experiences, traumatic events or alterations in brain chemistry.

Medically reviewed studies show that individuals who experience chronic pain and catastrophize have higher activity in parts of the brain associated with pain and changes in pituitary responses and the hypothalamus.

Imbalances in the behavioral inhibition and approach systems that regulate anxiety and impulses can also lead to catastrophic thinking. Fatigued individuals with anxiety or depression are more likely to catastrophize as they might ruminate on negative emotions.

Signs of Catastrophizing

In most cases, catastrophizing is a sign or symptom of underlying mental health conditions such as depression, social anxiety disorders, panic disorder, agoraphobia, and generalized anxiety disorders.

Although the thinking can vary among individuals, some common signs of catastrophizing include racing thoughts, pessimism, anger, fear, overthinking choices, situations and events, and negative self-talk.

Conditions Associated with Catastrophizing

Catastrophic thinking can lead to feelings of hopelessness that can contribute to various associated conditions, including chronic pain, depressive disorders, anxiety disorders, and fatigue.  

Catastrophizing and Chronic Pain

Pain catastrophizing occurs when an individual is worried and is obsessed over the pain they experience and cannot let go of the thought of pain. Therefore, catastrophizing commonly occurs in individuals experiencing chronic pain.

Chronic pain patients are constantly feeling pain and discomfort. The fear of the pain leads to certain behaviors, like discouraging physical activity, that can worsen the symptoms.

Studies in patients with chronic pain, rheumatic diseases and depression showed that patients who catastrophize experience greater pain severity and increased feelings of hopelessness, distress and depression.  

Catastrophizing does not mean that the pain is not real, but rather, individuals feel helpless about finding relief for the pain, are fixated on the pain and believe that the pain will only worsen.  

Therefore, catastrophic thinking can predict pain intensity and psychological distress, as measured by the catastrophizing pain scale.  

Depression and Anxiety Disorders

Catastrophizing is a predictor of depressive and anxious symptoms in individuals. It is linked to depression and other anxiety disorders, including generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.

Catastrophizing schemas are linked to psychological distress, and ruminating over negative thoughts, emotions, and symptoms is inherent in diagnosing generalized anxiety disorders.

Individuals can also begin catastrophizing bodily sensations accompanying high anxiety; for instance, if their heart pounds in response to stress and nervousness, this can lead to a spiral of negative thinking, and they might believe they will have a heart attack.

Fatigue

Studies show that there is a link between catastrophizing and fatigue. Catastrophizing is a predictor of how individuals feel, and it can make fatigue worse.

Catastrophic Thinking in Teens and Children

Catatrosphizing learned at an early negative can have negative implications for young people and adults. Research suggests that catastrophizing increases sleep disturbances in teens and children.

Sleep-related catastrophizing is common among children, with one in four kids reporting sleep-related catastrophizing.

The symptoms of anxiety and depression can explain the relationship between kids’ catastrophic thinking and sleep issues. However, a significant association between depression and catastrophizing has been found in teens.

Studies in adolescents with high anxiety showed a significant association between stress and catastrophizing; the impact of daily hassles on anxiety is exacerbated by catastrophizing.

Experiencing daily hassles predicted levels of anxiety and stress in teens and adolescents.

When adolescents catastrophize, everyday stressors increase anxiety and stress levels, worsening the effects. However, further research must examine and establish the link between depression, anxiety and catastrophizing in teens and children.

Recent literature suggests that catastrophizing enhances anxiety and depressive symptoms in adolescents, teens and children.

Management of Catastrophizing

While it might feel overwhelming for individuals to stop catastrophizing, addressing catastrophizing requires individuals to learn how to manage anxiety and stress.

Building tolerance and understanding toward stress and anxiety is a way to stop catastrophizing.

Therapy can help stop the cycle of negative thinking that leads to catastrophizing. Some therapies include cognitive behavioral therapy, mindfulness, and in some cases, medication.

Mindfulness and Relaxation Techniques

Mindfulness can also help individuals limit catastrophizing. Mindfulness allows individuals to reflect on their emotions, thoughts, and feelings and focus the mind on the present moment. Several ways to grapple with anxiety and practice mindfulness include meditation, journaling, yoga, prayer, and positive self-talk.

Other relaxation techniques include getting exercise, proper nutrition, enough sleep, spending time outside or engaging in hobbies that individuals enjoy. Maintaining relationships, finding a community, and positive outlets can help individuals manage stress and anxiety and stop catastrophizing.

Therapy

Catastrophizing is often associated with mental illnesses; talk or cognitive behavioral therapy (CBT) is effective. Studies demonstrate that CBT can better manage pain catastrophizing in fibromyalgia patients.

CBT includes cognitive restructuring and reframing as it addresses the root cause of catastrophizing, including the thought and behavioral patterns.

To overcome catastrophizing, therapists might help individuals recognize repetitive, catastrophic thoughts and try replacing catastrophic thoughts with positive and realistic ones. 

Other ways to avoid catastrophizing include finding communities, maintaining relationships, practicing mindfulness, finding positive outlets, and keeping the body healthy. Anti-catastrophizing practices include maintaining a thought log, inventory and consulting evidence.

Individuals can also use mindfulness-based cognitive therapy (MBCT) that can help them identify and control irrational negative thoughts.

Medication

There is no specific medication to prevent catastrophizing. However, If catastrophizing is linked to an underlying condition like depression, doctors may prescribe antidepressants, including benzodiazepines, beta-blockers, and selective serotonin reuptake inhibitors (SSRIs).

Conclusion

Catastrophizing occurs when individuals think of a situation as being worse than reality. While it is a familiar feeling in many children and adults, catastrophic thoughts that interfere with everyday life can worsen an individual’s physical and mental health outcomes, as catastrophizing is linked to several mental health conditions and can deteriorate an individual’s quality of life.

Individuals can try to stop thinking about the worst by focusing on the present and trying therapy, mindfulness, relaxation techniques or medication to relieve their stress and anxiety.

If catastrophizing is connected to an underlying mental health condition, mental health professionals and therapists can provide individuals with coping skills to reduce catastrophizing.

References

Catastrophizing and Decatastrophizing: A Comprehensive Guide

Catastrophizing: The Worst Thing Ever

Understanding Catastrophizing and How to Stop It

What is catastrophizing? 6 ways to stop catastrophic thinking

https://psychcentral.com/lib/what-is-catastrophizing

DISCLAIMER

The contents of this article are provided for informational purposes only and are not intended to substitute for professional medical advice, diagnosis, or treatment. It is always recommended to consult with a qualified healthcare provider before making any health-related changes or if you have any questions or concerns about your health. Anahana is not liable for any errors, omissions, or consequences that may occur from using the information provided.