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All about Worry

What is worry?

Worry is closely related to anxiety but it is different. Worry is cognitive activity, meaning it happens above your neck! Worry is all that thought-based self-talk activity that leads to anxiety. It tends to be verbal rather than imaginal, so it’s the ongoing narrative self-talk kind of chatter than hums along in our heads. Worry tends to be future oriented rather than focused on the past. And it frequently involves “What if…?” kinds of questions or predictions of future negative outcomes. Worry comes from our ability to think about the future and to imagine possible scenarios that might happen. As humans have evolved this capacity for imagining the future in a way that animals can’t, our anxiety has also increased. Dr. David Barlow calls this “the dark side of intelligence.”

What is Generalized Anxiety Disorder?

Generalized Anxiety Disorder is a diagnosis known for chronic, uncontrollable worry. Compared to people with other kinds of focused anxiety, people with GAD  (pronounced spelled out G-A-D)  tend to have vague, not-well-defined worries about the future. They also tend to have more trouble stopping the worry once they get started compared to other people. Most research shows that, in general, people with GAD don’t worry about different types of things than other people, but they do tend to worry more about little things like chores around the house, being late to appointments, etc. People with GAD experience significant physical symptoms when they worry. To meet criteria for a diagnosis, three of six physical symptoms have to show up more days than not in the last six months. These physical symptoms include:

  • feeling restless, keyed up, or on edge
  • trouble falling asleep or trouble staying asleep
  • difficulty concentrating or your mind going blank
  • muscle tension, especially in your shoulders, neck, or jaw
  • feelings of fatigue
  • irritability

Other symptoms include headaches, stomach aches, and being easily startled.

Common Worry Themes

There are also some common themes to worries in general. These themes tend to include beliefs about the importance of control, and over exaggerated sense of responsibility and the desire for perfection (or having unrealistically high standards). The desire for control can take many forms but in terms of worry often looks like over preparing, over planning, or over thinking in order to try to get a certain outcome or ensure a certain kind of perception by others. Worriers with high needs for control also have trouble delegating to others (with tasks at work or chores at home). A sense of over responsibility can look like taking on more than is necessary because of beliefs that their influence on a particular outcome is greater than it actually is. For example, if you have someone over to your house you may feel responsible for them having a good time and put a great deal of effort into decorations, food and drinks, and stressing about the conversation, when actually the responsibility to enjoy themselves is on the guests! Finally, perfectionism involves having very high standards or rigid expectations for the behavior of self and others. When these expectations aren’t reached, worriers tend to be hard on themselves and very self-critical. They might also be critical or controlling of other people’s behavior if it’s not consistent with their own expectations.

The First Step to Taking Control of Worry

One of the first steps to getting a handle on worry is to recognize your worry triggers and how your worry spirals from there. Doing this will help you:

  • recognize signs and symptoms of your worry so you can intervene sooner
  • identify triggers that are likely to prompt your worry, so you can be prepared to use your skills
  • introduce things that make the worry better and disrupt the cycle
  • avoid things that make the worry worse and keep it going longer

You might start by collecting information about how your worry spirals unfold.You’ll first need to learn about your worry triggers, the signs and symptoms that make up your worry, and then work to identify which ones show up earliest in the cycle. For example, I tend to clench my teeth when I’m worrying about something. I use that to alert me that I need to take care of myself. When I notice it, I think back and ask myself what the trigger was—when did my mood go from okay to worried? Asking this would help me remember that it was when I read an email about a meeting next week. I would then remember that I thought, “Oh no, I have to bring up bad news in that meeting. What if I someone gets upset with me?” I would remember that this thought led to me “venting” to my co-worker, which only made it worse, and that led to my teeth clenching. When you can recognize the thoughts, feelings, and behaviors that unfold during your worry you can recognize them as signals to try something different, like relaxing your body and mind or challenging negative thoughts so that they’re more flexible. If you notice you have a lot of worries that are difficult to control and experience physical symptoms that get in the way of you enjoying your free time or interfere with work or school,  it might be time to talk to your doctor or a therapist about getting some help. Not sure where to start? Psychology Today has a great Find a Therapist option that can help or you can contact me for a free 15 minute consultation

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