I regularly get waves of dread or anxiety out of nowhere - started when I started getting peri symptoms. I also get feelings of grief and will sometimes start crying for no reason. I've found that I can work out if these feelings are 'real' or not by stopping and thinking about them - the 'real' feelings can be linked to a cause - e.g. worried about starting a new job, feeling sadness over a past bereavement as we approach an anniversary, but the 'fake' feelings aren't linked to anything - I'm feeling an emotion that isn't linked to any specific 'cause'. I've also learned that I experience some physical changes (a 'tingly' feeling under my skin and the skin on my face feels tight) at these times. I've found that acknowledging these feelings and reminding myself that they're not real does help. If I find that the feeling isn't a 'real' one, it helps to remind myself of this ' "Yes, you're feeling really upset now, but that's just your hormones talking, there's really nothing to be worried about." It's bizarre, but it does make me feel better. "It's not me, it's the menopause" makes me calm down a bit!!!
What if my intrusive thoughts are related to an aspect of a cause, e.g. “this could turn out really bad” how do I know if that is real or just my fear?
I find it helps to keep a record of my worries - by tracing the pattern, I can often see how irrational my fears have been.
For example, regarding health anxiety, during the past two months I have 'felt' that I was suffering from: a brain tumour, breast cancer, bowel cancer, stomach cancer, heart attack, brain aneurism, blood clot in the leg, vaginal cancer, cervical cancer...that works out at more than one terminal illness/fatal condition a week! So when the tenth health panic popped up this morning, I could review my list from the last 8 weeks and ask myself how likely it is that I would be suffering from 10 terminal illnesses at the same time? And if I'm not suffering from all 10, then why is it any more likely that I'm suffering from 1 of them than from the other 9?
It doesn't always work - sometimes I just have to ride out the hormone surge until it eases. But quite often, I can talk myself out of panicking!
Same thing with other worries. Examine the facts, ask myself how likely it is, and when my brain comes back with 'but it could mean...' respond sharply with 'but it also could not mean' and go and do something else to take my mind off it!