Catastrophizing is a type of cognitive distortion characterized by one forecasting a negative event or assuming the worst possible outcome of a situation. To some extent, we all experience catastrophizing, especially during times of peak stress. However, when the severity or frequency of this mindset becomes extreme, it might be a manifestation of a more serious mental health condition.
What Is Catastrophizing?
Although catastrophizing is often related to future-worries, it can also consist of reflecting on the past in a way that generates feelings of regret, shame, and fear. Catastrophizing makes it difficult to stay present, because of this constant worry. There is generally limited evidence to support a person’s assumptions when catastrophizing, and this makes it easy for thoughts to spiral and become overwhelming.
Catastrophizing can be broken down into three components–magnification, rumination, and helplessness.1 These terms refer to one overemphasizing the importance of an event (real or imagined), thinking about it obsessively, and consequently feeling helpless or out of control.
Common signs of catastrophic thinking include:
- Racing thoughts
- Excessive overthinking
- Mentally reviewing a scenario repeatedly
- Ignoring positive aspects of a situation
- Making assumptions about the future
- Negative self-talk that contributes to feeling incapable
Some examples of catastrophizing include:
- The student:After not doing so well on a math test, a junior in high school becomes extremely upset. She thinks, “If I don’t get an A in math this year, my GPA will go down. If my GPA isn’t perfect, I won’t get into a good enough college. If I don’t go to an Ivy League school, then I won’t have any career prospects and I’ll never be happy.”
- The plane passenger: A passenger on a plane feels a minor turbulence. They immediately think, “That turbulence was just the first of many…this plane probably can’t handle it. I know we are going to crash and I’m going to die.”
- The romantic: A young man goes on a date. When he gets home, he starts thinking about how it went. He finds himself questioning everything he said and thinks, “She definitely thought I was a loser. Everyone I date thinks I’m the worst. I know I’ll never find a wife…I’m going to be sad and alone forever.”
What Causes Catastrophizing?
There are many factors and stressors that can contribute to catastrophic thinking. To some extent, catastrophizing may be an individual’s coping skill to protect them from disappointment.1 It’s often a learned behavior or an extreme version of the common trope, “hope for the best, but expect the worst.” As previously mentioned, catastrophizing may occur more frequently during times of peak stress related to family, friends, or work. It may also stem from concerns about illness, conflict, life transitions, or grief. When catastrophizing is more chronic or severe, it can indicate that an individual may be struggling with deeper mental health issues.
Catastrophizing may be caused by…
Anxiety
Individuals who suffer from anxiety disorders, such as generalized anxiety disorder, pain disorder, and specific phobias, often struggle with catastrophizing. For instance, a recent study of 2,802 participants found that catastrophic thinking was a predictor of anxiety disorders.2
Depression
Individuals struggling with depression also have a tendency to catastrophize. A study conducted in young children found that catastrophizing was related to depressive symptoms.3 For older participants, findings suggest that the connection between catastrophizing and depression was mediated by anxiety (potentially connected to the underlying component of worrying).3
Individuals with depression may struggle with catastrophizing related to beliefs about the cause of a negative event, the consequences of a negative event, or negative evaluations of self.3 These types of assumptions can contribute to feelings of hopelessness.
Fatigue
Catastrophizing has also been linked to fatigue. Furthermore, research suggests that catastrophizing can result in increased fatigue in individuals with chronic illness. For example, an individual might fixate on their fatigue, ultimately magnifying it and making it more difficult to handle.4
Chronic Pain
Chronic illness and mental health are closely related, and the connection between chronic pain and catastrophizing has been studied extensively. “Pain catastrophizing” consists of an individual ruminating on and overestimating the threat of pain, leaving them feeling helpless.5 However, studies show that the connection between chronic pain and catastrophizing depends on the type of pain syndrome.6 Regardless, across the board, catastrophizing can possibly be tied to pain intensity, severity, and distress.5
Obsessive Compulsive Disorder
Catastrophizing is common in individuals who suffer from OCD. Obsessions are often related to worry about what has gone wrong or what may go wrong in the future–a person’s compulsions aim at neutralizing these worries. Rumination is also a connecting factor, as it is a primary symptom for individuals struggling with OCD and is a cornerstone of catastrophic thinking.
Insomnia
Insomnia and catastrophizing have also been linked, as individuals who struggle with insomnia tend to catastrophize more, thus increasing their anxiety.7 This is a vicious cycle, because catastrophizing the effects of losing sleep ultimately further affects one’s sleep in negative ways.8
Post-Traumatic Stress Disorder
Catastrophizing has been labeled as a “cognitive precursor” to the development of PTSD Symptoms. Additionally, PTSD “symptom catastrophizing” was a predictor of symptom severity.9
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Treatments for Catastrophizing
There are no treatments aimed at targeting catastrophizing itself, but rather the disorders or conditions associated with it. Combating catastrophic thinking is not about being naively positive. While distressing and unfortunate things happen to everyone, addressing negative thoughts includes learning how to assess the true risk of a situation in order to cease obsession about what has gone or could go wrong. Once one recognizes their tendency to catastrophize, there are a number of ways to address it. However, if catastrophizing becomes chronic and severe, seeking professional help might be necessary.
Therapy
Individuals struggling with catastrophizing should consider therapy, especially if they are suffering from anxiety, depression, or other mental health conditions. Finding the right therapist is key to successful treatment. It’s important to feel there is a good match between patient and therapist, as well as a baseline level of comfort and understanding. In the first few sessions, clients can expect to complete an intake assessment. This means answering questions about their health history, symptoms, and why they are seeking treatment.
Often, the first step in addressing catastrophizing is building awareness that this type of distorted thinking is occurring. A variety of therapeutic approaches can be helpful in terms of treating conditions associated with catastrophizing and targeting cognitive distortions including catastrophizing.
Therapy for addressing catastrophic thinking may include:
- Cognitive behavioral therapy (CBT): CBT is perhaps the most popular treatment for targeting catastrophic thinking, as it provides individuals the tools to identify and challenge their distortions. By doing so, individuals can begin to shift the thoughts and feelings that are untrue and unhelpful in their lives.10
- Dialectical behavioral therapy (DBT): DBT involves skills training that targets mindfulness, interpersonal effectiveness, and emotional regulation.11 Learning these skills can help with catastrophizing, as they are focused on helping individuals remain in the “here and now” as opposed to allowing emotional distress to cloud judgements about reality.
- Mindfulness-based stress reduction (MBSR): MBSR is a treatment that teaches individuals mindfulness, meditation, and yoga in order to help them learn to respond to life’s challenges thoughtfully and effectively. MBSR emphasizes the importance of shifting perspective in order to manage emotional responses.
- Acceptance and commitment therapy (ACT) – ACT combines mindfulness techniques and behavioral therapy to help individuals find meaning, despite the inevitable challenges of life. ACT can be helpful in combating catastrophizing as it encourages individuals to accept that worry and fear are normal human emotions, while not allowing them to take control.
- Exposure response prevention therapy (ERP): ERP therapy encourages individuals to build tolerance to distressing thoughts and emotions. Through exposure to their idea of a “catastrophe,” clients learn that they can tolerate difficult experiences.
- Psychodynamic therapy – Psychodynamic therapy is focused on helping clients build insight as they explore their unconscious. In having a space to explore their defenses, wishes, and childhood experiences, individuals can get to know themselves better. This can be helpful for individuals who catastrophize, as it allows them to understand the roots of their distorted thinking patterns.
Medications
Medications may also be used to treat underlying disorders that cause catastrophizing, such as Benzodiazepines*, SSRIs**, and SNRIs**. These are often used to target symptoms of anxiety and depression. That being said, there is no medication that specifically treats catastrophizing.
*This medication has black box warnings, the most serious kind of warnings from the FDA for abuse or misuse, risk of physical dependence and risk of serious side effects, including death, when combined with an opioid.
**These medication have a black box warning, the most serious kind of warning from the FDA for a risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting any of these medications.
7 Tips for How to Stop Catastrophic Thinking
In addition to therapeutic or psychiatric treatment, there are several healthy coping mechanisms you can practice at home if you find yourself struggling with catastrophizing. Coping skills don’t always work right away and can take practice over time. Trying a variety of coping skills can be helpful in figuring out what is most helpful.
Below are seven tips for combating catastrophic thinking:
- Meditation: Meditation has been shown to be an effective tool to manage anxiety. Having a meditation practice can help individuals work on staying in the present moment in order to reduce worry about the past and future. There are several different ways to start meditating, including using meditation apps or listening to meditation podcasts.
- Mindfulness: Like meditation, mindfulness is aimed at helping individuals remain in the “here and now.” This may include breathing exercises, mindful walks, and even mindful eating. By engaging in these everyday activities with intention, individuals can stop catastrophic thinking before it begins or interrupt it once it starts.
- Yoga: Yoga is a mental and physical mindfulness practice that can be particularly helpful for reducing symptoms of anxiety. Through grounding and uniting the body and mind, individuals can calm their nervous systems and become increasingly aware of anxious thoughts. As anxiety decreases, catastrophizing likely will as well.
- Physical movement: There are several mental health benefits of exercise including decreasing anxiety and depression symptoms and managing stress. It can be helpful to find a type of exercise that is enjoyable, and set small goals in order to build a sustainable habit. Consistent physical movement can also help decrease an individual’s tendency to catastrophize.
- Thought reframing: Thought reframing, a technique emphasized in CBT, can also be used outside of the therapy office. Thought reframing refers to viewing a potentially difficult or challenging situation in a more neutral or positive way. This can include examining evidence and reality checking thoughts to evaluate if catastrophizing is occurring.
- Journaling: Journaling is a fantastic coping skill for those dealing with catastrophizing. By writing out thoughts and feelings, individuals can begin to release stress and worry. Additionally, seeing catastrophic thoughts on paper can help someone realize the irrational nature of their worries.
- Reaching out for support: Reaching out for support can also be helpful when someone finds themselves spiraling into catastrophic thinking. Discussing catastrophic thoughts with someone else can provide perspective about the reality of the situation.
Final Thoughts
If you or a loved one is struggling with persistent catastrophizing that is affecting quality of life, therapy can help! Therapists are trained to watch out for cognitive distortions and can often provide guidance about how to reframe negative thoughts. Finding a therapist from an online directory is a good first step towards healing.
Catastrophizing Infographics
