Catastrophic Thinking in Sobriety

Have you ever been sure that something devastatingly bad is going to happen? Or that your luck has run out and you’re next on the universe’s hit list? I get these thoughts frequently, something I never experienced during my drinking and using days. I become overwhelmed with the feeling that because life has been so wonderful for me lately that it’s a sure sign something bad will happen soon. I find myself waiting for the other shoe to drop. At times, the thoughts consume me. They find their way into my decision-making. I find myself considering disasters like impending deaths, freak accidents, and other catastrophes like car accidents or a house fire, and how those would affect my life and how I would cope. I never knew these thoughts had a name or a diagnosis, until I learned about catastrophic thinking.

What is Catastrophic Thinking?
If you’re like me, you might be confused by the term catastrophic thinking. Catastrophic thinking is defined as worrying about, and imagining, worst-case outcomes of situations. These negative, fake scenarios are generally much more intense and graphic than what can be expected in reality. An example of catastrophic thinking is my reaction when my husband isn’t home from work at his normal time. I send him a text and if he doesn’t answer, I automatically begin thinking he might be hurt or dead somewhere, in a car crash or assaulted. Another example is if I have chest pain, I assume I’m having a heart attack or some other serious disease. Someone who engages in catastrophic thinking magnifies external threats, but more commonly they misinterpret and intensify internal threats. This means that the emotions, thoughts, and sensations you feel are perceived as signs of immediate physical or psychological danger.

Who Experiences Catastrophic Thinking?

Catastrophic thinking is tightly linked to anxiety disorders. Catastrophic beliefs can play out in many different situations. Some of those are:

• Panic – immediate catastrophic consequences of a physical sensation, like if my heart is racing I’m dying.
• Social anxiety – catastrophic beliefs about the social consequences of anxiety, like if people see me sweating and nervous, they will shame or reject me.
• Agoraphobia – catastrophic thinking about the effects of anxiety, for example, if I panic I’m trapped, or if I get on a plane I won’t be able to handle the anxiety.
• Obsessive compulsive disorder –catastrophic interpretation of intrusive thoughts, like if thinking something is unacceptable I am unacceptable.
• Post-traumatic stress disorder – catastrophic beliefs about danger, for example, if a tragedy happened to me before, it could happen again. Flashbacks about this danger could be a sign for danger.
• Pain – catastrophic beliefs about the consequences of pain like, if I’m in pain I must stop all activities immediately; it’s unsafe to move.

This list of situations are all manifestations of common types of anxiety. Anxiety is commonly experienced by people with substance use disorders and vice versa. About 20 percent of Americans with an anxiety or mood disorder also have an alcohol or substance use disorder. Having both an anxiety disorder and substance use disorder can be a vicious cycle. Many people with anxiety use alcohol to cope or lessen the effects of their anxiety, when in many cases, alcohol and drugs can make anxiety worse.

In my case, I don’t ever recall having anxiety in my drinking years, apart from a period of about a year when I feared driving over bridges and I felt extreme anxiety crossing them. I didn’t realize it was anxiety I was feeling or that I probably should have seen a medical professional about it. I was ashamed for feeling the way I did. It was also a year when my drinking was extremely heavy. When I got sober I experienced anxiety for what felt like the first time. Then I realized I was experiencing what I finally could identify as catastrophic thinking. I imagine the worst possible scenarios, encouraged by my outer stimuli and inner thoughts that create the perfect storm for anxiety. My catastrophic thoughts create the anxiety and my anxiety creates the catastrophic thoughts.

Being aware of catastrophic thinking puts some of the puzzle pieces together for me. I think drinking was my coping mechanism for undiagnosed and unacknowledged anxiety. For years, I never had to worry. I was literally care-free when I was drinking. The alcohol removed anxiety, but it also removed happiness, joy, gratitude, and pain from my life. I was numb. It’s not surprising then that I still had these thoughts when I got sober. I’ve had to learn how to deal with them without the crutch of drugs and alcohol.

How to deal with catastrophic thinking in sobriety

Identifying your catastrophic thoughts is the key to dealing with them and moving past them. The first step is acknowledging your thoughts as catastrophic and then playing the tape in your head. By identifying the thought as catastrophic, you know that the anxiety is much worse than the actual consequences of the experience if the situation actually occurs. Then you can identify best-case possibilities and work through your fear to think in a rational fashion. By weighing the evidence and facts available to you, you can develop a realistic plan to cope with the situation. Working with a psychiatrist, psychologist, or other trained professional can help with this process.

The most important part of dealing with catastrophic thinking is not letting it go unnoticed. It needs to be managed, not ignored. Persistent negative thoughts can tell you a lot about your past drinking and using habits, your current coping skills, and your emotional reactions that generate fear. These are essential to your ongoing, successful recovery.