Family physician Joan Smith used to enjoy her patients and practicing medicine, but then she became terribly worried about being sued again. Five years ago, you see, a formerly friendly patient filed a nonsense lawsuit. The patient alleged Smith did not spend enough time with him during one appointment.
The case was dismissed, but the embarrassment remained. Smith found herself taking extra steps every time she saw a patient–just in case another lawsuit was filed. When she received mail, she found herself scanning the return addresses for lawyers’ names. She was so worried about another court appearance that she spoke less with her patients and worked from a defensive stance, often second-guessing herself. In her mind’s eye, she saw somebody in a courtroom reading aloud every entry in every report, medical file, prescription and note she ever penned.
At home, there were sleepless nights. While driving, she had distant thoughts. And she was jolted by sudden moments of despair. She sometimes felt like she was living on the edge of doom.
Then there’s the story of a promising economics graduate from Dartmouth College in Hanover, N.H., who intended to become a top financial planner, like one of his favorite uncles. But at 43, he still was running a clothing store in a small New England town.
The man began to worry that he couldn’t do anything right; he became jittery before making telephone calls. He was so tied up in knots, he hid in the back office, crunching numbers, placing orders and tracking inventories. He was sure life had passed him by and he fretted about that too.
“Worry is a special form of fear,” says Dr. Edward M. Hallowell, senior lecturer at Harvard Medical School in Boston and author of “Worry: Controlling It and Using It Wisely.”
“To create worry, humans elongate fear with anticipation and memory, expand it into imagination and fuel it with emotion. The uniquely human mental process we call worry depends upon having a brain that can reason, remember, reflect, feel and imagine.”
Of course, nothing is wrong with some worry. It allows for planning.
Garden-variety worry prompts you to take care of necessary business by acting like nature’s alarm clock and sounding only when your attention is misplaced. Ordinary worry can be a key to success in life because it makes you anticipate what might go wrong and remember not to repeat past mistakes.
But “toxic worry” is a despair that causes a hand-wringing, gloomy and heavy brooding that restricts your actions, moods and thoughts. Toxic worry is like an alarm clock that frequently goes off when it’s not supposed to ring.
Smith eventually saw a psychiatrist about her excessive worrying, overcame it and learned to enjoy her patients as well as the practice of medicine.
The Dartmouth graduate also learned that his worry was treatable. He had always assumed that his fretting was unstoppable, and a moral weakness. But in reality, he, like many others, was born high-strung and prone to worry. He was in a dead-end job because he chose a far less competitive and stressful career. Like many excessive worriers, he used avoidance as his best means of coping.
After some training, he learned to boost his self-confidence and short-circuit the brooding by directing his mind away from harmful anxiety. He also learned to speak differently in his mind, soothing and encouraging himself with phrases like: “You’re doing your best,” “Give it a shot” and “Cut yourself some slack.” Eventually, he became a financial planner, not in Boston or New York City, but in the small town where he lived.
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Depending on your stage of life, some common worries may head your list of heavy daily concerns. When not worrying about having fun, children fret about issues of personal safety or that their parents might die. Older children and teens worry about their emerging identities, competence in school and first romances. Young adults, meanwhile, agonize about material things and first homes, while people in midlife tend to sweat out the details of career and child raising. Retired people lose sleep about being alone, illness and death.
Many people carry a huge load of toxic worry. They always expect the worst and believe that a Chicken Little attitude to life is somehow necessary for survival. When a career worrier is in control, there is rarely a situation or challenge not laden with imminent disaster.
The unspoken logic of a chronic worrier is that hand-wringing, constant fretting and sleepless nights will serve as some form of protection against unseen disasters. In reality, the worrier’s woes cloud better judgment.
Moreover, worriers tend to cluster in families. “To put it simply,” says Hallowell, “you might be a born worrier.”
Sometimes needless worry stems from depression or from painful shyness.
For other people, constant stewing often stems from broken trust, a broken heart or loss of faith somewhere in their lives. “If you suffer injustice in a major way at the wrong time, you may never be the same,” Hallowell says. “Afterward, you may worry constantly about the same thing happening again.
“Brooding and worry often come from a heightened sense of vulnerability in the presence of a diminished sense of power,” Hallowell says. “People also worry too much when they perceive a threat or feel they can’t control events.”
Toxic worriers are also prone to cycles of self-blame, doubt and criticism. For all these reasons, behavioral experts say the tendency to sweat blood over every little thing is also considered one of the worst possible, deeply entrenched negative habits. Left unchecked, worry soon deteriorates into a very serious state of anxiety and then paranoia, conditions that require more serious, longer treatments.
“In the U.S. alone, about 20 million people, one in every nine, has an anxiety disorder,” says Dr. Daniel B. Borenstein, president of the American Psychiatric Association in Washington, D.C. “Those conditions all started with excessive, needless worry.”
Defeating the worrywart syndrome is important to one’s general health because it can lead to depression, panic and obsessive-compulsive disorders, and even attention deficit disorders.
Moreover, your internal organs are affected. Excessive worry raises blood pressure, which is associated with higher risks for heart attack and stroke. Constant stewing also depresses the body’s immune system, which means you will have more trouble fighting off colds and flu. Toxic worry can cause chronic neck and back pain, breathing problems, sexual dysfunctions and digestive disorders.
“Medical science has proved that excessive worry is as much a public health risk as excessive blood pressure,” Hallowell says.
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Yet another reason for being so tied up in knots is the Information Age and the flood of news and knowledge, both useful and useless.
“One hundred years ago, people had limited exposure to the world around them,” says author Mary Ellen Copeland, author of “The Worry Control Workbook.” “People basically knew what was happening in their families and communities. Now we are inundated with information about horrible things that happen worldwide.”
To help defeat that information flood, Copeland suggests that individuals try to concentrate on what’s happening around them right now.
In one case, a businesswoman fretted too much about air travel. Though statistics show she would be safer in a modern jetliner than in her own car, she worried obsessively that any plane on which she traveled was doomed. The worry was holding her back at work because she had agreed to travel in her job as a pharmaceutical sales representative. So she made an appointment with a therapist. But in the middle of her first session, a plane crashed at the local airport and made her worry more obsessively than ever.
“I showed her some techniques to relax her mind,” says Gary Schroeder, a psychologist and assistant professor in the Adult Outpatient Psychiatry Clinic at the University of Arkansas Medical Center in Little Rock. “The first thing to do is close your eyes and breathe deeply from the diaphragm. Hold your breath for several seconds, and let the air out through pursed lips. It helps slow runaway fear and worry.”
Diaphragmaic breathing, a form of controlled breathing, is calming and takes attention away from whatever causes the worry and anxiety. Following that, the frantic person does something known as “body scanning” or “progressive relaxation.” With closed eyes, he or she imagines relaxation and comfort taking place in the scalp, neck, shoulders and then all the way down to the feet.
Once the body is calm, the person then thinks through the most to the least fearful situations. For instance, taking off in an airplane in a storm over the ocean from a foreign country might cause worry bordering on panic. But making a short flight of only 100 miles with a trusted friend in excellent weather may not be so terrifying after all. After those thinking drills are repeated for some weeks, the worrier steps up the activity and starts to confront his worst fear by driving somebody else to the airport. The final cure and release of the overwhelming stress is when the afflicted person actually gets on board a plane and takes a brief flight.
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Another technique that defeats worry is to examine the evidence. When one patient worried excessively about being in tall buildings, her mental-health worker asked her to list all the terrible things that happened when she had been on the fifth, 20th and 50th stories of a building. Had anybody fallen out of a window? How any of the buildings collapsed? Because the answers were “no” or “none,” the afflicted person was told to think carefully about what might happen the next time she visited a building’s upper floors.
“Worry is predominantly an intense mental activity,” Schroeder says.
“When a worrier understands his fears exist only in the mind, and without any real reasons, the despair tends to be defused.”
Adds the American Psychiatric Association’s Borenstein: “Often, irrational worries can be caused by extremely stressful events. A person may see a horrible auto accident and then start worrying obsessively about being in a car wreck too. If the worry lasts longer than six months, red warning flags should go up, and the person should read more about the topic and perhaps get help from a human behavior professional.”
Yet another way to defeat the over-fretting syndrome is to check your personal “connectedness.”
“People who are more connected–to other people, to ideas, to meaningful jobs, to prayer and the spiritual dimensions of life–easily go beyond the emotional ghetto of brooding,” Hallowell says.
