The Impact Realistic Pessimism May Have On Mental Health

Medically reviewed by April Justice, LICSW
Updated March 26, 2024by BetterHelp Editorial Team

“Realistic pessimism” refers to the idea that a negative outlook is a more accurate way of viewing life than a positive outlook. The question is, are such negative-leaning mindsets actually more aligned with reality than a tendency to look on the positive side? How do each of these viewpoints affect a person’s mental well-being, and which one may produce the best health outcomes? Ahead, we’ll explore the differences between these mindsets, share their potential impacts on overall mental health, and offer resources for adopting a more balanced perspective.

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The difference between optimists, pessimists, and realists

To begin the process of exploring different mindsets and their potential effects, It might help to take a look at the American Psychological Association’s definitions of optimists, pessimists, and realists:

  • Optimists are “people who anticipate positive outcomes, whether serendipitously or through perseverance and effort, and are confident of attaining desired goals.”
  • Pessimists are “people who expect bad things to happen to them and others or are otherwise doubtful or hesitant about positive outcomes.” 
  • Realists are people who engage in “thinking that is based or focused on the objective qualities and requirements that pertain in different situations.” This type of thinking “permits adjustments of thought and behavior to the demands of a situation” and “depends on the ability to interpret external situations in a fairly consistent, accurate manner.” 

A pessimistic realist is someone who believes that their pessimism is the most accurate way of viewing the world, and an optimistic realist is someone who believes the same about their optimism. In actuality, however, a purer form of realism without either slant is generally considered to be the most accurate and the most potentially healthy.

While a pessimist generally views a metaphorical glass as half empty and an optimist sees the same glass as half full, the realist might simply see a method of quenching their thirst.

That said, it may be impossible to view the world in a totally objective manner all the time. Even the most practiced realist may sometimes skew more towards overly positive or negative thoughts about the future. If you think of yourself as a realistic pessimist—someone who does their best to assess the world at face value but tends to assume adverse outcomes are more likely than good outcomes—you may want to learn more about the impact that both pessimistic-leaning views and more realistic-leaning views can have on your overall well-being. 

Potential health impacts of pessimism or pessimistic realism

A glass-half-empty mentality may seem harmless and potentially even beneficial. You can’t have your hopes crushed if you never got your hopes up in the first place, right? But the truth is, a pessimistic outlook seems to be associated with more negative health impacts than positive ones. The following are examples of potential effects of this type of attitude:

  • Increased difficulty processing tragedy, trauma, and other adverse life events (which goes against the conventional wisdom that expecting the worst will help you cope in the face of disappointment)
  • Decreased emotional resilience in general
  • Poorer recovery prognoses for many medical conditions, such as cardiovascular events
  • Increased likelihood of developing or relapsing into episodes of some mental health disorders such as depression, anxiety, post-traumatic stress disorder (PTSD), and bipolar disorder
  • A weakened immune system
  • A shortened lifespan and heightened risk of mortality from a range of health conditions
Getty/Sarah Waiswa

Potential health impacts of realism

Optimists tend to overestimate the likelihood of things working out in their favor, and pessimists tend to overestimate the likelihood of an unfavorable event occurring. While optimism may be healthier than pessimism, neither mentality may be as beneficial as realism. Research indicates it’s actually having expectations that don’t match up with reality—in either direction—that can reduce overall well-being. 

Psychologists have theorized that for optimists, the disappointment associated with not experiencing the expected positive outcome may outweigh the positive impacts of anticipation prior to the outcome. For pessimists, the exact opposite may be true: the apprehension associated with dreading a negative outcome might negate the benefits of relief when the negative outcome is avoided. Realists, on the other hand, are able to avoid both of these thought traps. 

Realism is also associated with a healthier attitude towards risk than either optimism or pessimism. Optimists may disregard conventional safety measures and behave in a riskier manner because they believe that while bad things may happen to other people, it is doubtful that bad things will happen to them. Pessimists may be so unwilling to take risks out of fear of disappointment or failure that they may seal themselves off from potential sources of joy and fulfillment, such as making new friends, initiating a romantic relationship, trying out a hobby, etc. In contrast to both optimists and pessimists, realists may be more likely to take measured risks, weighing the pros and cons of their actions in an objective manner.

Realism may have potential positive implications for physical health as well. To illustrate this, consider the hypothetical scenario of being diagnosed with a serious disease from an optimistic, pessimistic, and realistic lens:

  • If an optimist is told they have cancer and have a 40% chance of survival, they may automatically assume that they will be in the 40%. They may not follow all of their doctor’s recommendations because they believe in their own luck and the power of positive thinking to carry them through.
  • If a pessimist is told they are in the same situation, they may automatically assume they are in the 60% of patients who will die from the disease. They might also disregard their doctor’s instructions for their care—not because they don’t think they need medical intervention, but because they believe nothing will help them and that they are doomed, regardless.
  • If a realist is told they have a 40% chance of surviving, they are the most likely to approach their health situation in a relatively logical, measured way. Even realizing that the odds are against them, they might choose to focus on what they can control and follow all of their doctor’s recommendations to maximize the possibility that they will end up being counted with the 40% of patients who survive. 

It’s also worth noting that realists may find more social success than pessimists or optimists, too. Their greater sense of understanding of the world around them may allow them to develop stronger connections and more meaningful relationships with other people. Social connectedness can be a significant predictor of both mental and physical health, so realism may provide additional benefits in this area of a person’s life as well. 

Ways to help refine your outlook on life

If you’re interested in developing a more balanced worldview, there are a few courses of action you might consider. First, practicing mindfulness techniques could help you learn to be more accepting and less judgmental of situations as they are, potentially promoting a greater sense of realism. Next, engaging in cognitive behavioral therapy (CBT) strategies may help you learn to recognize and challenge your thoughts, potentially shifting your perspective over time. 

While some CBT practices can be started on one’s own, working with a licensed professional therapist is usually recommended for maximum effectiveness. The process of shifting one’s perspective can be challenging without help, particularly since a person’s worldview may be shaped by elements of their personality as well as years of ‘practice.’ By leveraging professional cognitive behavioral therapy strategies, a therapist can help you examine and begin to change entrenched thought patterns that might not be serving you.

You may be skeptical about how therapy can impact your outlook, especially if you are inclined toward pessimism. In this instance, online therapy may be more appealing to you than traditional in-person therapy. With this format, you can attend therapy sessions from the comfort of your own home, which may help you to trust your therapist and open up more in order to reap the potential benefits. 

Looking to shift unhelpful thought patterns?

Recent scientific research indicates that online therapy may be as effective as in-person therapy in many cases. One 2021 study, for example, suggests that online cognitive behavioral therapy may be a viable alternative to traditional in-person CBT. If you are hoping to move away from excessive pessimism or optimism and towards realism, online therapy could be a beneficial resource for you. 


While excessive pessimism can sometimes seem like a more accurate worldview, it can actually make you prone to certain biases that could lead to negative health outcomes—and the same may apply to excessive optimism. Therapy can be a helpful way to reorient your thought patterns toward realism while also preserving a sense of hope.
Understand how different outlooks can shape life
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