Worry, Worry

Individual Counseling insights brought to you by Westlake Village-based California Psychotherapeutic Resources, Inc.

It’s a good thing that almost all of us worry. Think of worry as a built-in alarm device. When it is used wisely, it alerts us to danger and prompts us to navigate our way through a maze of solutions to life’s various problems. We need to think through our options when we are faced with problems, weighing the benefits and pitfalls of each alternative, and then come up with the best solution. From there we take action which, we hope, solves the problem. Worry is helpful when it is used at the right time and at the right level for resolving our difficulties. Like many things in life, however, too little worry, or too much of it, can be harmful.

Too little worry can result in impulsive decisions which may result in unfortunate consequences. Indeed, some people are high risk-takers who may not worry enough about problems – they may win, but just as often, they lose. Others avoid worry through substance abuse or other addictive behaviors and then lack the motivation and insight to deal realistically with life’s expected problems. Similarly, a laid-back, come-what-may approach, while it has some merits, sometimes suggests passivity and a lack of ability to participate in the complexity of life’s experiences.

As we all know, some people worry too much. Rather than solving a problem, too much worry becomes the problem. Not only does excessive worry create personal suffering, but it also affects the people around the worrier. Worry is a fairly common, but potentially serious, condition. A recent survey suggests that one-third of all office visits to primary-care physicians are associated with some form of anxiety. Furthermore, it has been estimated that one-fourth of all people, over the course of a lifetime, will at some point suffer from symptoms associated with an anxiety-related diagnosis. The stress which accompanies worry can have serious physical implications, including an increased risk for blood pressure and heart ailments, immune system deficiencies, and cancer.

Most people who worry excessively are well aware of their tendencies, although some simply view it as their normal state of affairs. (Indeed, some people like to worry because they feel that their mind is more active and worry allows them to feel more in touch with their inner experience.) The worrier is one who feels in jeopardy but believes that he or she lacks the ability to take action in the real world to solve the problem. Some people who worry feel that if only they can think the problem through repetitively, sometimes day after day, the problem will magically disappear. And many people worry about things they have no control over anyway. In truth, excessive worry does not solve problems – which are actually cleared up by considering real options and then taking action. Worriers harbor their problems in their imagination and often cannot find a way break free to the stage of taking action.

Many treatable conditions are associated with worry. For some people, worry is simply a habit or an entrenched way of dealing with life’s conflicts. But for others it is a symptom of an underlying condition which may be amenable to psychotherapeutic and/or medication intervention, such as –

  • Depression. Ruminative worry, often with negative thinking, is one of the primary symptoms of depression, along with sleep and appetite changes, lethargy, isolation, and a loss of pleasure in everyday life experiences. Fortunately, depression responds well to psychotherapy or medication, and often to a combination of the two.
  • Panic Disorder and Social Phobia. A panic attack is worry taken to the extreme – a feeling of terror accompanied by rapid heartbeat and fast breathing along with a need to run away from the situation. The person senses imminent doom. About 30 to 50 percent of the time, panic attacks are accompanied by agoraphobia, which is a fear of any public place where a dreaded panic attack might occur, like crowds, driving, stores, restaurants or elevators. Social phobia, on the other hand, involves a fear of being the center of attention, like speaking or eating in public. These conditions can be treated with powerful psychotherapeutic tools, and sometimes antidepressant or antianxiety medications can be a useful adjunct to therapy.
  • Obsessive-Compulsive Disorder. A person with OCD experiences unwanted and intrusive thoughts (obsessions) and may feel a compulsion to engage in rituals as a way of handling these unwanted thoughts. Strange thoughts are fairly common for most people, but when they are pervasive and seem uncontrollable and distressful, psychotherapeutic interventions combined with antidepressant medications can help to resolve the difficulty.
  • Generalized Anxiety Disorder. People with GAD lead fairly normal lives, but they worry about things that most of us can brush off. They find it difficult to let go of their worries, and this may have a genetic or biological basis. For the person with GAD, any event can prompt an automatic response to interpret things in a negative and fearful way, and this can lead to a cascade of worry. Psychotherapy is very effective in helping a person learn to think positively and to let go of distressing thoughts, and sometimes an antianxiety medication can be used judiciously as an adjunct to therapy.
  • Post-Traumatic Stress Disorder. Sometimes our old pain associated with tragic experiences is difficult to let go of, especially when these experiences have threatened our sense of integrity and safety. A trauma can set the stage for worry for years after the original event. Coming to terms with PTSD in psychotherapy usually involves learning to talk about the trauma, grieving the losses associated with the event, and finding ways to forgive. Some people with PTSD may also benefit from medication during treatment.

Tips for Managing Worry

There are many practical methods for dealing with excessive worry, a few of which are listed below –

  • Find Connectedness. When we feel connected to something larger than ourselves (a group of friends, our families, work, a sense of the past, ideas, and religious or transcendent faith), we are less likely to worry.
  • Seek Advice and Reassurance. We all need supportive feedback from others from time to time. Other people may have solutions to problems that we haven’t thought about. For reassurance, find people who know how to give it. Many of us spend a lifetime looking in all the wrong places for approval!
  • Understand the Difference Between Good Worry and Unproductive Worry. Good worry implies having a sense of control in solving life’s problems. It involves examining alternatives and then coming up with a systematic plan for meeting a challenge. Unproductive worry involves engaging in repetitively hashing over the same ideas time and again, negative thoughts, and no real plan for meeting the challenge.
  • Try to Do the Right Thing. Maintain your sense of integrity whenever you do something. Tell the truth. Obey the law. Keep to your promises. Let your conscience be your guide. Granted, we might tell an occasional lie or break a promise, and this is fairly common – but it also can set the stage for worry. We may think sometimes that we can get ahead in the world the easy way – but the price we pay could be excessive worry, among other penalties.
  • Sleep and Eat Properly. Lack of sleep and a nutritious diet can make us irritable, distracted, and anxious – all conditions that set the stage for worry. (Try to be mindful of the problem of overeating, however, as a way of making your worries disappear.)
  • Try to get at least half an hour of aerobic exercise every other day (this could be walking in your neighborhood). Exercise helps us dissipate the anxiety that often accompanies worry.
  • Avoid Substance Abuse. Drugs and alcohol may give the illusion of comfort for the time being, but using them has negative long-term consequences. They increase depression, cloud your judgment, and may give you something to really worry about later.
  • Add Structure to Your Life. Worry is often related to disorganization. Make a list of things to do each day and cross off tasks once they are completed. Leave early enough to make appointments on time. Put your keys in the same place every time you come home. Keep your house straightened up. When things are under control, there is less to worry about.
  • Minimize Catastrophic Thinking. Some people find it difficult to keep perspective when faced with even a minor stressor. Not every mole means cancer and not every bill is going to lead to bankruptcy. Test out the reality of these situations by talking them over with a trusted friend.
  • Keep a Pad by Your Bed and Make a Note of a Problem. Rather than tossing and turning all night as you worry about a problem, jot down a note about the problem and resolve to get to sleep – and then consider the problem in the light of the next day.
  • Limit Your Exposure to the News. Although there is value in keeping up with the latest news, understand that the media focus on bad news since this tends to sell best. We seldom hear about the good news in the world on TV or newspapers. Constant exposure to negative events increases our tendency to worry. Instead, look for what is good in life.
  • Keep Yourself Financially Secure. Live below your means and put money into a savings account. Pay off credit card debts. Consider ways to live more simply as a way of managing your finances.
  • Learn the Value of Judicious Complaining. Sometimes it helps to talk your way through a problem by complaining about it. Find a trusted friend and just let it all out. And then have a good laugh about it afterwards. If a friend is not available, write out your complaints.
  • Learn how to Let Go of Worries. This is a skill which might require some practice, and each of us will have our way of doing it. Some people do this by allowing themselves perhaps half an hour a day of worry time – and at the end of the allotted time period, they will be free of worrying until the next day. Some people give up their worries by writing them down on a piece of paper and then tearing up the paper. Some people prefer to hand them over to a higher power. There are mindfulness meditation techniques for letting go of your worrisome thoughts – just decide not to participate in anxiety-provoking thinking. Let the thoughts go (this method takes practice and uses techniques that increase your awareness through meditation or prayer).
  • Don’t Sweat the Small Stuff. And, in a sense, if you think about it, it’s almost all small stuff.

The Serenity Prayer

God grant me the serenity

To accept the things I cannot change,

Courage to change the things I can,

And wisdom to know the difference.

A Strategy for Learning to Manage Worry

Many people who worry excessively may not know that they even have a problem, although their tendency to worry may have serious consequences such as increased stress and a constricted lifestyle. They assume that this is the normal state of affairs for most people. Learning to manage worry, however, can open a new world of life experiences where problems are faced constructively and assertively. The following steps might be considered as part of a general strategy for getting worry under control.

  • Embrace the Problem. Examine your worrying tendencies. What triggers off an episode of worry? How do you experience worry? Does it happen at any special time of the day? What happens to you physically when you worry? What are your thoughts? Might worry for you be a symptom of an underlying condition such as depression, panic disorder, GAD, or PTSD? Learn everything you can about your worry. Defining and accepting it can take us a long way toward getting the problem under control.
  • Think Positively and Plan Constructively. Worry often involves negative thinking and repetitive thoughts that fail to solve our problems. When you catch yourself in a negative thought pattern, distract yourself (snap your fingers, tap your wrist), stop the thought and replace it with a more positive thought. If you work on this conscientiously over time, you can begin to develop a more positive way of thinking. Take a structured approach toward solving life’s problems. List the alternatives for solving the problem and choose an option that will work in the real world. List the steps you need to take to make that solution work – and then go to it, crossing off every step as you complete it.
  • Find Reassurance and Support. Work toward finding social support by making connections with family, friends, community groups, nature, or spiritual/religious organizations. Find someone who will listen to your thoughts and who can give you reassurance. It also helps, when you find yourself embedded in the morass of worry, to change your physical state. You can do this by exercising, meditating, praying, watching a movie, playing with a pet, calling a friend, listening to music, reading, or dancing.
  • Psychotherapy. Therapy provides some very powerful and effectual interventions for coming to terms with worry in a safe and supportive setting. You can learn productive ways to solve problems and to increase your effectiveness in the world. Everyone deserves the chance to function fully and completely – and with happiness.