Anticipatory Anxiety (Catastrophising)

Anticipatory Anxiety

Anticipatory anxiety is where a person experiences increased levels of anxiety by thinking about an event or situation in the future. Rather than being a specific disorder in its own right, anticipatory anxiety is a symptom commonly found in a number of anxiety related conditions. It can be extremely draining for people as it can last for months prior to an event. The worries people experience specifically focus on what they think might happen, often with catastrophic predictions about an event. The nature of negative predictions about the event will be the difference between an anxiety level that is incapacitating or merely uncomfortable.

Anticipatory anxiety has many of the characteristics of generalised anxiety: increase of attention, apprehension, restlessness and avoidance. During anticipatory anxiety, a person’s body may be habitually tense, waiting for the event. This can also have a disabling effect, since having a tense body may actually lead to problems such as hyperventilation, chest pain and muscle spasm. Anticipatory anxiety may also shape behavior (i.e. decisions about how to behave, what to say, where to go, etc.) in hopes of avoiding a return of symptoms. At lower levels this fear is referred to as ordinary “worry;” at higher levels it may become so intense that it can be called “anticipatory panic.”

Common conditions that have a component of anticipatory anxiety include, panic (with common predictions regarding a fear of having a further attack, fainting or dying), social phobia (with predictions about saying or doing something embarrassing, e.g. blushing, sweating or saying the wrong thing), before public speaking (for example, forgetting what to say) and generalised anxiety (with negative worry or fears about the future). Anticipatory anxiety may cause problems in relationships with others, since individuals are often preoccupied with the thought of the feared event. It can also affect a person’s ability to concentrate, which may prevent them from working to their full potential, or enjoying favourite activities.

The DIY Self diagnosis

If you can answer YES to most of the questions it is likely that you are affected by anticipatory anxiety.

Do you experience feelings of tension and anxiety in the build up to an event?
Do you have images or negative predictions about what may happen at this event?
Do you sometimes avoid events or situations because of the increased anxiety they provoke?

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