I'm afraid of going crazy: what to do?

Some people come to the psychotherapy consultation explaining that the reason why they have gone to the psychologist is the fear of falling into madness.

Although the fact of experiencing this fear is not in itself proof that the person suffers from a disorder psychiatric, the truth is that it is almost always a valid reason to initiate a process of psychotherapy. Let's see why.

• Related article: "Mental health: definition and characteristics according to psychology"

What is the fear of losing your sanity?

People who say they are afraid of going crazy often suffer a great concern for hypothetical psychological disturbances that they have noticed in themselves. These can be quite varied, but usually they have to do with having difficulties when it comes to controlling one's own actions, understanding the intentions of others people, make decisions in an appropriate way, perceive in an undistorted way the stimuli of the environment, remember things well, or to concentrate on tasks concrete.

In short, the fear of falling into madness affects these psychological areas:

• Concentration and attention management skills
• Memory
• Social skills
• Management of impulsivity and emotions
• Rational thinking and decision making

These are very different mental processes, which already indicates one of the characteristics of this fear: they point towards an extremely diffuse problem, insanity, which makes it easier for us to continue to feed this fear out of sheer confirmation bias.

And it is that madness exists, but only insofar as the popular definition of madness exists. In other words, madness is not a valid psychological construct, but rather an idea that can be approached from the social sciences; In the same way that according to the science of Biology there are no different races of Homo sapiens, but there is a concept of human races that can be approached from Sociology, Anthropology, etc.

This means, among other things, that people who fear going crazy do so by thinking through concepts inherited from previous generations and that, although they survive in popular culture, do not explain anything from the point of view of science Health.

What is traditionally considered a "crazy" person can display behaviors similar to the symptoms of psychiatric disorders such as schizophrenia or bipolar disorder, or it may simply correspond to behaviors that do not fit in with the conventions social. All of us would have been considered crazy in other times, for example, just because of the type of clothes we wear, or because of our way of thinking adjusted to the 21st century.

With everything, fear of losing your sanity is a form of psychological distress that should not be underestimated. In situations like this, the solidity of the concepts from which fear arises does not matter so much, but the way in which that fear damages the quality of life of the person. Addressing the former by leading the person to question their fears (among other psychotherapeutic intervention measures) will be a way to solve the latter.

Possible causes of fear of going crazy

Behind the fear of going crazy there can be very different causes, and these should be examined in therapy, from personalized attention. However, as a general description of this type of problem, we can say that the most frequent causes of this kind of fear are the following.

1. Anxiety problems

Suffering from anxiety makes us more likely to feed fears that are not based on anything real. Since our nervous system is in "alert mode," we easily fall short of giving importance undeserved to indications that something is wrong with us (beyond the anxiety problem itself in Yes).

• You may be interested in: "Types of Anxiety Disorders and their characteristics"

2. Tendency to hypochondria

The tendency to hypochondria occurs in people who are often apprehensive, easily embracing the belief that something bad will happen to them in the field of health. In this case, it would be a question of assuming that a disease that affects the brain could be developing. It doesn't have to be a disorder, but it does lead to distressing situations relatively frequently.

If this tendency to hypochondria reaches psychopathological extremes (for example, it occurs in those who do not fear or after going through several medical check-ups), there is a phenomenon known as anxiety disorder due to disease. Also in this case we are not talking about insanity, among other things because the symptoms of this disorder affect a well-defined aspect of the person's life, and they do not invalidate it and render it incapable of being functional in other contexts.

3. Psychotic-type disorders

It is possible that the causes of the fear of going crazy are symptoms of a psychiatric disorder such as schizophrenia, in the one that the problems to perceive the reality as it is intensify, sometimes putting in danger to the person and to the others. However, the line between the symptoms associated with schizophrenia, on the one hand, and the mental processes of people without mental illness, on the other, is surprisingly blurred in various aspects. For example, auditory hallucinations can occur relatively frequently in people who never develop psychopathology.

In any case, as we have seen, the concept of "insanity" does not fit the nature of psychiatric disorders, and it is not useful to describe or understand them. These health problems are very diverse and with correct treatment many times they do not completely cancel out the the person's ability to make decisions and adapt to day-to-day challenges, nor do they manage to “absorb” their identity.

4. Vital crises

Radical changes such as moving to another country, divorcing or changing careers involve immersing yourself in a whole series of new experiences that arrive at the same time and that they can give the impression of losing control over what is being done.

The need to adapt to these new roles without having familiar references fuels the perception that everything around us is shaking.

5. Consumption of drugs

Addictions and psychoactive substance abuse can also be behind this feeling. It is a serious health problem that must be treated as soon as possible with professional help, but fortunately, it usually stops affecting perception and rational thinking once it has been possible to stop using for several months (although the risk of relapse is still there).

6. The suggestion arrived through third parties

Social pressure and the contexts of psychological manipulation typical of harassment and abuse dynamics can lead the victim to believe that she is crazy. This is something that happens for example with gaslighting, a set of manipulation strategies sometimes used by abusers to make the victim believe that everything bad that happens to them is due to not being able to think well.

To do?

The fear of going crazy is, whether or not there is a diagnosable psychopathology, a reason to go to psychotherapy. Through psychological therapy it is possible not only to address the root of the problem that generates discomfort, but also to learn about what mental health is, and on how limiting the labels historically used to stigmatize those who show anomalous ways of behaving and perceiving reality are.

Thus, if there is a psychopathology to be treated, it will be approached understanding that the problem lies in the specific ways in which it compromises the quality of life of the person, and not in the mere existence of an ambiguous phenomenon called "madness" that theoretically would be part of the identity of the person.

In the field of psychiatry and clinical psychology, essences do not exist, and that implies that no one is condemned to carry a certain identity on their backs. "Psychopathological": both the behaviors that shape the disorder to be treated and the thought patterns through which we perceive that psychopathology can be modified.

On the other hand, in the absence of a psychological disorder, therapy will also be helpful; in this case, to clear doubts, to improve self-esteem and to prevent possible problems of stress and anxiety caused by those insecurities in oneself, for example.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
• Santos, J.L.; García, L.I.; Calderón, M.A.; Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Roman, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical psychology. CEDE PIR Preparation Manual, 02. CEDE. Madrid.