Overcoming Worry

Ask a group of doctors about the conditions they treat most frequently and they’ll likely place stress among the top ten. The factors triggering all this stress seem endless: pressures having to do with work, home, money, relationships, and even how we respond to a daily commute. It’s important to acknowledge that some life circumstances are legitimate cause for serious concern and worry while others are pointless. Learning the difference is a useful life skill.

How we deal with garden-variety stress and worry is partly under our own control. We can rise to the occasion with a little problem-solving action or we can collapse into anxiety, thinking about nothing except the dire possibilities, wallowing in that useless thinking we call worry.

Whether you’ve made worry a daytime activity or it’s keeping you awake at night, you’re certainly enjoying life a lot less because of it. And since you’re agonizing about events that may never occur, you’re also engaged in the ultimate waste of time. Here are a few steps to conquering worry that may well restore some pleasure to your life.

Worst-case scenario  A tried and true formula for overcoming worry is to analyze the situation carefully and list all the dire possibilities you’re obsessing about. Then select the worst eventuality and live it. Truly imagine this possibility occurring and accept it emotionally. “Oh, dear,” you can say to yourself, “Now it’s happened. Just what I was worried about.” Next, devote your energy to figuring out what you’re going to do about it, listing the steps you’ll take in the aftermath. In other words, when you start intelligently and objectively solving what once terrified you, you’ve begun to conquer the source of your worry.

Jane worries constantly that she might lose her job and have no income. She knows she’s a valued employee at her workplace and that her persistent fears stem from a childhood memory of her father losing his job and the family being thrown into turmoil. After working through the exercise above, Jane created a file and hid it away on her laptop. It’s a carefully thought out (and occasionally changing) page labeled “First Steps After Sudden Unemployment.” The first line is “Two weeks in Paris!”

Consider the odds  Try to be as objective as possible here. Ask yourself, “Really, what are the chances that the worst case will actually happen?” Fortunately, for the better part of our lives, our worst fears rarely do occur. It’s ironic that the truly awful situations come when we never expect them.

Fear of flying? The odds of dying in a plane crash are one in 11 million or the same as being struck by lightening…seven times. That Uber you took to O’Hare is far riskier.

Get the facts straight  We often become anxious and worry about possibilities that have almost no basis in reality. Take any worrisome situation and list the specific issues that define the sources of your anxiety.  Now look carefully at these issues and compare them to the facts of the case. You’ll probably discover that many of your worries are actually quite unfounded.

Most physical symptoms are described as functional because they’re a response from your body based on a situation you’ve placed it in. Worried at 2 am about that burning sensation in your chest? Could it be the lasagna and Chianti you had a few hours earlier?

With the facts straight, take positive steps  Some worries do have a basis in reality. However, if you sit wringing your hands in helpless despair you’ll never get anywhere. Review the real sources of your trouble and rename them “challenges.” Simply renaming your worries will place them within your power, not you in theirs. Now go ahead and tackle each challenge.

Don’t agonize over the inevitable  When the company you work for is doing badly, acknowledge you just might get laid off. Odds are your teenager will experiment with drugs or get a nose ring. The IRS will find something during its audit that will cost you money. And yes, your beloved pooch will likely cross over before you do. The serenity prayer can be a very helpful motto.

God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference.

Put the subject of your worry into proper perspective  It certainly is worthwhile to pause and say to yourself, “Wait a minute. How much does this worry item really matter to me?” If you’re agonizing about losing a job you basically hate, thinking about the loss as an opportunity for growth may be a better use of mental energy. Or when you’re stewing over some trifling concern maybe you should be thinking “I can’t believe I’m actually giving this nonsense any consideration at all.”

You can’t change the past, no matter how hard you try  Better to not waste a whole lot of time worrying about what you could have (or should have) done. Sorry, but once you’ve turned in your final exam you can’t go back and change the answers. Accept that whatever occurred is now over and learn from your mistake.

Nutritional supplements  Interestingly, there are two nutritional supplements that might offer some relief from constant worrying:

—St. John’s wort (450 mg twice daily) works by raising your brain’s levels of serotonin, one of several neurotransmitters. Serotonin is your “factory installed” stress buffer, and since excessive worry is really an unhealthy, virtually obsessive over-response to something stressful, boosting your serotonin will help. Yes, this is also what a prescription antidepressant (like Lexapro or Zoloft) does, but is much milder and virtually free of side effects.

—N-Acetyl L-Cysteine/NAC (600 mg twice daily) has become a favorite among psychiatrists who want to try something gentle for their patients who have any form of obsessive thinking. NAC has passed good clinical trials and is getting a thumbs up from many physicians who keep track of such things.

If, despite these suggestions, you simply can’t stop worrying, consider professional help. Obsessing endlessly about the same issues to the point where you can’t move forward with your life might require some counseling to give you a fresh perspective.

Christine Savas, LPC, Jennifer Davis, LPC, and Janet Chandler, PhD, all have extensive experience with worry.

If you don’t feel like starting talk therapy (“I don’t want to hear myself talking about myself anymore”), skip the therapist and go directly to traditional Chinese medicine. In our group, Mari Stecker, Cindy Kudelka, and Suzi Katlin also have had good results with chronic worriers.  Yoga therapy is also a helpful option.  Renee Zambo teaches patients mindfulness practices, meditation, and breathing techniques that reduce feelings of stress and anxiety.

Life’s too precious to bring it to a halt with worry.

Be well,
David Edelberg, MD