How many times have we said “I’m going crazy!”, “I’m going to go crazy!”, “I’m out of my mind!” during excited moments, of strong stress or emotional load ?!
In this case they are, for the most part, colorful expressions to indicate our state of mind – the fear of going crazy – that do not turn into a loss of mind.
At other times, the feeling of truly losing control of one’s mental faculties becomes more threatening. It seems real and leads to consequent brooding or ruminations , which do nothing but increase the state of anxiety and alertness. But even in this case it is more the fear of the condition we are experiencing and its consequences than the actual danger.
A particular emotional, physical or physiological state can in fact lead the person to be alarmed, believing they can go crazy . This judgment only increases the previous state, in a vicious circle that feeds on itself.
Usually people who are afraid of going crazy tend to observe themselves very carefully. They interpret altered mental states as a sign of impending “madness”. During an anxiety state, they interpret typical mental confusion as loss of control. Or they read continually thinking about the past (rumination) as indicative that they will not get out of it. Or they still consider worries about the future (brooding) as a trap that will lead them to “go mad”.
The fear of going crazy originates in history
First of all, let’s try to understand the story that expressions like mad, mad, mad carry with them. In ancient times, the condition of madness was associated with spiritual, religious and mystical causes. Deviant behavior was interpreted as divine punishment, whereby the insane had to be removed from society, if not burned alive.
Towards the beginning of the 19th century, the sick began to be interned in special places, but treated with methods such as lobotomy, electroshock, physical restraint and isolation. Only towards the middle of the last century were the first psychiatric drugs synthesized and dignity given to the psychiatric patient.
Historically, it is not difficult to understand how, even on a cultural level, the fear of going crazy and its consequences are threatening. This further increases the fear of going insane , even if there is no objective reason to believe it.
How do you go “crazy”
In reality we know that it is difficult to become “crazy” from one day to the next. Losing one’s mental faculties, such as during a psychotic onset , is a rather rare event. It is certainly very different from believing that you can lose control during or as a result of a strong emotional activation or a state of mental confusion due to anxiety.
Serious psychiatric problems, such as to cause one to lose touch with reality, usually manifest themselves during the course of development. However, there are pre-onset symptoms and signs that act as a wake-up call. For all the rest, these are emotional, physiological, cognitive alterations that are understandable within a psychopathological functioning, but which do not lead to the loss of one’s mental abilities.
Disorders associated with the fear of going insane
The fear of going crazy is present transversally in various disorders, where we can identify vulnerability factors that favor its onset. On a cognitive level, there are some factors that favor the vulnerability of the subject when the thought of being able to go crazy emerges. In particular the beliefs about:
- the likelihood of developing mental illness
- to the terrible and unbearable condition of mental illness
- the inability to face this possible condition materially and emotionally
- the incompetence of the medical profession (distrust),
- to the unbearability of physical and physiological sensations, considered a danger signal (anxiety sensitivity)
There may also be beliefs that increase the fear of going mad. For example the fear that the other will withdraw and that worrying about one’s mental faculties will help to stay sane.
Mental health anxiety disorder (hypochondria)
Among the various disorders, in health anxiety disorder (called hypochondria) , which is characterized by the fear of having a serious illness, there is also the fear of being able to go insane . We talk about mental health anxiety .
Somatic symptoms generally emerge that do not have an organic basis or are disproportionate in intensity to the existing problem. Body worries and excessive awareness of what is happening in the body. Fear of contracting a serious mental illness. This leads to resistance to medical reassurance and hypochondriacal behaviors (requests for reassurance, searches for information on the internet).
Central to this disorder is the stable tendency to misinterpret information relating to body symptoms and any other information deemed relevant to mental health. This determines selective attention on the body and lowering of sensory thresholds, with a greater perception of apparent “oddities” that fuel the fear of going crazy . Safety-seeking behaviors lead to an increase in anxiety-inducing symptoms, in turn judged as a sign of mental illness.
Emotional activation and fear of going crazy
Another (non-clinical) condition that leads people to believe they are losing control of their faculties is experiencing a highly altered emotional state.
In fact, we all have a window of emotional tolerance within which we are able to live our emotions and have the feeling of being able to manage them. This was structured as a child in interactions with our parents. The more they were able to accommodate and contain emotions, the more they favored the enlargement of this window.
If, for example, the parents responded with depression to the activation of the child they did not favor its enlargement. Therefore, those with a narrower window are more likely to perceive emotions as threatening and difficult to control. The moment they leave this window they are perceived as dangerous, triggering the fear of going crazy .
Also in this case it is not a question of “madness”, but of training ourselves to widen our window in order to be more flexible, and to be able to live our emotions without the fear of becoming “crazy”.
How to help and get help
Accept the emotions and not fear them
First of all we can try to change the perspective through which we observe our emotional, physical and physiological reactions.
These are just normal body responses, which if we learn to know and accept are not that terrible. I can be unpleasant, but they still want to communicate something to us and as such, we must learn to listen to them.
Being curious helps us to observe what happens to us without necessarily judging it dangerous and threatening, but simply a new experience. No one has ever gone insane from experiencing anxiety, sadness, joy or anger.
Learn to meditate and normalize somatic symptoms
The mindfulness meditation can definitely help you from this point of view, allowing the person to be in the “here and now” and observed suspending judgment. Obviously it is a practice that must be trained and used by fully understanding the theoretical principles of reference.
Identifying the stimuli that favor the onset of the vicious circle (physical / emotional state – perceived threat – increased physical / emotional state), can help to be ready in moments of greatest vulnerability, to face them with openness and acceptance.
As we have seen, psychological factors play an important role in increasing somatic symptoms. If we rate a dizziness as terrible, we will be more likely to fidget and make it continue.
Targeted psychotherapy
The cognitive-behavioral therapy from this point of view provides the tools to better deal with the physical symptoms and reduce the overall stress that can exacerbate them. It is therefore recommended to rely on a professional with whom to acquire the techniques most functional to us.
The therapeutic goal is twofold: to learn to normalize somatic alterations, without getting scared and to reduce the sense of self of a vulnerable person and at the mercy of their emotions. The fundamental purpose of the work is therefore to train the patient to normalize the symptoms, re-attributing them to harmless causes. By accepting to be with their emotions and physiological reactions, living them for what they are, without being dominated by the fear of going crazy.
