Anxiety Files

Simple and powerful techniques for coping with anxiety and worry.
Robert L. Leahy, Ph.D., is the author of Anxiety Free and The Worry Cure. He is Clinical Professor of Psychology in Psychiatry at Weill-Cornell Medical School and Director of the American Institute for Cognitive Therapy. See full bio

Eight Weeks to End Your Worries

Eight Weeks to End Your Worries

worryThe 8-Week Challenge

OK worriers. Here is the challenge for you. I will dedicate this blog for the next eight weeks to giving you the tools to get a handle on your worries. But it's going to require some work. Are you willing to actually do something to deal with your worries?

All of us worry at times---but some of us worry almost every day. In fact, 38 % of people say that they worry every day and chronic worriers often say, "I've been a worrier all my life". Worry eventually leads to depression and makes your life miserable. So, let's do something about it.

What is a worry?

What do I mean by "worry"? Let's define worry as repetitive thoughts about the future that are pessimistic. Typical worries are in the form of "what if?" statements. Do any of the following sound familiar to you?

• What if I never find the lover of my dreams?
• What if I end up alone?
• What if I have a dreaded disease?
• What if my money runs out?
• What if my lover leaves me?
• What if someone I care about gets hurt?
• What if made a mistake?
• What if I get rejected?
• What if I make a complete fool of myself?
• What if I never get to sleep?

You get the picture.

wheelsYour worries are predictions---- and they just get repeated over and over in your head. It's not like you have one thought for one minute--- "What if I have a dreaded disease?"---and then you move on to your usual activity. I am not going to count that as a worry. That's just an annoying thought. No, worry for us will be repeating these thoughts, getting stuck on them, feeling like you need the answer to them---and that they are important for you. You keep spinning your wheels in a thought and you never move forward.

Worries are not your feelings. For example, saying "I feel anxious" is a report about your emotions, it's not a prediction. A prediction is a statement that we could potentially check out and find if it's true or false. For example, "I will fail the exam" is something we can verify.

Do you have Generalized Anxiety Disorder?

Take a look at the list below and see if you qualify for the diagnosis of Generalized Anxiety Disorder (GAD).

• Excessive worry for most days for six months

• Difficulty controlling the worry

• Your worry interferes with your daily life

• Three of the following symptoms most days:

o restlessness or feeling keyed up or on edge
o being easily fatigued
o irritability
o muscle tension
o difficulty falling or staying asleep, or restless unsatisfying sleep
o difficulty concentrating or the mind going blank

 

GAD is chronic. One year after being diagnosed (but not treated) 85 % of people with GAD are still having significant problems. In about three-fourths of the cases of GAD, their worry has preceded their depression-and their depression is often a chronic, low-level depression, marked by pessimism, lack of confidence, and difficulty in enjoying things.

How Your Worry Affects You

tensionChronic worry-the kind that goes on for months--- is a central feature of "Generalized Anxiety Disorder" (GAD). About 7 % of us have GAD-and women are twice as likely as men to suffer from this problem. (In fact, in one study, where they loosened the definition of GAD, 24% of people had many of the symptoms at some time.) If you have GAD, then you worry about several things. For example, a mother worried about her daughter, her own work, her ex-husband making payments and falling asleep. She also worried that she was worrying too much. People with GAD have muscle tension, difficulty with digestion, aches and pains, fatigue, and difficulty concentrating.

In fact, 93% of people who have GAD also have another psychiatric problem, usually depression or another anxiety disorder. People with GAD are more likely than others to see gastroenterologists and cardiologists. 25% of people who see their physicians for psychological problems have GAD.

Your chronic worry can result in nausea, irritable bowel syndrome, fatigue, aches and pains, difficulty concentrating, indecisiveness, and feelings of hopelessness. Your anxiety and your worry may lead you to smoke more, drink excessively, misuse drugs, binge eat, or lose sleep

Do your worries have an impact on your life? For example, do any of the following apply to you?

• I worry so much that I can't relax.
• My worries keep me from enjoying things.
• There are things that I am afraid of doing because they will make me worry.
• I can't get my worries out of my head.
• I try to stop worrying, but I can't.
• I am often aware of my thoughts and how they bother me.
• I often ask other people to reassure me.
• I think my worry is out of control.
• I'm driving myself crazy (or making myself sick) from all my worrying.
• I am exhausting myself with my worry.

If any of these statements applies to you, then you have a problem with your worry. If someone you know could say yes to any of these statements, send this article to them.

The good news is that there is something you can do about worry. With new forms of cognitive-behavioral therapy, people can get substantial relief from their worry.

The Worst Advice

worst adviceBut let's start with the worst advice--- the kind of advice that doesn't work---but people keep telling you to follow. Do people tell you the following?

• Try to think positively.
• Why do you punish yourself with your worries?
• You need to believe in yourself.
• Just tell yourself to "STOP WORRYING".

We could go on with more well-intentioned, but useless advice. But none of it helps.

Getting Started

Getting StartedTake a look at some of my previous blogs on anxiety and worry---- how your worry makes sense to you, how worry is related to intolerance of uncertainty, the innate predisposition toward anxiety, and the difference between productive and unproductive worry. See my blogs at http://blogs.psychologytoday.com/blog/anxiety-free These blogs should give you some valuable information on the nature of anxiety and worry.

Getting a handle on your worries will require work on a daily basis. Not a lot of time, but you need to be disciplined. Your worry is not going to go away completely and there is no magic bullet. But there are a lot of self-help techniques that we have in cognitive-behavioral therapy that can be useful to you. But it's like the health club--- you can join it, but you need to use it.

What do you have to lose by doing something constructive?

Here are some suggestions for you to start with---this week--- to get a handle on your worries. Keep a written record so that you can see what you are doing and check on your progress.

1. List your specific worries
The first thing you need to do is to keep a record of your worries. Write down the most common negative thoughts about the future that are bothering you. Feel free to add to the list. You need to be aware of these worries if you are going to do anything about them.

My Specific WorryI’ll never get my work done.My boss will be angry.I’ll look like a fool if I say something.I will run out of money.I will never get to sleep.

2. What triggers your worry?
Sometimes our worries are triggered by particular situations. For example, you might begin to worry about money when you spend more money than you want or you get your bills. You might worry about your appearance more before you go to a party.

TriggerActual WorryLying in bed at nightI will never get to sleep. I won’t be able to concentrate tomorrow. I’ll look exhausted.Opening my bills.I am running out of money. I’ll go broke. They will foreclose on my house. What if I lose my job, then what?Planning on going to a party.I look ridiculous. What will I say? I’ll sound boring. No one will like me.



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