Mental Health Understanding Catastrophizing and How to Stop It A focus on negative thoughts and disastrous thinking By Michelle Pugle Michelle Pugle Facebook LinkedIn Twitter Michelle Pugle is an expert health writer with nearly a decade of experience contributing accurate and accessible health information to authority publications. Learn about our editorial process Updated on March 25, 2023 Medically reviewed by Michael MacIntyre, MD Medically reviewed by Michael MacIntyre, MD LinkedIn Michael MacIntyre, MD, is a board-certified general and forensic psychiatrist. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Definition How to Stop Causes Frequently Asked Questions Catastrophizing is when someone assumes the worst-case scenario or thinks things are much worse than they actually are. Also called catastrophic thinking, it is a form of distorted thinking or cognitive distortion. Both children and adults can experience catastrophic thinking. Certain techniques can help shift this way of thinking and prevent spiraling into negativity. What Is Catastrophic Thinking? Catastrophizing is when your mind twists information into an imagined scenario of everything that can go wrong. It is a type of cognitive distortion. Some examples of catastrophic thinking include: If I don't pass the test, I'll fail the class, I'll never get into college, and I'll never have a career.If my work isn't flawless, I'll never get a promotion, and then I'll be a failure at my job.If I don't make a good impression, everyone will laugh at me and I'll be a social outcast. Catastrophizing can be overwhelming, and it can be difficult for a person to realize they’re doing it unless they’re made aware of the problem. In children, catastrophic thinking can manifest into feeling convinced that certain bad things are true. For example: No one likes me.I will never be cool enough.Everyone is talking about me.I'll never be able to do it. This line of thinking spirals quickly. Thoughts not just possible, but certain. For children and adults alike, catastrophizing comes down to blowing things out of proportion. It creates barriers to facing challenges because problems seem much larger and harder to handle. You may delay or avoid driving, for example, due to fears about getting severely injured or disfigured in accidents or damaging your car beyond your financial ability to repair it. Pain Catastrophizing Pain catastrophizing doesn’t mean someone’s pain isn’t real. It means they’re fixated on the pain, may feel helpless about finding relief, and may feel it’s only destined to get worse. This kind of thinking can play a role in how someone experiences pain, as measured by the pain catastrophizing scale. This scale is considered one of the most important tools for examining the relationship between psychology and chronic pain and disability. The questionnaire asks to what degree the person experiences certain negative or irrational thoughts while in pain. Examples include: I feel I can’t stand it anymore.I anxiously want the pain to go away.I keep thinking about how badly I want the pain to stop.I feel I can’t go on.I wonder whether something serious may happen. Primary and Secondary Chronic Pain Classifications How to Stop Catastrophizing You have the power to change your way of thinking by working on cognitive reframing (looking at your thoughts in a different way). The following steps may help ease your catastrophic thinking: Verywell / Danie Drankwalter Self-Guided Exercises Breathing exercises: Try taking a few deep breaths to calm yourself before addressing your negative thoughts. You can use a breathing exercise app or online video, or simply focus on taking in deep breaths for several moments.Meditation apps: Meditation apps exist for children and adults to help teach ways of practicing mindfulness. These apps typically have options geared toward specific meditation goals like reducing worry or persistent negative thinking.Mindfulness exercises: Mindfulness exercises are based on bringing you back to the moment so you can put some space between what’s happening now and the things you’re assuming will happen. Psychotherapy Cognitive behavioral therapy (CBT) is a form of psychotherapy, or talk therapy, that includes cognitive reframing or cognitive restructuring. CBT can be used to: Recognize when you're catastrophizingDetermine the accuracy of your thoughtsProvide ways of coping with and challenging negative thoughtsShare techniques for shifting thought patterns in the future to create lasting changes A small 2017 study found that CBT was effective at addressing catastrophizing in fibromyalgia patients, allowing them to better manage their pain. Medications While there’s no medication prescribed specifically to help stop catastrophic thinking, you and your doctor can discuss treating underlying conditions that may be contributing to or causing your negative thinking behaviors. For example, anxiety disorders can be treated with a variety of medications, including benzodiazepines and antidepressants. What Causes Catastrophic Thinking? Catastrophic thinking can happen in response to traumatic events in the past that reframed your worldview or led to or reinforced beliefs such as the world is bad, people shouldn’t be trusted, and taking chances leads to getting hurt. It can also be associated with mental health and chronic pain conditions, including the following: Anxiety disorders: A 2015 study found that people who engaged in catastrophic thinking were more likely to have anxiety disorders. Depression: One 2012 study found that catastrophic thinking can lead to feelings of hopelessness, which can contribute to depression. Post-traumatic stress disorder (PTSD): Catastrophic thinking can also be a precursor to PTSD symptoms. Obsessive-compulsive disorder: It is common for people with OCD to fixate on the possibility of major harmful events such as job loss or illness. This can lead to catastrophic thinking. Attention deficit hyperactivity disorder (ADHD): Catastrophic thinking can also be a feature of ADHD. Chronic pain: Catastrophizing about chronic pain and associated symptoms like depression, sleep disturbances, and anxiety have been shown to negatively affect coping outcomes in a wide variety of pain conditions, including fibromyalgia (chronic disorder causing widespread pain and fatigue), endometriosis (tissue lining the uterus forms outside that organ), and Parkinson’s disease (progressive neurological illness affecting movement). If you have signs or symptoms of any of these conditions, mention them to your healthcare provider. Treating them may help catastrophic thinking as well as the other issues they can cause. Summary Catastrophizing is when you think something, someone, or a situation is way worse than what the reality actually is. It's associated with some mental illnesses like anxiety disorders, depression, and post-traumatic stress disorder. You can try to stop catastrophic thinking by bringing yourself to the present and relieving anxiety. If catastrophizing is tied to an underlying mental disorder, it may help for you to work with a mental health professional in getting treatment. A Word From Verywell It’s fair to say we’ve all had times when things seemed much worse than they actually were. This happens and is nothing to worry about. However, if the worst-case scenario has become your default mode when thinking ahead, you may be catastrophizing, which is something you should address. Sometimes meditation and deep breathing exercises can help slow down your thinking and place you back in the moment, away from spiraling negative thoughts. If you’re still catastrophizing after trying self-guided exercises, you may need to reach out for professional help. With consistent effort, you may begin to see more realistic outcomes and stop the cycle of negative thinking. Frequently Asked Questions What are the signs of catastrophizing? Signs of catastrophizing include blowing things out of proportion, thinking the worst will happen, and believing irrational thoughts about yourself, others, and situations that have already happened or have yet to happen. Is catastrophizing a mental health condition? Catastrophic thinking isn't an official diagnosis. Rather, it is a symptom of a number of different conditions, including anxiety, depression, and post-traumatic stress disorder. 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Distinct aspects of pain catastrophizing according to chronic pain syndromes. Clinical & Biomedical Research. 2018;38(1). doi:10.4322/2357-9730.77809 By Michelle Pugle Michelle Pugle, BA, MA, is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. Her work focuses on lifestyle management, chronic illness, and mental health. Michelle is the author of Ana, Mia & Me: A Memoir From an Anorexic Teen Mind. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit