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Tuesday, November 22, 2011

What Me Worry?

Here is Part II of my posts about worry.

Even if you do not have a clinically-diagnosed anxiety disorder, chances are, like most North Americans, you live with some degree of chronic stress.

Stress and anxiety are insidious and can case a whole host of physical and psychological problems.

My whole cracked-tooth fiasco this fall, which ultimately led to painful and EXTREMELY expensive root canal and crown procedures, was all due to my tendency to clench my jaw and grind my teeth when I am under stress.

Nevertheless, I have made significant improvements to my stress management over the past few years. Because of my high anxiety levels, I struggled with insomnia for over a decade.

Chronic stress has been linked with heart disease and obesity (because of elevated stress hormones) and anxiety is also associated with clinical depression. For many of us, our stress and anxiety is due to worry - what's going on in our heads, not our environments (i.e., not due to survival - out-running a saber-toothed tiger -, as it was for our paleo-ancestors, nor war, famine or natural disaster, as it is for millions of people in the developing world).

The main things most people tend to worry about are:

1. Money
2. Work/career
3. Health
4. Relationships
5. Lack of confidence/self-presentation

It isn't realistic for most of us to just stop worrying. Some degree of worry can be productive. The first step is becoming aware of your worries. Even if you think you are a particularly self-aware individual, you may be surprised by what you have not noticed about your thoughts until you really focus in on them. Sometimes you don't even realize you are worrying - especially if you are a chronic worrier - until you experience the physical effects from it (insomnia, pain, fatigue, irritability, etc.).

There are some very straightforward ways you can keep your worry from getting out of control. Learning to worry more effectively involves several steps:

1. Identifying the source of your worry
2. Determining if you have any control over the issue
3. Deciding if it makes sense to take action
4. Decide when to take action
5. Actively problem solve to resolve issue

I like to use a graphic representation called The Worry Tree, a tool often used in cognitive-behavioural therapy (CBT):

http://www.get.gg/docs/worrytree.pdf

People who worry a lot also tend to ruminate. Unlike worry, which is future-focused (what if, etc.), rumination is past-focused (i.e. Dwelling on a mistake, etc.). Rumination is another common symptom of anxiety disorders and depression.

http://www.get.gg/docs/RuminationWorry.pdf

If you are wondering whether or not your worry might be excessive, try taking this quiz:

https://www.outcometracker.org/library/PSWQ.pdf

If you feel that worry is negatively affecting your life and/or health, do not be ashamed to get help. Avoidant coping strategies (i.e. drinking, taking drugs, shopping, eating, etc.) generally only make things worse but psychotherapy, particularly CBT, and some anti-depressant medications can be very effective.

"Worry never robs tomorrow of its sorrow, it only saps today of its joy". ~Leo Buscaglia