Warding Off Worries
A new book examines why women tend to worry more than men, and what we can all do to stop stress
By Barbara Kantrowitz and Pat Wingert
Nov. 1, 2005 - Do you think youíre a born worrier? You might be. According to the National Institutes of Mental Health, about 19 million American adults suffer from anxiety disorders, with women more likely than men to be literally ďsick with worry.Ē In ďThe Worry Cure,Ē to be published by Harmony Books next week, psychologist Robert Leahy explains why we worry so much and outlines seven steps to curb that ever-mounting stress.
Worrying may not seem like a problem that needs professional attention, but Leahy argues that excessive worrying can be a precursor to more serious illness, like depression. He recommends seeking help if your worrying feels out of control, if you feel itís intensifying or if your physical health is affected (as evidenced by indigestion, insomnia or constant fatigue). As the director of the American Institute for Cognitive Therapy in New York City, Leahy teaches patients to fight worry through cognitive behavior therapy, which aims at changing thought patterns that lead to anxiety. We spoke to Leahy about why women are more prone to worrying, how anxiety affects us and how to stop fretting so much. Excerpts:
NEWSWEEK: Why do women worry more than men?
Dr. Robert Leahy: There are a number of possibilities. Worriers tend to be more concerned about how other people feel and are better at empathy than nonworriers. Worriers also overempathize, and I think women are more likely to do this than men. In other words, they are concerned with the effect a particular action might have had on another person. Women also tend to ruminate a lot. They tend to go over something over and over again to be sure itís the correct decision. Men are more willing to fail--or perhaps men have more of an illusion that theyíre not failing. The extent to which you worry and the extent to which you ruminate predicts whether or not youíre going to be depressed and whether or not youíre going to stay depressed. Worry tends to precede the onset of depression. You keep anticipating the worst thing happening. Worriers are intolerant of uncertainty. They believe that if they donít know for sure what the outcome is going to be, it will be bad. And they think they need to continue worrying until they find a perfect solution.
Whatís happening in our brains when we worry?
The emotional part of the brain tends to be deactivated to some extent. Thatís the amygdala, where all your anger, anxiety and arousal come from. Whatís activated is the thinking part of the brain, the part that allows us to have language and abstract thinking. When people worry, almost all their worry is in terms of language and abstract thinking. People who worry have a hard time identifying and differentiating their emotions. They have very negative views of their emotions. They feel they have to get rid of unpleasant emotions immediately. Worrying is a way of avoiding the impact of emotion.
How does worrying affect the rest of our body?
During that abstract linguistic arousal, youíre thinking and not feeling. When you stop the language of worry, it bounces back as physical arousal and tension and other kinds of anxious physical sensation. Thatís why worriers have a lot of physical tension, irritable bowel syndrome, indigestion, aches and pains.
Are you born a worrier or is worrying created by the way you are raised?
There are several factors. One is temperamental, in terms of being easily aroused, having a fear of novelty, inhibition. Those are built-in predispositions. The other thing is anxiety sensitivity. Some people are more sensitive to their anxious arousal. They think it is a sign of going out of control, that thereís something terribly wrong with them. This anxiety sensitivity seems to be a general trait that is actually more characteristic of people who have anxiety disorders and who worry.
In terms of child-rearing experiences, there is no one pattern that is characteristic of all worriers, but what we do see is that worriers when they were kids had been more involved in whatís called reverse parenting. In other words, their mother or father--[but] primarily the mother--would present the child with their problems. The child would try to take care of the mother or try to make peace between the mother and the father or do other things that a parent would do. The child who becomes a worrier is sort of taught that youíve got to take care of other peopleís feelings, other peopleís needs. The consequence of that is that thereís nobody taking care of you and youíre always thinking about how other people feel. So reverse parenting is one factor. Another is that parents of worriers are overprotective. They are always presenting the child with dangers and trying to confine the childís freedom. The message is that the world is dangerous, you have to always anticipate the worst ... Kids growing up with these overprotective parents donít learn that they can take care of themselves. The other thing is that parents of worriers who are overprotective are not warm. So the child is taught that the world is dangerous, but donít come to [them] for help. Of course, worriers have worried mothers so they probably imitate that style, too.
Are worriers people who have had difficult lives?
The reality of it for many worriers is that there really are not a lot of terrible things happening. If you are a worrier, you have to ask yourself why you continue predicting the worst when nothing bad has happened.
How do worriers feel about worrying?
Worriers often are of a mixed mind about worrying. They have positive views (they have to worry to be prepared) and they have negative views (this worry is driving me crazy). They say they donít want to give up the worrying because they donít want to leave themselves open to danger.
Does worrying get better or worse as women age?
Anxiety and depression are most common in women between the ages of 18 and 33. There are a lot of demands that women have during those ages in terms of going to college, relationships. There are a lot of life changes, a lot of uncertainty and unrealistic expectations about what you have to look like, what your job has to be, what your romance has to be. As people get into their 30s, 40s and 50s, they have adjusted their expectations and have stabilized in terms of work and friendship. You wouldnít have ďRomeo and JulietĒ for people in their 50s; it would be called ďThe Honeymooners.Ē
Are there common worries women have that are different from mens'?
Women are more likely to have panic disorder and agoraphobia [the fear of being in open or crowded public spaces] and they are more likely to be depressed and more likely to have generalized anxiety. In terms of the content of worry, women will often worry about relationships but also about work and performance.
What specific tips would you give for women who worry too much?
Ask yourself if your worrying is productive or unproductive. Is your worry going to lead to a productive course of action that you can take in the next day or two? What are you going to get out of this worry? Is it going to lead to a to-do list? And if it doesnít, then itís unproductive worry.
That leads to the second point, which is: are you willing to accept uncertainty? One of the core issues with all worry is your attitude about uncertainty. One of the things I say to people is think about all the things you do during the day that involve uncertainty: crossing the street, getting food in a restaurant, saying hello to a stranger, getting in an elevator, getting in an airplane. All of these involve uncertainty. You canít be absolutely sure, but you basically make a good bet.
The third [tip] is to identify what your predictions are and then challenge them. One of the things we do is have people actually set aside worry time. You write out your worries for 30 minutes a day, then set it aside so youíre not worried during the entire day. Basically what happens is you get bored with your worries. One of the goals of this treatment is not to gain certainty but to gain boredom. Boredom is very useful and thank God thereís a lot of it, and itís free!
The fourth step is looking at the extent your worrying is related to your core issues. Do you have to be perfect? Do you have to be better than everyone else? Do you think that if you donít have a relationship, you wonít be able to live?
The fifth is: How do you deal with failure? Worriers tend to think that failure is catastrophic and they tend to believe that if they think about failure, they will fail. The overwhelming majority of things people worry about tend to have fairly positive outcomes.
The sixth is: Use your emotions rather than worry. Sometimes emotions, painful emotions, are an important source of information about what you need: more affection, more recognition in your work, more opportunity to advance. You donít have to feel good all the time.
The final tip is to put time on your side. Go back in time and look at things you used to worry about and see if they bother you now. You can stand back and stretch time. Imagine how you are going to feel about this a month from now or a year from now. One of the things about worriers is that they are always living in a future that never occurs. The alternative is to try and focus on making the present moment as good as it can be. Just enjoy the moment.
© 2005 Newsweek, Inc.
© 2005 MSNBC.com
Published online 11/1/2005