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Inability To Cope With Uncertainty Linked To Mental Health Problems

Inability To Cope With Uncertainty Linked To Mental Health Problems

Anxiety disorder and depression are caused by underlying factors - those behaviors (thoughts and actions), situations, and circumstances that motivate apprehensive and pessimistic behavior. The inability to cope with uncertainty is often one of those behaviors for many anxiety disorder sufferers.

The inability to cope with uncertainty often develops early in life due to experiencing early life trauma - where a situation or circumstance occurred that caused harm to the individual or a loved one (or someone they knew). Examples include experiencing abuse, the loss of a loved one, being the victim of violence, watching a loved one deal with a major illness, a tragedy in the world, or even something in a movie or television show, and so on. Once experienced, the child realizes that bad things can happen, can cause great harm, and can happen at any time. Therefore, they conclude uncertainty has the potential to bring that harm.

Anxiety disorder sufferers typically prefer, and therefore, only feel safe when things are certain. Certainty means there are no surprises that have the potential to cause harm. When things are uncertain, the potential to experience harm exists.

Anxiety disorder involves unhealthy risk assessing and finding ways to keep safe. This is learned behavior, which often develops early in life due to experiencing early life trauma (and/or having anxious parents who demonstrated abnormal risk assessing behavior).

Developing healthy ways of coping with uncertainty can help reduce anxiety (and depression). Therapy is a great way to learn this important life skill.

You can read a recent article about this below:


Why inability to cope with uncertainty may cause mental health problems

November 7, 2018 by Benjamin Rosser, The Conversation

Not knowing is an uncomfortable experience. As human beings, we are naturally curious. We seek to understand, predict and control – it helps us learn and it keeps us safe. Uncertainty can feel dangerous because we cannot predict with complete confidence what will happen. As a result, both our hearts and minds may race.

While it is quite natural to experience uncertainty as uncomfortable, for some it is seemingly unbearable. Psychologists have even suggested that finding it difficult to cope with the experience of not knowing (also known as intolerance of uncertainty) could seriously affect our mental health – occurring alongside a number of conditions. But does it play any part in causing them? My review, published in Cognitive Therapy and Research, aimed to find out.

It's easy to see how the concept of uncertainty is linked to mental health. If uncertainty can feel dangerous, then it might feed our worry and anxiety. What's more, if getting rid of that feeling of uncertainty feels essential, then the compulsion to wash our hands again and again to make sure they are clean and safe might also feel essential. And if we ultimately feel unable to cope with the change and unpredictability life throws at us, then it's understandable that we are at risk of feeling defeated and depressed.

The science

By looking at the scientific evidence as a whole, I asked whether intolerance of uncertainty really has the far reaching influence on mental health difficulties suggested. And importantly, does it cause those difficulties?

The answer is not straightforward. Overall, the evidence is full of mixed findings and there are strikingly few studies that actually test what happens to a person's mental health when their ability to tolerate uncertainty changes. Such change does seem possible. We see it in the lab, such as when people are encouraged to think of uncertainty as a problem versus something that can be accepted. And we see it in therapy, through treatments like cognitive behavioural therapy – which helps people manage their problems by changing how they think or act.

We are certainly not at the point where we can confidently explain what role our response to uncertainty plays in our mental health, but we can cautiously offer some possibilities based on the research as a whole. While the findings are mixed, the best evidence that intolerance of uncertainty may cause mental health difficulties is for anxiety. In fact, a number of studies have found it may cause or increase symptoms of anxiety. That's because when we struggle to cope with the experience of uncertainty, our minds may worry and come up with an increasing number of frightening possibilities.

The struggle with uncertainty might also help us understand depression. Some evidence suggests that we may find that our mood is more negative when we feel less able to cope with the unknown. But low mood is only part of the experience of depression, so fuller investigation is needed.

Perhaps surprisingly, there is little evidence to support the idea that difficulty in dealing with uncertainty plays a part in causing the compulsions and obsessions seen in OCD. But, of the difficulties that have been explored, this is also the area with the least research.

Practical implications

Understanding what underpins mental health difficulties is important because it can help us understand how to provide better support for the many of us who have these experiences. Mental health difficulties are common – in fact, they often occur together. This raises the question: are they really separate things? Over recent years, psychologists have started suggesting that what underpins one mental health difficulty may actually also be shared across others. There is some support for this suggestion. For instance, the process of thinking repeatedly and unhelpfully about our concerns may lead to both anxiety and depression.

So while these difficulties look different on the surface, underneath the same processes may be at work. This is an exciting idea. Instead of having countless treatments, we could have support that targets these shared processes and is helpful for a wide range of issues. But first, we need to be sure what the shared processes are – and serious work is going into efforts to gain this understanding.

Our ability to weather the uncertainty that life presents us with is one process that might be shared across different mental health difficulties. If so, then this understanding could helpfully add to the therapeutic toolkit across different difficulties – a possibility that is already being explored. For example, cognitive behavioural therapy that reduces intolerance of uncertainty might help improve a range of mental health problems. What's more, intolerance of uncertainty may also play a broader role, such as in eating disorders and psychosis. But right now, there's too much guesswork and not enough evidence directly testing these ideas.

Ultimately, people deserve to be supported to make the changes that will help them the most. And so, we need research that clearly shows what those areas of change should be. After some intriguing initial research on the links between uncertainty and mental health, it is clear that this is an area worth figuring out. Until then, we will all have some uncertainty to bear.

REFERENCES:
Rosser, Benjamin. “Why inability to cope with uncertainty may cause mental health problems.” https://theconversation.com/why-inability-to-cope-with-uncertainty-may-cause-mental-health-problems-105406

Grupe, Dan W, et al. “Uncertainty and Anticipation in Anxiety - An integrated neurobiological and psychological perspective.” Nat Rev Neurosci. 2013 Jul; 14(7): 488–501. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276319/

Carleton, R N, et al. “Increasingly Certain about Uncertainty: Intolerance of Uncertainty across Anxiety and Depression.” Journal of Anxiety Disorders., U.S. National Library of Medicine, Apr. 2012, www.ncbi.nlm.nih.gov/pubmed/22366534.


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The combination of good self-help information and working with an experienced anxiety disorder coach, counselor, or therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.


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Authors: Jim Folk, Marilyn Folk, BScN. Last updated November 20, 2018.

anxietycentre.com: Information, support, and coaching/counseling/therapy for problematic anxiety and its sensations and symptoms, including the latest in anxiety research: Inability To Cope With Uncertainty Linked To Mental Health Problems.