I am afraid of going crazy: what to do?

The fear of falling into madness is a form of psychological distress that can cause many problems.

Some people come to the psychotherapy office explaining that the reason they have come to the psychologist is the fear of going mad. the reason they have come to see a psychologist is the fear of going crazy.

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

In what does the fear to lose the sanity consist?

The persons who manifest to have fear to become crazy usually suffer from a great preoccupation by hypothetical psychological alterations that they have noticed in itself. These can be quite varied, but usually have to do with having difficulties in controlling one's actions, understanding other people's intentions, making decisions in an appropriate manner, perceiving environmental stimuli in an undistorted way, remembering things well, or concentrating on specific tasks.

In short, the fear of falling into insanity 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 points to one of the characteristics of this fear: they point to an extremely diffuse problem, insanity. an extremely diffuse problem, insanityThis makes it easier for us to continue to feed this fear out of pure confirmation bias.

And the fact is that madness exists, but only insofar as the popular definition of madness exists. That is to say that 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 mad do so by thinking through concepts inherited from previous generations and which, although they survive in popular culture, do not explain anything from the point of view of health sciences.

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

Yet, the fear of losing one's sanity is a form of psychological discomfort that should not be underestimated.. In situations like this, it is not so much the soundness of the concepts from which the fear arises that matters, but the way in which this fear damages the person's quality of life. Addressing the former by leading the person to question his or her fears (among other measures of psychotherapeutic intervention) will be a way to solve the latter.

Possible causes of the fear of going crazy

Behind the fear of going crazy there can exist very diverse causes, and these will have to be examined in therapy, from the personalized attention. However, as a general description of this type of problems, we can say that the most frequent causes of this kind of fears are the following.

1. Anxiety problems

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

2. Tendency to hypochondria

The tendency to hypochondria occurs in people who tend to be apprehensive, easily embracing the belief that something bad will happen to them in the area of health. In this case, would be to assume that a disease affecting the brain might be developing.. It need not be a disorder, but it does lead to distressing situations relatively often.

If this tendency to hypochondria reaches psychopathological extremes (for example, it occurs in those who do not get rid of this fear even after several medical check-ups), a phenomenon known as illness anxiety disorder occurs. Here again we do not speak of insanity, not least because the symptoms of this disorder affect a well-defined aspect of the person's life, and do not invalidate the person or make him or her unfit for life. do not invalidate the person or render him or her 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 which problems in perceiving reality as it is are intensified, sometimes endangering the person and others. However, the line separating 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 several respects. in several respects. For example, auditory hallucinations may occur relatively frequently in people who never end up developing psychopathology.

In any case, as we have seen, the concept of "insanity" does not fit the nature of psychiatric disorders either, and does not serve to describe or understand them. These health problems are very diverse and with the right treatment often do not completely annul the person's ability to make decisions and adapt to the challenges of everyday life, nor do they "absorb" his or her identity.

4. Life crises

Radical changes such as moving to another country, getting divorced or changing careers involve immersing oneself in a whole series of new experiences that come at once and can give the feeling of losing one's identity. can give the feeling of losing control over what you are doing..

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

5. Drug use

Addictions and the abuse of psychoactive substances may also be behind this feeling. This is a serious health problem that should be treated as soon as possible with professional help.The risk of relapse is still there, but fortunately, it usually ceases to affect perception and rational thinking once you have been able to stop using for several months (although the risk of relapse is still there).

6. Suggestion by third parties

Social pressure and psychological manipulation in the context of bullying and abuse can lead the victim to believe that he or she is crazy. This is something that happens for example with gaslightinga set of manipulative strategies sometimes used by abusers to make the victim believe that everything bad that happens to her is because she is not able to think straight.

What 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 mental health.The labels historically used to stigmatize those who show abnormal ways of behaving and perceiving reality are limiting.

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

In the field of psychiatry and clinical psychology there are no essences, and this implies that no one is condemned to carry a certain "psychopathological" identity on his or her shoulders: both the behaviors that shape the disorder to be treated and the thought patterns through which we perceive this psychopathology can be modified.

On the other hand, In case there is no psychological disorder, therapy will also be useful to clear doubts, to improve self-esteem and to prevent possible stress and anxiety problems caused by insecurities in oneself, for example.In this case, to clear doubts, to improve self-esteem and to prevent possible problems of stress and anxiety caused by these insecurities in oneself, for example.

Bibliographical 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. ; Román, P. ; Hernangómez, L. ; Navas, E. ; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Psicología Clínica. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.