Most clinicians and researchers agree that worrying is a central feature of generalised anxiety disorder. As we discussed in my last entry, one of the common things that people with generalised anxiety disorder experience is chronic worrying.
The aim of this entry is to provide an overview of what worrying is, what triggers worrying, what keeps it going, and most importantly, how to treat it effectively.
UNDERSTANDING WORRYING
You can think of worrying as a self-talk activity, where we 'talk to ourselves' about possible future negative events that might happen and of which we are afraid. We discuss the event with ourselves and we think about how we might deal with it should the event happen. As such, worrying is a type of vigilance for threat, and an 'attempt' at mentally 'solving problems' that haven't yet happened. We say 'attempt' because often a good solution is not found, and people are left thinking they will not be able to cope should their worst fears happen. We say 'solving problems' because people often think that worrying is problem-solving, when in fact effective problem-solving is a very different type of activity (which you will read about in entry 9)
"WHAT IF..." WORRIES
People with generalised anxiety are often having an internal conversation about things they fear might happen. In this way, worrying often occurs in the form of "What if......" questions. The questions play in your mind like a song and the words may sound like these:
"What if I can't get to my appointment on time?"
"What if I fail my exam?"
"What if I can't do the job?"
"What if I can't provide for my family?"
"What if something happens to my child?"
"What if my husband/wife/partner has an accident?"
"What if I get anxious during my interview?"
"What if my face turns red?"
"What if I get sick?"
As you will have noticed, the abbove examples of worrisome thoughts are about external things (e.g., work, family, etc) or internal physical things (e.g., illness.)
What are the "What if..." questions you often ask yourself? (What external things or internal physical things do you tend to worry about?).
WHAT TRIGGERS WORRYING?
Worrying can be triggered by various things. Some triggers may be more obvious and linked to external things for example:
*Seeing a certain image (e.g., in the newspaper or on the T.V. news)
* Hearing certain information (e.g., on the radio or in a conversation)
* Being put in a certain situation (e.g., having to make decisions, perform a task, lead others)
Some triggers may be less obvious. These may be thoughts or images that seem to just pop into your head out of the blue. An initial "What if....." question that comes to mind for no apparent reason, can even be a trigger for worrying. For example, the thought "What if I left the iron on?" might pop into my head. If i think "I probably didn't" and decide not to worry about it, chances are i will forget about it, and the thought will slip my mind. However. if instead I start to 'chase' the thought further (e.g. "The ironing board might catch fire and that will spread to the whole house." "The house might burn down and then i will lose everything."), then the original "What if..." question has now triggered a worry episode.
Write down any external images, information, and situations, or any internal images or "What if...." thoughts, that have triggered worrying for you.
WHAT MAINTAINS WORRYING?
People who describe themselves as chronic worriers are often disturbed that they seem to spend much of their waking hours worrying excessively about a number of different life circumstances. They do not understand why this activity continues. They often ask, "Why do i do it?" and "What keeps my worrying going?"
NEGATIVE BELIEFS ABOUT WORRYING
In addition to the specific things people worry about, people with generalised anxiety disorder may also worry about that fact that they are worrying. In this case, such worriers are often concerned that worrying is "bad" and they hold negative beliefs about the activity of worrying. For example, they may believe that:
* Worrying is uncontrollable, and will take over and result in a loss of control (e.g. "I won't be able to control my worrying, and it will never stop".)
* Worrying is dangerous, and will cause either physical or mental harm (e.g. "If I keep worrying like this I will go crazy/have a breakdown/become ill.")
Holding these negative beliefs about worrying makes the process of worrying very distressing for you, and this will even keep your worrying going. Researchers believe that it may be these negative beliefs about worrying that are unique to people with generalised anxiety disorder.
What worries-about-worrying do you have? (What are the disadvantages of worrying?)
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