Stress management and relaxation techniques may help break the cycle of catastrophizing. Some ideas to try include:
What Is Catastrophizing?
Catastrophizing is thinking the worst will happen. But self-care, seeking support, and therapy can stop this adverse behavior.
Catastrophizing involves thinking that the worst will happen after actions or events you experience in your life.
Yes, considering the consequences of a decision or life event is a regular part of thinking things through. But, if you find yourself unable to stop thinking about the worst possible outcome, no matter how improbable, you’re catastrophizing.
Catastrophizing is a way of thinking known as a cognitive distortion. It’s not a mental health condition.
But living with a mental health condition may put you at a higher risk of developing this negative way of thinking. You may also have a higher risk for catastrophizing if you’ve experienced traumatic events or seen those around you go through similar thought processes.
But you can take steps to stop catastrophizing. Self-care, talking it out with loved ones, and therapy options can help you challenge the negative thoughts and feelings you experience.
A person catastrophizes when they think the worst possible outcome will occur in a situation or due to a choice they make, according to the American Psychological Association (APA).
If you’re catastrophizing, you may be worried about a disastrous outcome with little reason or facts.
Catastrophizing can lead to stress, anxiety, and depression. Research from 2014 shows that catastrophizing can also worsen the experience of chronic pain.
Catastrophizing can start as a small thought and then rapidly escalate.
For example, you have a disagreement over dinner plans with your significant other. As you think about it, you start to believe that they don’t love you anymore and that they’ll break up with you.
If you continue to follow these thoughts, it may cause you to worry about where you’ll live or other big picture scenarios. Having these thoughts can lead to a panic attack or other reactions to stress and anxiety.
Catastrophic thinking is often a symptom of an underlying mental health condition, such as anxiety or depression.
Though it can be hard to tell when you’re spiraling with your thinking, there are some signs to look for:
- You have general feelings of depression, anxiety, or pessimism.
- You have racing thoughts.
- You feel stuck in your head.
- Anger or fear may start to feel overwhelming.
- You experience negative self-talking.
- You excessively search the internet for solutions to whatever problem you’re experiencing.
- You find yourself overthinking a situation, choice, or event.
When you experience catastrophic thinking, you may not believe you deserve good things, or that good things can happen to you. You may start to look for reasons something won’t work, which can sometimes lead you to create the reality you were fearing.
At some point, nearly everyone experiences some catastrophic thinking. It becomes a problem only when it affects your daily life.
Experts still don’t know the exact cause of catastrophizing. Some possible causes include:
- differences in brain chemistry or changes in processes
- learning it as a coping mechanism from family members or people close to you
- a response to one or more life events or experiences, such as witnessing both parents losing their jobs, divorce, drug addiction, or other traumatizing events
A study published in 2010 looking at catastrophizing due to chronic pain showed that people who experienced it had changes in their pituitary and hypothalamus responses. It also noted that the brain area that registers emotions associated with pain had an increased level of activity.
A 2017 study showed that catastrophic thinking is linked to a deeply held core belief. It is thought to be a mechanism to regulate negative emotional responses. Focusing on negative thoughts puts stress on the body that can manifest in physical symptoms and conditions.
Some suggest that low self-esteem and fear form the root cause of catastrophizing. You may feel like you can’t successfully handle a problem or event.
Other possible causes of catastrophizing include:
Catastrophizing isn’t a mental health condition. But it can be a symptom of a mental health condition.
Conditions that may cause you to experience catastrophizing include:
- major depressive disorder (MDD)
- anxiety disorders
- attention deficit hyperactivity disorder (ADHD)
- obsessive-compulsive disorder (OCD)
- post-traumatic stress disorder (PTSD)
You may not experience catastrophizing if you’re living with one or more of these conditions. But it’s possible these conditions can increase your risk of experiencing this type of negative thinking.
You can take steps to prevent catastrophizing from spiraling out of control. Some of these steps include:
- practice journaling when you are experiencing these thoughts can assist you in recognizing patterns and revisiting these entries at a later time, possibly with someone you trust
- practice mindfulness
- challenge your thoughts and fears
- schedule a worry session to review and think about your fears for a few minutes
- focus on solutions to the problems
- work on accepting uncertainty
- create problem-solving strategies for the what-if scenarios
- talk with a friend or family member
If you have trouble controlling your thoughts on your own, you may consider reaching out for more help. Some therapy options include:
- Cognitive behavioral therapy (CBT).CBT is effective in reducing catastrophizing among people with fibromyalgia, according to research from 2017 . CBT techniques include cognitive restructuring, reducing cognitive distortions, and recognizing how thoughts and behaviors interact.
- Mindfulness-based cognitive therapy (MBCT). According to 2019 research, MBCT may help reduce catastrophizing by helping you control your thoughts and identify irrational and negative thinking.
A therapist and treatment team can help you identify if medication would be helpful and appropriate to reduce your symptoms.
If you have an underlying condition, consider seeking treatment and follow the plan crafted by your therapist or healthcare professional.
You can also take general steps to improve your health. Eating a balanced diet, getting exercise, participating in activities, and other positive steps may help you feel better overall.
You can take steps to manage your negative thoughts and emotions. If you find that catastrophizing is interfering with your life, you can start by:
- journaling and reflecting on your thoughts and feelings
- practicing positive self-talk and mantras to remind yourself that you can handle whatever comes your way
- devising strategies to solve potential issues
Stress management and relaxation techniques may help break the cycle of catastrophizing. Some ideas to try include:
- Identify potential triggers of stress and recognize them. Sometimes just being aware of stressors can help you have a plan for coping.
- Make time for yourself and your needs. Taking a few minutes each day to do something for yourself like taking a walk or reading a book can help you relax.
- Exercise. Moving your body triggers feel-good hormones and decreases stress.
- Spend time outside. Going outside and spending time in a green space can reduce stress.
- Get enough sleep. Not sleeping enough can worsen stress and symptoms of mental health conditions like depression or anxiety.
If these steps don’t work, consider reaching out to others for help. Friends and trusted family members may be a good place to start. You can also ask your doctor or healthcare professional for recommendations on therapists in the area.
If you’re looking for a therapist but unsure where to start, Psych Central’s How to Find Mental Health Support resource can help.
Last medically reviewed on April 22, 2022
10 sources collapsed
- Burns L, et al. (2014). Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: A systematic review.
dovepress.com/pain-catastrophizing-as-a-risk-factor-for-chronic-pain-after-total-kne-peer-reviewed-fulltext-article-JPR - Frostadottir AD, et al. (2019). Effects of mindfulness based cognitive therapy (MBCT) and compassion focused therapy (CFT) on symptom change, mindfulness, self-compassion, and rumination in clients with depression, anxiety, and stress.
frontiersin.org/articles/10.3389/fpsyg.2019.01099/full - Galvez-Sánchez CM, et al. (2018). Cognitive impairments in fibromyalgia syndrome: Associations with positive and negative affect, alexithymia, pain catastrophizing and self-esteem.
frontiersin.org/articles/10.3389/fpsyg.2018.00377/full - Gellatly R, et al. (2016). Catastrophic thinking: A transdiagnostic process across psychiatric disorders. [Abstract].
link.springer.com/article/10.1007/s10608-016-9763-3 - Lazaridou A, et al. (2017). Effects of cognitive-behavioral therapy (CBT) on brain connectivity supporting catastrophizing in fibromyalgia.
ncbi.nlm.nih.gov/pmc/articles/PMC5296218/ - Lazaridou A, et al. (2017). The association between mindfulness, catastrophizing and pain interference among patients with fibromyalgia: The moderating role of mindfulness.
jpain.org/article/S1526-5900(17)30244-4/fulltext#relatedArticles - Petrini L, et al. (2020). Understanding pain catastrophizing: Putting pieces together.
ncbi.nlm.nih.gov/pmc/articles/PMC7772183/ - Quartana PJ, et al. (2010). Pain catastrophizing: A critical review.
ncbi.nlm.nih.gov/pmc/articles/PMC2696024/ - Seto H, et al. (2017). Relationships between catastrophic thought, bodily sensations and physical symptoms.
ncbi.nlm.nih.gov/pmc/articles/PMC5678578/ - Why do we catastrophize? How to end worst-case-scenario thinking. (2021).
straighttalkcounseling.org/post/why-do-we-catastrophize-how-to-end-worst-case-scenario-thinking
How to stop catastrophizing
Catastrophizing means that a person fixates on the worst possible outcome and treats it as likely, even when it is not. Therapy and medications can help people reduce, or stop catastrophizing.
It is a type of cognitive distortion. 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 than it is.
Research suggests that catastrophizing can worsen both physical and mental health outcomes. For example, people with chronic pain who catastrophize may experience more severe pain.
Read more to learn about what catastrophizing is, its causes, management strategies, and more.
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According to a 2020 review article, there is little agreement about what catastrophizing even is, let alone what causes it. There are several potential reasons for catastrophizing:
- Depression: Having depression may cause a person to ruminate on negative emotions, causing them to catastrophize.
- Anxiety: High anxiety may increase a person’s risk of catastrophizing.
- BIS-BAS dysregulation: The behavioral inhibition system (BIS) and behavioral approach system (BAS) are two theoretical systems people use to regulate impulses and anxiety. Differences in these frameworks may help explain why some people catastrophize and some do not.
- Interoceptive sensitivity: This means that a person more readily notices small changes in their body, such as sensations of digestion or changes in heart rate. People with high interoceptive sensitivity may notice these changes and catastrophize them.
Anxiety is closely linked to catastrophizing.
People with anxiety experience heightened fear and preoccupation with danger or threats. For example, they might worry about an upcoming test, going out alone, or social situations.
All people feel nervous sometimes. However, anxiety disorders cause intense anxiety that interferes with daily life.
Anxiety
The primary difference between anxiety and catastrophizing is that sometimes, anxiety can play a useful role in a person’s life. For example, anxiety can help a person protect themselves from dangerous situations. However, catastrophizing usually has no benefits.
Having catastrophic thoughts can fill a person’s mind with unnecessary emotions that take time and thoughts away from reality. While both anxiety and catastrophizing can be harmful, anxiety may be beneficial in some circumstances.
Depression
People with depression may ruminate on negative emotions, causing them to catastrophize. When a person experiences prolonged feelings of hopelessness, they may catastrophize and imagine the worst-case scenario.
Pain catastrophizing
“Pain catastrophizing” is when a person obsesses over and worries about pain, feels helpless when they experience pain, and is unable to put worries or thoughts of pain aside.
A 2019 study published in the journal Pain reports that pain catastrophizing was highest among study participants with generalized pain. This is chronic pain affecting one or more parts of the body.
Additionally, a 2020 Frontiers in Psychology article emphasizes that catastrophizing may increase the intensity of pain and make it more disabling. However, some advocates, especially in the chronic pain community, argue that the term stigmatizes people living with pain and may dismiss their lived experiences.
Most people experience fear and worry at some point. However, if a person constantly fears the worst, 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 antidepressants include:
- Selective serotonin reuptake inhibitors (SSRIs): These increase the amount of the neurotransmitter serotonin in the brain. They are often the first-line treatment for people with depression. However, they may also be prescribed for a variety of anxiety disorders. Examples include fluoxetine (Prozac) and paroxetine (Paxil).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): These medications increase the amount of serotonin as well as norepinephrine in the brain. Examples of these include duloxetine (Cymbalta) and venlafaxine (Effexor).
- Tricyclic antidepressants (TCAs): These drugs include amitriptyline and nortriptyline (Pamelor). Doctors do not prescribe TCAs very often today because of their undesirable side effects.
- Atypical antidepressants: Examples include bupropion (Wellbutrin, Aplenzin) and trazodone.
Sometimes, a doctor will 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.
For people with anxiety, a doctor may prescribe antidepressants or anti-anxiety drugs such as :
- Beta-blockers: These can help ease physical anxiety symptoms such as rapid heart rate and sweating.
- Benzodiazepines: These fast-acting anti-anxiety medications work in about 30 minutes and can help a person feel calm and sleepy. However, they are potentially addictive.
- Buspar: This is a mild anxiolytic, or anxiety-reducing drug, that takes about two weeks to work.
Mental health experts may use cognitive behavioral therapy (CBT) to help a person address their catastrophic thinking. CBT promotes mindfulness of catastrophic thinking, recognizing one’s actions, and managing and correcting 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. Having one bad day does not mean all days will be bad.
- Recognizing irrational thoughts: 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.
- Knowing when to 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 break the stream of thoughts and help a person change the course of their thinking.
- Thinking about another outcome: Instead of thinking about a negative outcome, try to focus on a positive one or even a less-negative option.
- Offering positive affirmations: When it comes to catastrophic thinking, a person has to believe that they can overcome their tendency to fear the worst. They may wish to repeat a positive affirmation 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.
Mindfulness means being present and grounded in the current moment rather than fixating on the past or future.
In some cases, it can help with mental health issues such as depression. For example, mindfulness-based cognitive therapy (MBCT) may help prevent depression relapse.
A 2020 study found that mindfulness reduced anxiety and stress among nurses. Another 2018 study of women with fibromyalgia found that some types of mindfulness could moderate pain sensitivity and catastrophizing.
People can practice mindfulness by using grounding exercises. Try breathing deeply, remaining present in the moment, and noticing small details of one’s surroundings — sights, sounds, smells, and sensations.
Catastrophizing is a common behavior that affects many people during times of stress. It does not necessarily signal a mental health condition. However, if it becomes a chronic habit or interferes with daily life and functioning, it may be a sign of depression or anxiety.
A psychotherapist can help a person manage catastrophizing thoughts, and a doctor can help refer a person to the right treatment professional.
Last medically reviewed on October 20, 2022
- Depression
- Mental Health
- Anxiety / Stress
- Psychology / Psychiatry
How we reviewed this article:
Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Chand, S. P., et al. (2022). Anxiety.
https://www.ncbi.nlm.nih.gov/books/NBK470361/ - Chand, S. P., et al. (2022). Depression.
https://www.ncbi.nlm.nih.gov/books/NBK430847/ - -Dorado, K., et al. (2018). Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia.
https://journals.sagepub.com/doi/full/10.1177/2055102918807406 - France, C. R., et al. (2020). Pain resilience and catastrophizing combine to predict functional restoration program outcomes.
https://painsa.org.za/wp-content/uploads/2020/06/Pain-resilience-and-catastrophising.pdf - Ghawadra, S. F., et al. (2020). The effect of mindfulness-based training on stress, anxiety, depression and job satisfaction among ward nurses: A randomized control trial [Abstract].
https://onlinelibrary.wiley.com/doi/abs/10.1111/jonm.13049 - Petrini, L., et al. (2020). Understanding pain catastrophizing: Putting pieces together.
https://www.frontiersin.org/articles/10.3389/fpsyg.2020.603420/full - Wheeler, C. H. B., et al. (2019). Meta-analysis of the psychometric properties of the Pain Catastrophizing Scale and associations with participant characteristics [Abstract].
http://journals.lww.com/pain/Abstract/2019/09000/Meta_analysis_of_the_psychometric_properties_of.5.aspx
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