Extreme worry and anxiety

Published Categorized as anxiety

Of the many emotions that rattle about, the one I am asked most about is anxiety. This is no surprise as it can cause considerable distress, people’s suffering can be long-term and there are no quick fixes. It takes time and dedication to reduce the effects of worrying.

Anxiety is the emotion we feel when we worry. It can involve restlessness, inability to focus, ruminating, catastrophising, hypervigilance, nervousness, an unsettled and churning stomach and/or insomnia.

Everyone worries. It’s normal to worry when situations arise that throw up a bucket-load of uncertainty – like losing our job or being told we’re going to be evicted. But this kind of worry is about real and considerable things – things that are concrete problems that need sorting. Worry only becomes a real problem for those for whom even the small stuff triggers worry and those whose brain’s can gallop along with a stream of ‘what ifs’ to the extent that if they actually shared what they were thinking, most people would call for a reality check! There is evidence that the mind has the capacity to make things seem far worse than they actually are or are likely to be!

Normally CBT (Cognitive Behavioural Therapy) is great for addressing worries. Many concrete worries can be helpfully challenged and therefore soothed. It’s usually easy to find evidence that disproves someone’s worry that everyone thinks they are rubbish at their job, for example. It can equally be easy to find evidence that you coped before in a similar circumstance when you’re unsettled about how the future will pan out. It’s also a helpful reality check that what you’re dreading is actually very unlikely and you only think it’s not because your worrying has distorted your thinking. But when hypothetical worries run away with themselves no amount of reasoning will sort them as this kind of worrying will always find something else to worry about and as these worries are not based on facts, reasoning becomes ineffective.

Worrying that becomes out of control needs to be challenged at a deeper level. Here I cursorily cover some ides about how someone could do this:

  1. Worriers need to catch worries based on concrete problems (that can actually be sorted) early on, before a wave of catastrophising kicks in. The irony is, worriers tend not to have great faith in their problem-solving abilities – which can mean they see problems only as a threat and will therefore avoid them (so the worrying continues). A healthier attitude to problems can see that they can also bring opportunities: to learn, to improve things, to grow.

2) Worriers need to make conscious any ideas they hold about worrying like:

  • Worrying means I care
  • If I worry really hard, I will find a solution.
  • I won’t cope if things don’t go exactly to plan

and challenge these. Worrying might sometimes drive you to cover all bases, but at what cost? You could have felt agitated, not slept and sometimes actually be less able to think things through carefully or achieve as much as you could because you are consumed by anxiety.

3) It’s helpful for some worriers to explore their relationship with uncertainty and for others to consider not trying so hard to guarantee certainty. Both avoiding uncertainty and trying to guarantee certainty are impossible!

Worriers tend to have a smaller comfort zone than people who worry less because of their attempts to control and stay ’emotionally safe’. Quite often worriers try to ensure certainty and/or avoid uncertainty by: spending ages gathering up information before making a decision, not acting at all (avoidance), ignoring information that triggers worry, assuming the worst and so end something before getting truly involved, looking for reassurance all the time, being controlling, over-protecting others, over-analysing things, not trusting others to do anything etc. Worriers can slowly prove to themselves that they will cope without these strategies (that strive for certainly or avoidance of uncertainty) by making small planned changes to do less of these things – and prove to themselves that they still survive!

4) And at a very deep level, it helps worriers to get to the core of their worries and be more accepting of them. I read somewhere that to worry, is to hope. Our worrying could be reframed as feeling threat to all the things we value. If we can torture ourselves by catastrophising about the death of a loved one, the loss of our health and all that they would entail, etc. we can see worry of born of threat to all we hold very dear. Interestingly, we tend to worry with words in our heads, not pictures – because the pictures would be too painful and so we avoid them. Facing those fears (possibly by visualising them) can ironically work towards alleviating them as the avoidance can be what perpetuates the agitation. If we can face that fear, we can settle ourselves.