How I learned to quiet the ‘what if’ questions, stop expecting the worst, and start trusting myself.
The old adage goes “hope for the best, plan for the worst.” This seemed like wise and responsible advice. Especially when it came to my health or the health of my loved ones. Over the years I became very good at envisioning and thinking through all those worst-case scenarios ‘just to be sure’. But somewhere along the line, and as my anxiety grew, I forgot to also hold onto the hope and belief that things could turn out ‘just fine’.
What is Catastrophizing?
My life has been full of terrible misfortunes most of which never happened.Michel de Montaigne
Catastrophizing is when we misjudge the danger we face and expect the worst will happen. It’s a common challenge in many anxiety disorders. Think of having a security system in your house. You set it when you leave or are heading to bed. The alarm will go off if someone tries to break in but not when your neighbor takes her dog for a walk or you get up for a drink in the middle of the night. But what if your house alarm starts blaring not only when a burglar is at the window but when you’re not actually in danger?
This is what it’s like to live with health anxiety. We find our natural ‘warning system’ (that fight-or-flight response I wrote about before) going into overdrive and creating all these false alarms. As a result, Anderson et al suggest we tend to:
- Overestimate our likelihood of having or developing a serious medical condition
- Think things are far worse than they are
- Not consider the more likely and less serious explanations for our symptoms
- But also, underestimate our ability to be successfully treated, cope with a diagnosis, or handle health issues
The ‘What If’ Worry Loop
I struggled with these ‘what if’ questions for over a decade and can still get caught in their ‘worry loop’ of assuming the worst from time to time. Sneaky doubts like:
“This is the third headache I’ve had this week – what if I have a brain tumor?”
“My arm feels numb – what if I had a stroke?”
“I’m so tired lately – what if I’m getting diabetes?”
It didn’t matter how improbable the medical condition was or how minor my symptom, my thoughts would race and soon I had myself convinced that I was that ‘1 in 250,000’. I found myself trapped in this kind of F.E.A.R. thinking (False Events Appearing Real).
“What if this time, is the time, that my worst-case scenario comes true?”
Yes. I could be that ‘1’ in 250,000. That’s an uncertainty I’m slowly learning to live with. But I could also be 1 of the 249,999.
How I stopped expecting the worst
1. Know my Triggers
Over time, I started to recognize that certain experiences and situations lead to my health worries. These are my ‘triggers’. As the CalmClinic explains, triggers are not why we have an anxiety disorder, but they can set off an anxiety episode or make our symptoms worse. They may happen internally (that weird heartbeat) or be something we encounter externally. Situations like meeting someone just diagnosed with a serious disease, hearing about a viral outbreak in the news, or unfortunately the Go Fund Me campaign shared to my facebook feed. These types of triggers can focus our attention on possible health issues like that new rash we might otherwise dismiss. There are also general triggers shown to contribute to anxiety such as alcohol or certain medications, caffeine, stress, isolation, and conflict.
Being aware of what makes me anxious gives me the opportunity to say ‘NO’ before I’m swept up and overwhelmed by negative thoughts. One tool we can use to help identify our triggers is to write in a mood log. Keeping track of how we feel before, during and after situations along with any other contributing factors like diet, sleep, or weather can reveal patterns over time and give insight.
2. Challenge my Assumptions
After a very difficult summer, I took a step back and tried to understand “how did I get here?” I realized I was making many unhelpful assumptions that were feeding my anxiety. These underlying beliefs were the “if….then” and “should” statements that motivated my choices and behaviors. Nagging thoughts like, “if I’m not constantly vigilant, then I will miss something important,” “I should never dismiss my symptoms” or “if my doctor doesn’t order the test, then she could make a mistake.”
We can tell if our assumptions are unhelpful when they are rigid, over-generalized and unrealistic. They don’t change, even if our personal experience proves them wrong. The good news is that our brains are a wonderful organ designed to adapt. Our thoughts are not reality and practicing thinking in a new way can ‘rewire’ us to approach our concerns with new meaning.
It can be difficult to identify these assumptions at first. As Anderson et al explain, we develop this rule-book “as a way to protect ourselves and to make ourselves feel less vulnerable.” I had invested so much of myself into these patterns of thinking I was no longer conscious of their effect. Journaling prompts like writing for H.E.A.L.T.H. can help us question our concerns and create the space needed to get a more fair perspective. And check out the exercises in module 8 of the Helping Health Anxiety workbook.
3. Letting Go
Many of us with anxiety have trouble tolerating uncertainty. I like to know what’s going to happen and plan for what’s to come. But as we’ve discussed in an earlier post, nothing in life is certain, especially our health. Worrying about all those worst-case scenarios doesn’t stop them from happening. There’s a famous quote by Leo F. Buscaglia
Worry never robs tomorrow of its sorrow, it only saps today of its joy.Leo F. Buscaglia
Dr. Robert Leahy from Psychology Today explains the problem is we are caught thinking in terms of possibilities when we should be thinking about probabilities. As he points out, we can’t rule out ‘possibility’. It’s possible that my headache could be a sign of a brain tumor. But is it probable? Are there other more common reasons I could have a headache this week?
At one point I just became so exhausted by all the ‘what if’ questions and fear that I was missing something. I had to let go. Let go of the need to control things that I couldn’t control and focus instead on the things I could do here and now. And let go of my belief that things should turn out a certain way instead of embracing the exciting mystery of other possibilities.
Embrace uncertainty. Some of the most beautiful chapters in our lives won’t have a title until much laterBob Goff
Helpful Exercises and Resources
4. Ask for Help
Finding our way out of the worry trap can be difficult to do on our own. Sometimes we need a lifeline to help us climb out. If you have a medical concern, see your doctor. They can conduct an evaluation as well as explain why our symptoms do or do not relate to the conditions we’re worried about. Meeting with a therapist can also provide us with a kind ear, tools for managing our anxiety and new perspectives.
You’re BRAVER than you believe,
and STRONGER than you seem,
and SMARTER than you think.A. A. Milne, Winne the Pooh
Check out this related post: “Will I Be Okay?” How to Stop Reassurance Seeking in Health Anxiety
I’m not an expert. If you have any concerns about your health, you should always consult your doctor or other qualified health-care provider and don’t disregard or delay seeking professional medical or mental health advice, diagnosis or treatment because of anything you read on this site. Wishing you well.