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No anxiety, no fear, no insomnia, feel your calm

"My anxiety lingers", are you a chronic worry person ?

"My anxiety lingers", are you a chronic worry person ?

I once received a message on the background saying that she seems to be a person who easily feels anxious. Every day, she worries about various things in her life: she is afraid of leaving the door unlocked, she is afraid of being excluded if she does not get along well with her colleagues at work, she worries if she has done something wrong when her boss calls her, and she cannot help but worry about her financial situation before she goes to bed at night. She said she always felt that something bad might happen. This feeling has been with her for a long time, although she sometimes does not like this feeling, but she feels unable to get rid of.

If you have had similar feelings in your day and feel that you always have a variety of different worries, then you may be a chronic worrier / worrywart.

What is chronic worry?

Dr. Thomas Borkovec, professor of psychology, defines worry as “a series of thoughts and images that are full of negative emotional overtones and are more difficult to control” (Borkovec et. al, 1983, p. 10). People feel anxious because they feel they may encounter some potential problems and need to anticipate them or try to solve them (Dash, 2013).

Chronic worry describes a pattern of perseverative worry. It is not a diagnostic term, but rather a subjective feeling: a person is in a constant pattern of worry and feels like a chronic worrier  someone who is constantly worried and worried about a variety of things (Dash, 2013; Ward, 2010; Mann, 2008).

Generalized Anxiety Disorder (GAD), because chronic worry may be a manifestation of having GAD (Khoshaba, 2012). According to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5), the diagnostic criteria for GAD are as follows (American Psychiatric Association, 2013):

  • Show excessive anxiety and worry about numerous events and activities for most of the time for at least 6 months. And they are unable to control their feelings of anxiety. This excessive worry is demonstrated when the same things that may only make most people feel slightly anxious, but cause people with GAD to feel strong (much more than they should) anxiety. At the same time, people with GAD feel unstoppable anxiety about every aspect of their lives.
  • Adults with GAD also need to have at least three of the following symptoms (children only need one): fidgeting uncomfortably, feeling tense or irritable, easily fatigued, hard to concentrate, easily irritated, muscle tension, and sleep disturbances.
  • The feeling of anxiety affects daily life, work, and social life. For example, worried thoughts excessively disrupt the sufferer's concentration, and unable to stop being anxious even though they have more urgent work to do, so that their work performance drops dramatically.

If you find more or less in line with these conditions yourself, rather diagnose yourself, you should find a professional to do it.

It is important to note that although the core symptom of GAD is chronic worry, but it doesn't mean that chronic worriers are GAD patients. Because chronic worriers may not meet all the diagnostic criteria for GAD (Ruscio, 2002). Also, people with GAD do not necessarily perceive themselves as “chronic worriers”; “chronic/long-term” is a subjective feeling.

Image source : Pexels

What are the characteristics of a chronic worrier

1. Prone to catastrophizing ideas

Chronic worriers easily think the worst of the situation when they encounter problems. For example, some chronic worriers worry if their boyfriend is in a car accident after they notice he is 15 minutes late. At the same time, chronic worriers are not confident in their problem-solving abilities, and they believe that they are unable to handle when the worst case scenario happens, they have no choice but to worry about it (Dash et al., 2013).

2.  Higher anxiety sensitivity

Chronic worriers have a high anxiety sensitivity. Anxiety sensitivity refers to the sensitivity to physical and mental anxiety reactions, such as sweaty palms, rapid heartbeat, dizziness, etc. It is the “fear of fear”.

It is normal to have anxiety reactions in some situations, such as a first date, an important exam, etc., and the vast majority of people will also feel anxious and uncomfortable. However, low-sensitively people will see anxiety reactions as temporary and harmless, such as a rapid heartbeat before a date, and low-sensitively people tell themselves that this means they are excited.

People with high anxiety sensitivity will catastrophize their anxiety reactions. They have a premonition that these reactions will worsen until they can't cope with them. For example, high-anxiety-sensitive people feel faint when they are dizzy due to anxiety, or feel they may have a heart attack when their heart is racing due to a speech. This thought in turn exacerbates the worry (Hendriksen, 2016; Floyd et al., 2015). Anxiety about the feeling of anxiety itself, and fear of the feeling of fear itself, are also important triggers of panic attacks.

3. More rumination 

Some chronic worriers report that they spend 10% of their day in ruminative thinking, i.e., thinking negatively about what has happened in the past (J. Oathes, 2006).

For example, if they are shown a discomforting picture, chronic worriers cannot stop recalling the picture for the next three days. Also, they will focus more on problems they cannot solve than non-worriers; at the same time, by focusing too much on their past mistakes, chronic worriers will make mistakes and then make them again and again afterwards (J. Oathes, 2006).

Why me ?

Risk factors for being a chronic worrier

1. chronic, antecedent factors

There are some factors that can make people more prone to worry.

a. Heredity

In studies of identical twins (meaning the same genetic makeup between the two), it has been found that if one identical twin suffers from anxiety, the likelihood that the other will also suffer from anxiety is 31-88%. This compares to a 0-8% incidence in the general population. This suggests that innate genetics plays a role in being prone to anxiety.

Research suggests shown, infants not always inherit a symptom of anxiety, but rather a unique temperament, a more sensitive and emotional temperament that makes people more susceptible to being stimulated by anything small and risky,then creates apprehension as they grow up/process (Bourne, 2009).

b. Improper parenting style.

Childhood experiences can also have an impact on people's tendency to worry. For example, parents of chronic worriers may show an overly cautious attitude toward the world. Their parents are more likely to be afraid and worried than the average person. They may be overly concerned about some potential danger to their children, for example, they may say, “Don't stare at the TV all the time, what if something goes wrong with your eyes?” The more parents show fear in front of their children, the more children will grow up acquiring this trait and tend to worry excessively about safety issues.

In addition, parents may set the standard too high. If parents are too strict, children may worry about whether they will be accepted by their parents and whether they are good enough. As they grow up, they feel insecure and depend on a particular person or place where they feel safe, and when they are in public or social situations where they might “lose face”, they try to control their behavior. They internalize their parents' values, become very perfectionist, and fear rejection by others.

 c. Chronic stress.

If stress is accumulated over a period of time without abating, such as lasting for months or years, stress will accumulate. Chronic stress may affect the nervous system, making people emotionally unstable, or experiencing generalized anxiety. Chronic stress may be caused by psychological problems that have not been resolved for many years, or it's because you've experienced many problems at the same time. Sometimes a series of bad things can happen, and they are not terrible individually, but they can be exhausting and worrisome when concentrated together.

2. The reason why your worries continue: your positive thoughts about them.

Although chronic worriers may also feel uncomfortable with worry, but they continue to excuse it. Many chronic worriers have positive thoughts about worry and think it is necessary for them (Dash et al., 2013). For example, they say “worrying helps me prepare better” and “if I want to do things right, I must worry about all the possible mistakes”. Chronic worriers rationalize their worries so that they continue to focus on them stubbornly (Dash et al., 2013).

Of course, such positive thoughts are very often in their subconscious, they feel, more than “rationally I would like to stop this worry, but I can not do. ” But if they examine themselves carefully, they will find that they more or less  had the thought of being proud of their own more worries.

Image source : Pexels

What are the effects of chronic worrying?

1. Habitual Avoidance.

When people worry about a situation or something with potential threat, we will adopt avoidance for self-protection. Because chronic worriers always feel insecure, they persist in avoidance and thus develop avoidance habits, turning avoidance from a form of self-protection to a form of restrict (Orsillo & Roemer, 2011). It affects many aspects of the chronic worrier's life, limiting their choices as well as their performance.

For example, A is afraid of making mistakes because he recklessly tries new things, so at work, he does not dare to take the initiative to accept new projects and lose the opportunity to show himself; and in his relationship, he does not dare to express his love to his crush; on social occasions, he is afraid that he will offend others if he says the wrong thing, so he has to suppress his emotions.

2. Damage to your brain

Worry can cause a stress reaction, causing the sympathetic nervous system to release stress hormones, such as cortisol, to raise blood glucose and triglyceride levels in the blood to prepare for problems (Goldberg, 2015). But chronic cortisol release can cause health problems, such as headaches, high blood pressure,  or loss of libido.

In addition, chronic stress reactions can cause brain damage, resulting in structural changes or functional decline in the hippocampus and prefrontal areas, which are associated with memory, emotion, and cognition, and their impairment increases the likelihood of developing other mental disorders such as depression and dementia (Connelly, 2016).

3. Decreased ability to manage emotions

Some chronic worriers regard worry as a defense to repress thoughts and emotions that make them uncomfortable: when they feel worry, they don't feel the emotions that they want to avoid (J. Oathes, 2006). That is, many times when we feel anxious, we are actually avoiding a deeper, more frightening emotion, perhaps fear, perhaps loneliness, perhaps powerlessness. Anxiety is the universal currency of the emotional world, and any emotion can be exchanged for anxiety and experienced by us.

This unhealthy pattern of emotion management reduces the chronic worrier's ability to recognize emotions and to cope well with repressed emotions (Salters-Pedneault et al., 2006).

What to do when you are in a chronic worry.

1. relaxation exercises: relaxing breathing techniques

"In any program to overcome anxiety ...... , relaxation is fundamental." (Bourne, 2009, p. 77), research has found that deep relaxation can prevent stress accumulation and reduce generalized anxiety. If you can do 20-30 minutes of deep relaxation exercises regularly every day, you will also feel more relaxed in your daily life after a few weeks.

Relaxation exercises include: breathing exercises, progressive muscle relaxation, yoga, etc. Today we choose to introduce calming breathing exercises, which require less time, only 3-5 minutes at a time, and can be done in work and study environments.

  • Take a deep breath in through your nose, and try to fill the bottom of your lun, and hold for 5 seconds. In the process, breathe in as much air as you can to the deepest part of your body. You can also place your hand on your abdomen and feel it expand as you breathe in.
  • Pause, hold your breath, and slowly count from 1 to 5 in your head.
  • Through the nose or mouth, exhale slowly, counting from 1 to 5 (or longer if more time is needed), pushing out all the air.
  • If all the air has been pushed out, breathe twice with normal breathing, then repeat the above steps
  • Make sure you don’t hike your shoulders up. Keep them down and relaxed.

You may find it difficult to breathe deeply at the beginning, but it will improve after several exercises. If you feel dizzy during the process, you can stop for 30 seconds and then proceed again.

Practice 5 minutes of breathing every day for at least 2 weeks. If possible, choose a regular period of time to practice, then you can quickly use it when you encounter a situation that raises your anxiety level (Bourne, 2009).

2. challenge positive thoughts about worries and distinguish types of problems

As mentioned earlier, chronic worriers have positive thoughts about worrying, thinking that "worrying helps" or "worrying helps them cope better". But first, chronic worriers need to understand that "worrying" and "problem solving" are two different behaviors. Simply worrying keeps people trapped in their emotions while the problem and threat remain, but "problem solving" involves assessing the situation, developing a detailed plan, and putting the plan into action, which is the process of actually eliminating the problem (Smith et al., 2016).

Before solving a problem, first distinguish whether your worry is a "solvable problem" or a "non-solvable problem". You can use breathing techniques to relax yourself and then ask yourself the following questions (Smith et al., 2016).

  • Is your concern an actual problem, or does it just come from your assumption of "what...if ......"
  • If it's just a scenario, what are the chances that it will happen? In what way will it happen? Is it realistic in that way?
  • If it will happen, what can I do to reduce its consequences? Or is there nothing I can do about it?

Solvable problems are those that you can plan immediately. For example, if you are worried that you don't have enough money to live at the end of the month, then you can make a budget right away, while unsolvable problems have no immediate solution, such as "What if I get cancer someday?

If you find the problem solvable, then you can plan it immediately. Instead of a perfect plan, you need to focus on its feasibility. As soon as you have a workable plan, the feeling of worry can be alleviated. And for uncontrollable worry, you can try to divert your attention from it, here is one idea to cope with uncontrollable worry (Smith et al., 2016).

3. Allow yourself a "worry period"

When you're worried, it' useless to say roughly to ourselves, "Stop! Don't think about it!" ,  it will make people spend more attention on their worrying thoughts.

A recommended practice is to write down your worrisome thoughts as soon as you feel worried, making a "worry list". As you write, don't judge your thoughts ("That's silly to think that way!") Instead, simply record it and tell yourself: don't worry about it yet, you'll go back and read the list later. The advantage of this approach is that it interrupts your practice of immersing yourself in worrying thoughts, rather than suppressing them, you can express them appropriately.

Then, you can choose a fixed period of time, for example, 5:00-5:20 p.m., as your "worry time", during which you can browse your worry list and worry as much as you want. It is important to note that the "worry time" should not be too late, otherwise anxiety may interfere with sleep (Smith et al., 2016)

 

References:

  1. American Psychiatric Association. (2013). Diagnostic and statisticalmanual of mental disorders (DSM-5®). American Psychiatric Pub.
  2. Borkovec, T. D., Robinson, E., Pruzinsky, T., & DePree, J. A. (1983).Preliminary exploration of worry: Some characteristics and processes. BehaviourResearch and Therapy, 21(1),9–16.
  3. Connelly, K. (2016). Chronic stress and anxiety can damage the brain,increase the risk of major psychiatric disorders. Baycrest.
  4. Dash, S. R., Meeten, F., & Davey, G. C. (2013). Systematicinformation processing style and perseverative worry. Clinical psychologyreview, 33(8), 1041-1056.
  5. Floyd, M., Garfield, A., & LaSota, M. T. (2005). Anxiety sensitivityand worry. Personality and Individual Differences, 38 (5), 1223-1229.
  6. Hatfield, R. (2015). Difference Between State and Trait Anxiety.Livestrong.
  7. Goldberg, G. (2015). How worrying affects the body. WebMD.
  8. Hendriksen, E. (2016). What is anxiety sensitivity, and do I have it?Scientific American.
  9. J. Oathes, D. (2006). Sustained emotional processing in individualssuffering from chronic worry symptoms. [Dissertation]. The Pennsylvania StateUniversity.
  10. Khoshaba, D. (2012). Are you living with chronic worry and fear?Psychology Today.
  11. Mann, D. (2008). 9 steps to end chronic worrying. WebMD.
  12. Orsillo, S. M., & Roemer, L. (2011). The mindful way through anxiety:Break free from chronic worry and reclaim your life. Guilford Press.
  13. Ruscio, A. M. (2002). Delimiting the boundaries of generalized anxietydisorder: differentiating high worriers with and without GAD. Journal ofAnxiety Disorders, 16(4), 377-400.
  14. Salters-Pedneault, K., Roemer, L., Tull, M. T., Rucker, L., & Mennin,D. S. (2006). Evidence of broad deficits in emotion regulation associated withchronic worry and generalized anxiety disorder. Cognitive Therapy and Research,30(4), 469–480.
  15. Smith, M., Segal, M., & Segal, J. (2016). How to stop worry.Helpguide, collaborate with Harvard Health Publication.
  16. Ward, K. (2010). Worried sick: Break free from chronic worry to achievemental & physical health. Penguin. 

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