Am I going crazy?

We’ve all had difficult moments that make us question our sanity and ask ourselves “Am I crazy?” Maybe life’s just piling up—work deadlines, family obligations, social events—and it all starts to feel like you’re one step away from a mental breakdown. Sometimes a crisis, a particularly bad panic attack, or resurgence of a mental illness can feel like it’s taking over your life. 

These moments can make us feel unstable and like we’re losing our minds, but what is important to remember is that there is no such thing as “going crazy.” Some situations and feelings are harder for our brains to process than others, but they do not mean you are crazy.

“I don’t even know what ‘going crazy’ means,” says Dr. Patrick McGrath, Chief Clinical Officer at NOCD. “It’s not a definable thing. It’s not in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). We don’t have a diagnosis of ‘going crazy.’”

While “going crazy” isn’t an actual medical term, it’s a common phrase used to describe feeling unwell or feeling wildly different from our baseline, neutral state. “It’s ingrained in our society that if you’re having thoughts or feelings that you don’t like and you’re not in control of them, it must be because you’re losing control and going crazy,” explains Dr. McGrath.

Just because you are struggling or feel you’re losing control, it doesn’t mean you are “going insane.” It just means in this moment, things are more difficult than normal due to some intense emotions. Let’s take a deeper look at how and why this happens, and what you can do if you feel like you’re going crazy.

Could these feelings be related to a mental health issue?

When you’re dealing with mental health challenges, it can sometimes feel like you’re losing control. Overwhelming thoughts and feelings don’t mean you’re stuck forever, or that you can’t find your way through it. Navigating mental health issues can be tough, but it’s important to know that these experiences are common. 

Feeling unstable could be connected to a mental health condition. The only way to get a diagnosis is by speaking with a licensed clinician, however you can review this list to see if any of these mental health issues sound familiar to you. If so, it’s important to discuss your symptoms with a therapist.

Panic disorder

People with panic disorder often experience sudden, intense bouts of fear or discomfort, accompanied by physical sensations like heart palpitations, trembling, and a sense of impending doom. This intense surge of anxiety can lead to a fear of losing control or going insane. The unpredictable nature of panic attacks can create a profound sense of vulnerability, making people question their mental stability. 

While this can feel very scary, there are some proven treatments that can help you manage your symptoms. The suggested route of treatment for panic disorder  typically involves cognitive-behavioral therapy (CBT). Panic-focused CBT has been proven to reduce panic attacks and the fear of psychosis (which can be the same as the fear of going insane). If it’s right for you, your provider might also recommend medications like selective serotonin reuptake inhibitors (SSRIs) to help with the feelings of panic and hopelessness. 

Stress

Feeling like you’re “going crazy” isn’t always linked to a specific mental health condition. Sometimes, it’s the everyday stresses we deal with. Take a toxic work environment, for example. You know you’re qualified and have years of experience, but your boss constantly micromanages, belittles, and takes credit for your work. This can make you feel like you’re losing grip on what you know about yourself, and wonder if you’re going crazy.

The prolonged stress caused by having (or caring for someone with) a chronic illness, having an unstable financial situation, or the current political landscape are all examples of things that can push you to the breaking point. If living through COVID has taught us anything, it’s that intense, prolonged stress takes its toll on our mental health. 

Even though stress is often caused by circumstances that are entirely out of our control, we do still have control over the way we manage it. If your stress levels are affecting your mental health, there is absolutely no shame in reaching out for help.

Schizophrenia

Distorted thinking, hallucinations, delusions, and impaired social functioning are all symptoms that characterize schizophrenia. The presence of hallucinations and delusions creates an alternate perception of reality, making it hard for people to tell what is real and what is not. Because of this confusion, many people living with schizophrenia feel like they are going crazy or insane. 

If you are diagnosed with schizophrenia, your healthcare provider will typically prescribe you antipsychotic medications. While the term ‘antipsychotic’ might sound intimidating, all it means is the medicine will help your brain distinguish between what is real and what it is making up, allowing you better peace of mind and alleviation of your symptoms. These medications are often combined with therapy and family support, which can play a crucial role in managing symptoms and minimizing relapses.

Borderline personality disorder (BPD)

BPD is characterized by strong patterns of instability in interpersonal relationships, self-image, and emotions. People with BPD may experience intense and sudden mood swings, along with difficulties in forming stable identities and maintaining relationships.

If you have BPD, the emotional ups and downs and shifting self-perceptions may make you question your sanity. Episodes of intense anger, fear of abandonment, and distorted self-image contribute to this internal turmoil.

BPD can feel very consuming and isolating, but there are proven treatments that can help you manage your symptoms. The primary treatment for BPD is dialectical behavior therapy (DBT), a type of CBT adapted specifically for people who experience emotions very intensely. DBT focuses on helping people embrace the reality of their lives and behaviors, while also giving them the tools to make changes and leave behind patterns that aren’t serving them. Medications, such as mood stabilizers or antidepressants, can sometimes also be used in addition to DBT to address and alleviate specific symptoms.

Post-traumatic stress disorder (PTSD)

PTSD can develop after exposure to a traumatic event, leading to intrusive memories, avoidance behaviors, adverse changes in mood and cognition, and heightened arousal. People with PTSD may struggle with recurrent distressing memories that blur the lines between past and present.

The intrusion of traumatic memories and the associated emotional discomfort can create a sense of being haunted by the past. This can lead people to question their ability to maintain a coherent and stable sense of self.

PTSD can be extremely difficult to live with and can often feel debilitating. That being said, you are not alone and many people that live with PTSD have found relief and coping mechanisms through therapy. Trauma-focused, specialized therapies, such as prolonged exposure (PE) therapy are commonly used to treat PTSD. While taking the first step in asking for help can be hard, the reward of learning how to cope with your PTSD is 100% worth it.

Obsessive compulsive disorder (OCD) and feelings of insanity

OCD is a serious and misunderstood mental health condition marked by persistent, intrusive thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions). The compulsions are performed in hope of finding temporary relief from the obsessions, but often cause an ongoing cycle that is easy to get stuck inside. 

If you have OCD, these intrusive, unwanted thoughts, particularly those involving taboo themes, can trigger a fear where the mere presence of such thoughts is seen as an indication of losing control or going insane. This fear can lead to compulsions, such as hours spent googling symptoms, asking friends and family whether they think you’ve “gone mad,” or even seeking multiple psychiatric evaluations. 

Compulsions can often reduce anxiety for a short period of time, but anxiety is practically guaranteed to flare up the moment something triggers it again, leading to more compulsions and a strengthening of OCD’s vicious cycle. That’s why OCD tends to get worse without treatment. Luckily, there’s a tailor-made therapeutic approach that’s evidence-based, highly effective, and more accessible than ever before. It’s called exposure and response prevention therapy (ERP). 

Exposure and response prevention (ERP)

In ERP, a specialized therapist works closely with you to identify your main fears and the things that trigger them, whether rooted in physiological sensations or intrusive thoughts that preempt your doubts about your sanity. This systematic and collaborative approach ensures that exposures are tailored to your unique experiences, fostering a sense of agency in confronting your fears.

Dr. Farrell explains, “During a typical ERP session, a therapist will guide you to confront your triggers and sit with the anxiety you feel, rather than resorting to compulsive responses. This process will, over time, empower you to tolerate the anxiety associated with your fears, challenging the ingrained patterns of avoidance and compulsions.”

Research consistently verifies the effectiveness of ERP in treating OCD, with significant reductions in symptoms and improved overall quality of life.

Mental health self-care

Many mental illnesses can cause feelings of going crazy, but these feelings can also arise from the stresses of day-to-day life, from visiting the dentist to being laid off from a job. Dr. McGrath shares a few general self-care tips that can help you manage your stress and anxiety and calm the feeling of going crazy.

“Get good sleep, exercise, and eat well are always things we’re going to tell everybody to do all of the time. Don’t be scrolling on social media reels for hours and hours at a time, get up and move and walk around, interact with other people, be social,” stated Dr. McGrath. 

He also recommends referencing a time in your life where you were feeling more stable. “Go back to doing what you were doing when you were feeling well. And if you’re not doing the things you were doing when you were feeling well, that’s what you need to go back and do.” Maybe you used to spend more time hanging out with good friends, or you had a hobby you haven’t done in a while, or you used to go outdoors more often. Starting small, you can begin to integrate these positive factors back into your life.

Bottom line

Feeling like you’re going crazy is just that—a feeling. If this happens, it’s important to ask yourself why you think you’re so on edge. More often than not, a mental health condition, stress, or your current circumstances (or a combination of all of these) is contributing to the feeling of losing control. If you’re concerned about your mental health, speaking to a therapist can be immensely helpful.