How Does Catastrophizing Affect Your Mental Health?

Medically reviewed by Corey Pitts, MA, LCMHC, LCAS, CCS
Updated April 23, 2024by BetterHelp Editorial Team
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Can’t stop thinking about the worst-case scenario?

Does this thought process sound familiar to you?

"I can’t wake up late tomorrow. If I wake up late tomorrow, then I won’t start my work on time, so I will finish too late, and I will lose my job, then I will have no money, and I will lose my house, and, and, and…”

If you’ve ever gone down that rabbit hole, then you might be practicing catastrophizing, a cognitive distortion that may not be a useful mindset, even if your intentions are to motivate yourself.

Let’s dig a little bit deeper into what catastrophizing is, how picturing the worst case scenario can be harmful, and how methods like therapy can help in addressing catastrophizing thoughts.

What is catastrophizing?

If you’re preparing for a big event or a nerve-wracking social situation, these are just a few thoughts that may cross your mind:

  • “What if I don’t get there in time?
  • “What if I forget my cue?”
  • “What if they don’t like me?”

When you’re feeling worried or anxious, it can be tempting to slip into “what-if” thinking. These hypothetical or irrational thoughts are some of the hallmark signs of catastrophizing: the tendency to exaggerate or hyperfocus on the worst possible outcome. 

Many of us will experience these “what-if” thought patterns on occasion – but when catastrophic thinking becomes routine, it can increase levels of anxiety, lead to unhealthy behaviors, and negatively impact a person’s life and mental health. Catastrophizing can worsen existing depressive and anxious symptoms and influence mental health outcomes, particularly in those with high anxiety or other mental health conditions. 

If you’re concerned about catastrophic thinking and want to learn more about the science of these thought patterns, read on. We’ll consider common causes of catastrophic thinking, its effect on mental health, and six ways to prevent catastrophizing and adopt a healthier, more balanced mindset. 

What does it mean to catastrophize?

If you’re catastrophizing, it usually means you’re focusing on the worst possible outcome that can happen in a given situation. But beyond this basic definition, what does it really mean to catastrophize, and how do these thoughts take hold in the brain? 

Catastrophic thinking is a form of cognitive distortion, sometimes called a cognitive error. These are essentially thinking “mistakes” that occur when your emotional experience becomes disconnected from reality. When people experience catastrophic thinking, their minds inaccurately “magnify” a problem or negative thoughts and blow them out of proportion.

While some amount of cognitive distortion is normal for most people, more serious problems may develop when you become stuck in the pattern of catastrophic thinking. This may be especially common among those with anxiety disorders or other mental illnesses. Too much catastrophic thinking may lead to anxiety and other mental health problems.

Depending on your life experiences, you may resonate with some of these examples of catastrophic thinking: 

  • “I’m really sick, but if I don’t make it to class tomorrow, I’ll fail the entire course.”
  • “If I don’t do this job perfectly, I’ll be fired.”
  • “If I go to the party in this outfit, no one will talk to me.”

Catastrophizing can take various other forms, such as “pain catastrophizing,” the practice of magnifying a painful experience and its perceived significance. This can be especially problematic for chronic pain patients, such as fibromyalgia patients and those with rheumatic diseases. Exaggerating pain intensity and the threat that a painful experience poses can lead to greater pain interference (the level that pain interferes with day-to-day life), and may even worsen other mental health conditions, such as depressive disorders. Though chronic pain is undoubtedly difficult to manage, catastrophic thinking about that chronic pain can make the situation worse.

Across all of these examples, notice that the worst-case scenario is always perceived as the most likely outcome – even at the expense of a person’s mental health and overall well-being.

What causes catastrophic thinking?

When we engage in catastrophic thinking, we tend to worry about the worst possible outcome of a given situation or action, even if these outcomes are unreasonable or irrational. 

Most of us will experience these thoughts at various points in our lives: perhaps after a string of unfortunate events, or in anticipation of a stressful meeting, presentation, or another milestone. Negative thought patterns are a part of being human – and when we recognize them, we can develop coping strategies to combat them. 

However, if you find yourself constantly dwelling on the worst-case scenario, it may be a sign of a mental health concern. While the exact cause of catastrophic thinking depends on the person, these thoughts may stem from a place of anxiety, depression, obsessive-compulsive disorder, or another diagnosable mental health condition. Brain chemistry may also play a role. 

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How does catastrophic thinking affect mental health?

When we allow catastrophic thoughts to fester, they can negatively impact our mental health in several ways. 

1. Catastrophizing increases the risk of anxiety disorders

Research indicates that people who consistently engage in catastrophic thinking are more likely to have anxiety disorders. One 2014 study found that catastrophic thinking was a predictor of anxiety among high-anxiety adolescents. 

Similarly, more recent research from 2020 found that catastrophizing can be a warning sign of posttraumatic stress disorder (PTSD), a type of anxiety disorder, and also influence the severity of PTSD symptoms.

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

2. Catastrophizing can worsen existing mental health conditions

Beyond anxiety disorders, catastrophizing can increase the likelihood or severity of other mental illnesses. A 2012 study, for example, found that catastrophizing increases feelings of hopelessness among children, which can heighten the risk of depression. 

Some research also associates catastrophic thinking with attention-deficit/hyperactivity disorder (ADHD): a condition that may also lead to rumination, feelings of self-blame, and other challenges with emotional control.

3. Catastrophic thoughts can impact your physical health

Some research suggests that catastrophizing can even affect resilience to pain, which can amplify chronic pain and other feelings of physical distress. By increasing feelings of rumination and helplessness, catastrophizing can lead to greater distress in people with endometriosis, fibromyalgia, and other chronic physical conditions, based on a 2018 medically reviewed study.

When it comes to understanding pain catastrophizing, it’s important to remember that catastrophic thoughts can make it difficult to manage our emotions in response to stressful or unpredictable situations. They may be a symptom of an existing mental health condition, or eventually contribute to a new diagnosis. 

How to stop catastrophizing: Six therapist-approved tips

If catastrophizing is a symptom of another mental health condition, like generalized anxiety disorder or depression, it’s important to consult your doctor for a proper diagnosis and official medical advice. From there, you can create a plan to combat your catastrophic thoughts, as well as other symptoms that may amplify them.

In your daily life, here are eight tips to reverse catastrophic thinking, based on insights from mental health professionals.

1. Recognize and restructure the thoughts

If you’re struggling with catastrophic thinking, the first step is simply recognizing the thoughts exist.

Say you send a text to your romantic partner, and one hour later, they haven’t replied. You think to yourself: “They’re going to break up with me.”

In most cases, this isn’t a rational thought: more likely, your partner is simply busy with another obligation. In this moment, take a moment to notice and reflect on the thought, and ask yourself: is this rational? 

By accepting the thought as irrational or unhealthy, you can restructure it into a more reasonable thought. Cognitive restructuring is a component of cognitive behavioral therapy (CBT), and it challenges you to carefully examine your thinking in response to upsetting situations. 

While a therapist can guide you through the steps, the American Psychological Association (APA) outlines the five main steps for curious thinkers to try at home. 

2. Write the thoughts down

To recognize the irrational, it often helps to write down your catastrophic thoughts. Seeing them in written form can help you accept the irrationality of your thought process, and potentially replace them with more realistic, balanced, and compassionate beliefs. 

3. Consider other outcomes

Sure, there’s the worst-case scenario, but most situations present a variety of other possible outcomes. Take a moment to consider those alternative possibilities: the best-case scenario, as well as more neutral options. 

It may also help to write these down and challenge yourself to pick the most likely outcome from the list you’ve created.

4. Repeat calming mantras

As a coping mechanism for any challenging situation, therapists often recommend having a list of mantras on hand to help you calm down and maintain a sense of emotional stability. Mantras should be easy to remember and leave you feeling calm and safe when you feel like you might begin catastrophizing. Some possible mantras include:

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Can’t stop thinking about the worst-case scenario?
  • “Right now, I choose calm and peace.”
  • “Soon, these feelings will pass.”
  • “I am safe and loved.”

These are just a handful of possibilities! Find a mantra that feels natural for you, and don’t hesitate to modify them as your needs and goals change.

5. Stick to a self-care routine

Whether you’re working through catastrophic thoughts or another mental health challenge, consistent self-care is often the foundation of good mental health. Self-care doesn’t need to be fancy: just making sure that you’re getting enough sleep, adequate nutrition, and exercise can yield noticeable benefits.

Some people incorporate other activities into their self-care routines, choosing to practice mindfulness meditation or yoga, which specifically focus on the connection between their thoughts, actions, and bodies. 

6. Seek professional mental health support

You can try out any of these strategies on your own, but some people appreciate the extra support and expertise of a licensed therapist. 

While you may be more familiar with in-person therapy, a growing number of people use online therapy to meet their mental health needs. Using a digital platform like BetterHelp, you can match with a licensed therapist within 48 hours and begin scheduling sessions at a time and place that works best for you. Many BetterHelp therapists are skilled in using cognitive behavioral therapy (CBT) to help clients overcome negative thought patterns. Cognitive behavioral therapy can help you address negative thinking patterns and learn healthier ways to approach stressors. The trained mental health professionals will also work with your busy schedule to ensure your mental health needs are met.

Research suggests that online talk therapy can be as effective as in-person therapy, and often more reachable. One 2011 study found that internet-based cognitive behavioral therapy (iCBT) significantly reduced catastrophic thoughts and improved the quality of life in people with chronic pain conditions. More recent research affirms the value of iCBT, which can effectively treat anxiety, depression, postpartum depression, and other conditions that may increase the risk of catastrophic thinking.


Whether you tend to overthink social situations or experience chronic pain catastrophizing, you’re not alone in your thoughts. While our brains are incredible and accomplish many amazing things, they can also lead us astray. 

Fortunately, there are several ways to combat negative thoughts and approach stressful situations with a more balanced, realistic mindset. If you’re unsure where to start, an online therapist can offer the tools and compassion you need to begin the journey.

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