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Worried all the time? How to control anxiety
Colin Hawkins/Corbis
January 19 2013

Increasing numbers of us are finding that worry is taking over our lives — it even has a name: Generalised Anxiety Disorder. Psychologists Roz Shafran, Lee Brosan and Peter Cooper explain how to keep anxiety under control

Almost everyone has experienced anxiety at some time in their lives, and to do so is not only natural, but probably quite sensible, too. In some sense, the feeling of anxiety is like a signal to us that we need to take action. If we are walking alone down a dark street and start to feel anxious, we might think, “This is getting spooky, I think I’ll nip into the pub and call a cab”, so we will be doing something to get ourselves somewhere safe. If we have an exam coming up, we are likely to start feeling anxious. We might think: “It’s no use; I can’t pretend it’s not happening — I’ve got to revise or I’ll totally mess up.” Once again, anxiety can guide us to behave in a way that is in our best interests.

However, anxiety can also become unhelpful. Instead of protecting us, it can imprison us. It stops us from doing what we would like to do and living our life fully. The goal is not to live an anxiety-free life — for one thing, nobody ever does; and for another, anxiety can be useful — but to live your life with acceptable levels of anxiety in a full and rich way.

Feeling anxious is undoubtedly a fact of life, and there are few of us who could say that we have never experienced problems with it. Anxiety can be “normal” in the sense that it fits the occasion, but it can also be “abnormal” — that is, the anxiety starts to take over our thinking processes and our lives, and makes it difficult for us to function. It is likely that people who experience excessive and distressing levels of persistent anxiety are suffering from a disorder called Generalised Anxiety Disorder or GAD.

Research in many different countries has suggested that at least one person in every 25 has GAD. The most important feature of GAD is that people experience quite severe anxiety and worry about a wide range of things over long periods of time. Other symptoms include finding it difficult to control the worry; restlessness or a feeling of being keyed up; getting easily tired; difficulty concentrating, or feeling that your mind has gone blank; irritability; tension in the muscles; sleep disturbance, so that we have difficulty falling or staying asleep, or wake up feeling unrefreshed by our sleep; finding it difficult to function normally at home, at work, or elsewhere, because of the extent of the worry.

Worry can occur at any time, and this is also true for the onset of GAD. We tend to be more likely to start worrying at times of change and stress. But often this type of anxiety appears during middle age. This is the time of life that is often typified by stability in a number of areas of our lives. We may be more certain of who we are, and where we fit in the world. We may have an established career and home life. When worry appears later on, it is usually linked to some significant change, such as children growing up, the breakdown of a relationship, a bereavement, an accident or illness, or a major shift in the way we live our lives, such as retirement. This might challenge the status quo and generate doubt and uncertainty.

People with GAD tend to worry about the same kinds of things as people without GAD — only they fall into worrying more easily and tend to spend more time worrying. Research suggests that our worry tends to cluster around particular themes. These include our health, finances, relationships, family, work and finally, worry about worrying.

We worry in response to life’s uncertainties. People who worry find it hard to tolerate uncertainty, and spend a lot of time asking “what if” questions that make the anxiety worse. Typical examples include: “What if my partner has an accident on the way home?” or “What if my report is useless and my boss decides I should get the sack?”

Some worries are realistic (“real event” worries) and need to be dealt with using problem-solving techniques or finding practical solutions to the problem. For example, if I worry about the size of my credit card bill, then this problem exists and my worry is based on a real and present problem. Some worries are about things that may never happen (“hypothetical event” worries), and need an approach that tackles the worry itself. Sometimes, real event worries spiral into hypothetical event worries. For example, “My neighbours are noisy” could spiral into “I’ll never be able to sell the house, I’ll be stuck here for ever.”

Without realising it, we have ideas or beliefs about worry that help to keep it going. These can be either positive beliefs about worry, which cover the way in which people think worry might be helpful and therefore they need to keep doing it. Examples of positive beliefs would be “worrying shows that I care” or “worrying motivates me”. Or they could be negative beliefs about worry (the ideas that worry is dangerous, which make people more anxious and therefore prone to worry more). A typical thought might be “worrying so much means I am losing my mind”.

Even though you may always have had a tendency to worry — maybe your parents did, too — you can still learn to understand it and get on top of it. Excessive worry is not a part of your personality, and it’s not something that you should accept as inevitable.

How bad is your anxiety?
Answer yes or no:

  1. Have you always been a worrier?
  2. If there is nothing to worry about, do you still find yourself worrying?
  3. Do minor everyday things spiral into major concerns?
  4. Once it starts, is your worry hard to stop?
  5. Does worry stop you enjoying life?
  6. Do you friends or family often suggest that you worry too much?
  7. Or, do they often tell you to stop worrying?

If you answer yes to at least two of these questions, and if the worry is making it difficult for you to function properly at work, at home or in social situations, then you probably suffer from excessive worry.
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