Getting To Know Stress: Worry Management

What is worry?

According to the Association of Behavioral and Cognitive Therapies, worry is an anxious way of thinking about ourselves and the world. It usually centers around what bad things might happen in the future, and whether we will be able to cope with them. 

Worry is a kind of repetitive negative thinking, or negative self talk, in which we mentally attempt to solve problems that have not happened yet. 

"What if . . ." questions are often the starting point for worry. These questions that pop into our minds can be followed by anxious feelings and sensations. Some examples of what-if questions are:

• "What if I lose my job?"
• "What if my child gets sick?" 
• "What if I'm late for my appointment?"
• "What if I can't fall asleep?"

Worry has a chaining quality. Let's say your worry is, "What if I can't fall asleep?" You might then think, "I won't be able to perform well at my job tomorrow," and then, "My boss will fire me," followed by, "I won't be able to support my family," and conclude with, "We'll become homeless."

External things, such as reading the news, or a situation, such as having to make a decision, can trigger worry. Internal triggers, such as thoughts, images, and sensations, can also provoke worry. 

Why is it so hard to stop worrying?

Unfortunately, many people hold false but positive beliefs about worry. People who worry a lot often believe that:

• Worrying leads to solutions to problems.
• Worrying leads to a greater understanding of problems.
• Worrying is motivating.
• Worrying helps to prepare for the worst outcomes.
• Worrying prevents bad things from happening.
• Worrying means being a good person.
• Worrying means protection from bad feelings (e.g. "If I worry about something now, I won't be so upset if it happens down the road").

These positive beliefs can keep us stuck in cycles of worry. If we believe that worrying is helpful, we are more likely to listen to and spend time on our initial "What if...?" questions. Our original worry multiplies and becomes more intense.

Because worrying feels uncomfortable, we often try to control our worries. Sadly, these unhelpful avoidant coping strategies, or attempts to stop our worrying, just keep us mired in the worry cycle. Avoidant coping strategies can be both mental and behavioral. Here are some examples:

• Suppressing worries (e.g. telling ourselves to ‚Äòquit worrying')
• Pushing away anxious feelings
• Distracting ourselves
• Reassuring ourselves (e.g. telling ourselves ‚Äòeverything will be okay')
• Seeking reassurance from other people
• Excessively researching topics on Google
• Excessively making lists 

Research shows that trying to stop an uncomfortable thought often makes it return more frequently. Try not thinking about a white bear for 30 seconds. What do you think about? Avoidant coping strategies keep us from facing our worries, and in fact backfire. They just keep us worrying more. These unhelpful strategies prevent us from learning that our worst fears do not actually come true, and that our positive beliefs about worry are not helpful. We continue to buy into the notion that worry is uncontrollable.

How do I know if I am worrying too much?

The Association of Behavioral and Cognitive Therapies stresses the difference between normal and problematic worry. Almost everyone worries at some point. It is normal for worry to spike when we face problems, dangers, or new or unfamiliar situations. 

For about 3% of Americans, though, or 6.8 millions adults, worry goes beyond normal. The Anxiety and Depression Association of America (ADAA) explains that people with Generalized Anxiety Disorder (GAD) worry excessively and uncontrollably, which interferes with their daily functioning. They worry about a range of stressors, such as finances, health, work, family, and global events, and may also find themselves worrying about minor matters (such as running errands.) People with GAD also experience physical symptoms, such as muscle tension and feeling on edge. According to the ADAA, people with GAD may also have difficulty tolerating uncertainty, and try to plan or control situations. 

If you are curious about whether you might have GAD, the U.S. Department of Veterans Affairs suggests asking yourself these screening questions: 

• Do you continually worry or feel anxious about a number of events or activities in your daily life?
• Have you experienced this worry for at least 6 months?
• Do you have trouble controlling your worry?
• Do worry and symptoms of tension slow you down or keep you from doing the things you need to?

If you answered, "yes," to one or more of these questions, you may want to consider talking with your doctor. 

It is normal to experience an increase in worry, especially when there are a lot of stressful events going on around us. Lark coaches you on stress management strategies sourced from CBT, which can make a big dent in your overall anxiety levels. However, if you think you are struggling with chronic worry or GAD, it is best to talk with your doctor. 

So if I cannot just tell myself to stop worrying, what should I do?

If you have been diagnosed with GAD or consider yourself a worrier, you might be aware that you are worrying too much, but you might still hold some beliefs about worry being helpful or useful. 

But worry is not as beneficial as you believe. Anxiety Canada encourages worriers to act as detectives, taking a critical look at their positive beliefs about worry.

Anxiety Canada also suggests rethinking the helpfulness of your worries, checking in with yourself about how much you've lost to worry. Try asking yourself:

• Has worry impacted my relationships? Do people get annoyed with me because of my worrying?
• How much time, effort, and energy have I devoted to worrying? Is it worth it?
• How has worry impacted my physical health? Am I often tense and tired, and do I struggle with sleep because of my worrying? 
• Could I gain the benefits I believe I get from worrying in a different way?

If you are changing your mind about how helpful your worrying is, and are starting to see the costs of it, read on to gain some new worry management skills.

5 steps to managing your worries

The Association for Behavioral and Cognitive Therapies (ABCT) recommends practicing five steps if you've noticed that you're worrying too frequently or too intensely: 

1. Pick a 30-minute "worry time" that will take place at the same time and place each day.

2. Observe your daily worrying and learn to catch it earlier and earlier. You can do this by practicing mindfulness.

3. When you catch a worry forming, jot it down somewhere (the Notes section of your phone or a piece of paper will do), and delay focusing on it until your worry time. Tell yourself that you'll have time then to worry about it, and there isn't any point in getting upset over it now.

4. Redirect your attention to the task at hand.

5. When you get to your worry time, differentiate between worries over which you have little or no control, and worries about problems that you do have control over. This is the first step in problem-solving. If you can have some power over the problem, brainstorm some action steps, weigh their pros and cons, pick the best one, and plan it. (It helps to actually schedule a time and day to implement this step.) If the problem is mostly outside your control, remind yourself that it's not fixable, and there's no use worrying. 

Part of step 5 can also involve identifying the worst possible outcome, as it is often something that is not likely to happen, and with which you could cope. We will talk about how to do this next.

Facing worries head-on: worry scripts 

For hypothetical situations over which you have little or no control, Anxiety Canada describes a powerful tool based on the principle of exposure from Cognitive-Behavioral Therapy. Contrary to what your intuition might say, research shows that ‘exposing' yourself to these worries on purpose can actually help you cope better. You can ‘expose' yourself to your worries head-on by writing a worry script.

Examples of hypothetical, uncontrollable situations include to write a worry script about:

• Worries about you or a loved one coming down with a serious illness
• Worries about you or a loved one being in an accident, getting injured, or killed
• Worries about failure or loss (e.g. losing your job, getting divorced)

Remember that worry takes a lot of time, energy, and effort, and can make your anxiety worse in the long term. By facing worry thoughts, you will learn that you are able to handle them, that your anxiety about them goes down over time, and that you do not have to go to such great lengths to try to avoid them. You will change how you think about your worry, get a better idea of what you are afraid of -- and likely develop some actions steps that had not occurred to you before. Another bonus of a worry script is that when you begin to work on one worry, your anxiety about other worries usually goes down.

How to write a worry script

Anxiety Canada maps out a handy process for writing a worry script:

• Write about your worst-case scenario for one of your hypothetical worries. If you are afraid you might lose your job, you would write about losing your job.
• Incorporate your 5 senses (smell, sight, touch, smell, hearing), feelings, and actions. Make your script vivid and visual. If you are writing about losing your job, you might write about what your boss says to you, feeling your heart racing, having to pack up your belongings, etc.
• Write out (or record and listen to) your worry script for 30 minutes every day for 2 weeks, or until the script no longer produces anxiety. Schedule a time for this.
• Make sure you are writing out or listening to your script for enough time every day that you get a chance to experience a significant drop in anxiety each session.
• Write out or listen to your script by yourself in a place as free of distractions as possible (the bathroom will work in a pinch.) 
• If you experience increased anxiety while writing or listening to your script, that is normal -- you are writing about a scary scenario! Anxiety means the exposure is effective in helping you face your bothersome thoughts and feelings, rather than avoiding them. While this reaction may be uncomfortable in the short term, it will help you worry less in the long run.