Generalized Anxiety Disorder – Why You Worry
All of us worry. We worry about what people think of us, financial problems, our kids, our work, our health. But some people are so preoccupied with their worries that they cannot seem to put things in perspective. One of the most persistent psychological problems is called “generalized anxiety disorder”(GAD). This is a long-lasting problem where the individual has difficulty relaxing, feels a lot of physical tension (tight muscles, tired, headaches, sweating easily, grinding teeth). People with this problem often say, “I have always been a worrier”. Studies indicate that lifetime prevalence of GAD varies between 5.8% and 9%, with greater risk for women (2.5:1, M:F) and young adults. Patients presenting with GAD often claim that onset has been gradual and that they have been anxious since childhood, with some studies indicating average length of this problem to be 25 years prior to treatment
Do you believe any of the following?
- I need to worry to be prepared.
- Worry motivates me.
- Worry protects me.
- I am aware of my thoughts a lot of the time.
- I think that my worry will make me sick.
- I try to control my worry, but I can’t seem to stop.
- I can’t stand uncertainty.
- I look for the perfect solution.
- Worry is a sign of being responsible.
- If I let my guard down, something bad could happen.
People who worry a lot actually believe that their worry protects them and prepares them. They believe that their worry will keep them from being caught by surprise. Worriers are quite good at imagining all the bad things that could happen—often coming up with stories about terrible possible outcomes. Even though these terrible things end up not happening, the worrier just goes on to the next set of worries. Worriers often use their emotions to guide them, as if they are saying, “Well, I’m feeling really anxious, so something bad is likely to happen!” Worriers also think that they should be able to get rid of their negative feelings and worries immediately and completely—and then they worry that they can’t accomplish this. Worriers believe that they need certainty—“I need to know for sure that things will work out”—and, in the absence of certainty, the worrier thinks that the bad outcomes are highly likely.
In the absence of certainty, the worrier then looks to others for reassurance—“Do you think that Susan doesn’t like me?” or “Do you think that I’ll get fired?” Reassurance only works for a short period of time, so the worrier then thinks that things are still uncertain requiring further worry.
Worriers also worry about worrying too much. They may think, “All I do is worry”, “I can’t stop worrying”, “This worry will drive me crazy”, or “I’m ruining my health with all of this worrying”.
The good news is that there are helpful treatments for worry and generalized anxiety. Research on cognitive-behavioral therapy shows that many individuals can be helped with this anxiety. A variety of strategies and interventions have proven to be useful. Individuals can be helped with relaxation and breathing exercises, time management, procrastination, distraction from worry, assertion, and problem-solving. Worry can be reduced by being able to distinguish between “useful” and “useless” worry, modifying your need for certainty, learning how to challenge your pessimistic way of viewing things, and acquiring more rational and reasonable ways of thinking and feeling. Patients in therapy are often given self-help homework assignments that can help them gain more control over tension and worry and assist in putting worries aside. To read more about anxiety disorders and worry, see the chapter by Adrian Wells in Robert L. Leahy’s book Roadblocks in Cognitive-Behavioral Therapy. *
Blog Posts on Anxiety and Worry:
- Anxiety: Who Can You Trust?
- Afraid of Being Rejected?
- Practicing Your Obsessions: The Boredom Cure
- Having a New Relationship to Your Obsessions: Welcome to the Guest House
- Those Damn Unwanted Thoughts!
- “But what if I’m THE ONE?” How Intolerance of Uncertainty Makes you Anxious
- How Big a Problem is Anxiety?
- Are You a Worrier? 5 Tips to Turn Worry on Its Head
- Why Thought Stopping Doesn’t Work
- The Worst Advice for a Worrier
- Make an Appointment with Your Worries
- How to Think More Like a Cat… and Overcome Your Worries
- Those Damn Unwanted Thoughts!
- Listen to a Lecture on How to Handle Your Worries
- Eight Weeks to End Your Worries
- Taking the Blinders Off: Knowing What You Should Really Worry About
- What is Productive Worry?
- How Does Your Worry Make Sense?
Anxiety Free: Unravel Your Fears Before They Unravel You by Robert L. Leahy
The Worry Cure: Seven Steps to Stop Worry from Stopping You by Robert L. Leahy
Clinicians may find the following books on cognitive behavioral therapy to be helpful in treating anxiety:
Leahy, R. L., Holland, S. J., & McGinn, L. K. – Treatment Plans and Interventions for Depression and Anxiety Disorders (2nd ed.)
Leahy, R. L. – Cognitive Therapy Techniques
Sookman, D. and Leahy, R. L. – Treatment Resistant Anxiety Disorders: Resolving Impasses to Symptom Remission