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Anxiety and Exaggerations: Get Relief From Amplifying Possibilities into Catastrophes

Worry, anxiety, stress and panic reflect emotional expressions of catastrophic thinking. Technically, catastrophizing is an exaggerating, irrational, style of dwelling on real or imagined disasters. This is popularly known as painfully blowing things out of proportion. Fortunately, catastrophic thinking is correctable. I’ll emphasize how to do this.

What are the signs of catastrophizing? You unintentionally make a bad situation worse, or create a crisis out of little to nothing. You may chain together worsening possibilities as you sink into a descending cycle of despair. When catastrophic thinking fuses with raw-nerve tension, you’ll have trouble concentrating. You’ll have trouble figuring out what to do. When ongoing, catastrophizing can be a prelude to depression. Combating this thinking helps prevent anxiety-linked depressions.

What does catastrophic thinking feel like? You receive a registered letter from the legal offices of Wiggins and Trust. Before you open it, you assume you are going to be the subject of a ruinous lawsuit and then you dwell on the horrors of the suit. You feel helpless, vulnerable, and overwhelmed. Feeling too tense to open and read the letter, you put it aside. After days of gut-wrenching dread, you can’t take the strain any longer. You open the envelope. You discover that a great aunt willed you her painting of the Grand Canyon.

Are you willing to make necessary changes to combat and neutralize catastrophizing in order to gain the advantage of greater command over yourself and over the controllable events that take place around you? If so, here are sample cognitive, emotive, and behavioral remedies.

First Things First

Let’s get rid of needless blame first. Let’s suppose you blame yourself or others for your emotional turmoil. Paradoxically, by accepting your catastrophizing as an automatic and unpleasant thinking habit, you can quickly shed blame about this whole sorry process. Compared to the blame alternative, tolerance for tension can feel comparatively good.

It’s not your fault that you catastrophize. Like everyone else, you’re wired to catastrophize; otherwise, you wouldn’t be able to learn to do this and then to involuntarily tyrannize yourself in this way. Nevertheless, if you want relief from this form of manufactured misery, it is your responsibility to change course.

Don’t Trip on the Molehills

When apprehension escalates to anxiety, go back to what you were telling yourself when you first started to catastrophize. Map the pattern. You may find a molehill that you made into a mountain. If so, use a flip technique where you turn panicked thinking into an active concern about doing and getting better. Here are four steps in this process:

1. As best you can, suspend judgment about both yourself and the real or presumed catastrophic event.

2. Accept that you, others, and the world are as they are, and no amount of complaining will change that. Nevertheless, you owe it to yourself to change your catastrophizing pattern.

3. Guide yourself, or seek expert help, about how to contain catastrophizing and advance your enlightened interests.

4. Engage in productive activities that can null your failure expectations.

Actively follow these four steps, and you are likely to experience the sort of resilience that springs from your concern to do better. Because you’ll have clearer options, you are less likely to view yourself as vulnerable and helpless. You’ll make better decisions.

Combat Catastrophizing

We mostly think of catastrophizing as magnifying and dwelling on present problems and anticipating future disasters. However, you can anchor this thinking to a past, present, and future timeline.

1. You anguish over mistakes you made as if these selective recollections stamp the word failure on your forehead. As you extend this dread, you may panic over the possibility of others discovering, criticizing, and condemning you for past faults. However, you are mainly your own worst pain in the rump on this one. You’re better off focusing your attention on what you can do than what you may have done.

2. You look down and see that you are wearing different colored socks. You think that others think that you belong to the poor taste club. You make this event into the worst thing that can happen to you. You think that this error will haunt you forever. You feel mortified, fearful, and vulnerable. (Intentionally wearing off-color socks can help desensitize you to this type error.)

3. You anguish over the possibility of suffering from brain cancer. You feel fatigued. You think this is proof you have cancer. You get up fast from your chair and feel dizzy. You think this is proof you have cancer. You break into tears at the thought that because of this illness you’ll no longer be around to celebrate holidays and special occasions with your family and friends.

Let’s grant that you have made mistakes in the past, that the mismatched socks are a present-moment mistake, and that you have a tendency to jump to conclusions about future possibilities. So what!

The so what intervention helps put catastrophizing into a different perspective. However, you still haven’t put the catastrophizing issue to rest. There is more work to do, including expanding on your so what acceptance thinking. (Instead of exaggerating, you expand you coping capabilities.)

Expand your coping capabilities with a stop and reflect difference technique. For example, distinguish between concerns, calamities, and catastrophizing. Your house catches fire. That’s a calamity. When your reaction is one of concern, you care about what happened—perhaps deeply so. You accept—not like—the situation as it is. On the other hand, catastrophize and you figuratively throw gasoline on the flames. Extinguish these fires by imagining yourself infusing your actions with reasoned choices that propel productive purposes. Take the actions that you imagined.

Here are four examples of actions of acceptance to help you break a catastrophic thinking habit:

1. Acknowledge your tendency to create catastrophic fictions, and refuse to blame yourself for that.

2. Listen to your narrative. What is the story that you are telling yourself that feels so catastrophic? What are the facts and fictions in the story? Are you making a magical and illogical leap from what is possible to what is probable? For example, if you believe that you have an undiagnosed cancer, is this a fiction or a fact? How do you know?

3. Because you believe something catastrophic can happen, doesn’t mean that it will happen. The Mayan Calendar has the world ending on December 21, 2012. Many panic over this possibility. Were the ancient Mayans infallible prophets?

4. The catastrophizing reward system is where you experience a subliminal relief from distress that reinforces the stress that it relieves. When an expected catastrophic event doesn’t happen, or is not as bad as you thought, the relief you feel can reward your negative premonitions, making them more likely to come back. (A reward, such as relief or money, is a reinforcer only if it increases the frequency of the actions that it follows.) Make sure you reinforce your productive and not your dysfunctional reactions. Your awareness of rewards for worry or catastrophizing, can help snuff out these specious rewards.

By Dr Bill Knauss, author of The Cognitive Behavioral Workbook for Anxiety

 

The Tunnel of Depression

Depression makes a person’s world very small and narrow.  During a depressive episode, he enters a long tunnel of despair; a dark passageway encasing him in its concrete walls.  If he can see an exit, it is in the far distance, a sliver signifying a long and arduous journey ahead.

The tunnel constricts his vitality, his link to the world which isn’t all doom and gloom; where miracles and beauty and goodness are happen, But he cannot see it, cannot perceive the actuality of such events.  His reactions to these events is often sadness; a despair borne of his inability to feel the happiness of such things.  There is also a sense of hopelessness because the failure to enjoy such things isn’t just temporary.  He feels it’s permanent.  He will never feel the joy of a great vacation, a heart-felt complement or the glow of a child’s sweet face.

As he travels the tunnel, it can close in on him.  He can feel suffocated; that he will die of asphyxiation before he blows out the other side of the tunnel.  His breath feels like it is being sucked out of his lungs.  He just doesn’t have the stamina to continue.  But continue he must, if only on bloodied knees.

As long as you’re on your knees, it might help to pray.  Abraham Lincoln, who suffered from depression his entire life, once wrote:

“I have been driven many times to my knees by the overwhelming conviction that I had nowhere to go.  My own wisdom, and that of all about me, seemed insufficient for the day.”

Lincoln knew all too well the tunnels of depression.  But he kept going, kept persevering.  And you will too.

Flashlights can help us in the tunnel as can wise guides or trusted friends; flashlights of skills about how to deal with depression before we go into the tunnel.  One of the most important skills is the hard-won knowledge that there is a beginning, a middle and end to our depression — even if we don’t feel this is so at the time. A wise guide can be a therapist who can tell us what to expect and not to listen to the howling winds of depression that blow through the tunnel, to ignore the bats of doubt that live in the recesses of the walls.  A trusted friend, can be someone who experiences depression him or herself, but is well enough at the time to walk through the tunnel with you, step by step.

While flashlights don’t light up the whole tunnel, don’t make the depression magically go away, they do provide a beam of concentrated light that burns through that darkness and provides a path, a walkway to an opening that is the end of the experience of a depressive episode.

Often, folks with depression can see the entrance to the tunnel and are heart-struck with a sense of real dread.  Having experienced depression before, they know just how bad the journey will be once they’re through the portal.  But they are pulled, as if from a rope emanating from the dark reaches of the tunnel, into depression.  Attempts to turn around work sometimes.

Sometimes we are strong enough.  Sometimes, we have the strength to override the gravitational pull of the tunnel.

But sometimes we don’t.  And in this sense, it’s confounding.  Because if we can do it sometimes, why can’t we do it all the time?  Maybe that’s part of the mystery of depression.  Because sometimes, even when armed with the best of skills, we still must enter the tunnel of depression.

But we must always remember the bright light that awaits us on the other side.

 

 

Is Minor Depression Minor?

Someone is dogged by a bad mood that they just can’t shake for a month or two.

Is it a big deal?

Isn’t some suffering expected in this universe? If someone is distressed and impaired by low grade depressive symptoms, how seriously should we take their complaints? Scholars like Jerome Wakefield and Allan Horwitz are concerned that our diagnostic system has transformed normal sorrow into a psychiatric disorder. By taking minor depression seriously, are we paying homage to the worried well?

So far the fields of psychology and psychiatry have largely overlooked minor depression. The amount we know about it is dwarfed by what we know about major depression.

Here are four reasons why you should care about minor depression.

1. Minor depression is persistent. In 2001, Mark Hegel and his colleagues studied patients in New Hampshire who went to their primary care doctor. On the doctor’s visit, they filled out a depression screener – a standardized questionnaire about common symptoms of depression. Many patients reported on the screener that they just weren’t feeling up to snuff—complaints of a low mood, vague aches and pain, problems concentrating. Some of these patients had minor depression, which involves persistent problems with a sustained low mood without the full complement of major depression symptoms. In primary care settings, such patients are encountered more often than are patients with major depression. Historically, such less affected patients often receive a period of “watchful waiting.” Watchful waiting simply means that they would be watched carefully by their physician for a time, with the optimistic assumption that most would likely get better over a period of weeks, but if they got worse, a traditional treatment for depression, like antidepressants, could be initiated. Hegel wondered if this assumption was warranted. What would happen if a group of these patients were simply followed over one month of watchful waiting? Would most get better on their own?

Much to Hegel’s surprise, only about 1 in 10 of these patients with minor depression got better in a month’s time. Nearly everyone else remained stuck in their low mood.

Epidemiological studies take Hegel’s finding one step further. Judd and his colleagues in a representative sample of the US population found that when you reevaluate people who are bumping along with a minor depression a year later, nearly 3 in 4, or 72%, will be bothered by one or more symptoms of depression.

2. Minor depression is prevalent. The persistence of minor depression helps explain why low grade depression symptoms are so prevalent in the population. More than one fifth of the population, 22 percent, suffers from at least one bothersome symptom of depression. In fact, people who have shallow depression(forms of depression that fall short of the criteria for major depression) outnumber people with deep depression 7 to 1.

3. Minor depression causes major problems. There is growing evidence that the term minor depression is something of a misnomer; it is not minor in its consequences. Individuals with minor depression may use outpatient services and miss work almost as frequently as individuals with major depression. Overall, the economic impact of minor depression is comparable to that of major depression, in part because so many more people are affected by minor depression.

4. Minor depression often escalates to major depression. The final reason you should care about minor depression is that it oftentimes does not stay minor. Minor depression has been estimated to quintuple the future risk for developing a deep major depression. Indeed, if you wonder why we have a growing epidemic of major depression, look no further than the immense pool of people with shallow and persistent low-grade depression. Thus, figuring out how and when to intervene when a person can’t shake a low grade depression is not about cosseting the worried well, it’s about denying the next wave of recruits to the army of major depression.

By Jonathan Rottenberg, Ph.D.

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