Everyone feels anxiety. This is a normal human condition. It is what we feel in response to ambiguity. When you do not know what is going on, when you do not know what to do about what is going on or when you do not know what may happen next, you feel anxiety.
So what do you do when you feel that sensation? You try to get rid of it. Anxiety is an unpleasant sensation with physical components such as butterflies in the stomach, mostly felt like nausea, shortness of breath, jitteriness, or just plain old uptightness. It also comes with symptoms such as pre- occupation with the situation, and the overall emotional reaction of wanting to eliminate those sensations as soon as possible. The best way to get rid of the anxiety is to resolve the ambiguity, so you ask “What if…?” questions like “What did he mean by that?” “What if this is what is happening?” “What should I do?” “If I do this, then what will happen?”
When the what-ifs help you figure it out your anxiety is reduced. Imagine that the moment you walk into the break room at work people stop talking. That could raise some anxiety! So your thoughts rev up. “Were they talking about me? Am I in trouble? Is there a secret no one is telling? Am I about to be fired?” Your anxiety rises with each new thought until you begin to feel a bit sick. Then it dawns on you, “My birthday is tomorrow! I bet they were planning a surprise!” Now anxiety disappears and you can decide how to proceed: act like you did not notice anything, leave the room, or sit right down and join in the plans.
In that scenario, worry resolves the unwelcome anxiety. What-if thinking generates ideas and solutions—like brainstorming the problem of anxiety. We use that kind of thinking to our advantage when there is a problem to be solved.
But in the same way what-if thinking becomes worry and becomes a problem by itself. People with anxiety disorders often start out with sensations of anxiety not necessarily related to an objective problem. That is an outcome of many factors such as neurotransmitter function, or areas of the brain connected to anxiety being over-active, or the impact of stress and trauma on brain structure and function. We also know that consistent lack of sleep and other physical problems may cause anxiety. Drug and alcohol use may also contribute. For example, alcohol and marijuana, both often thought to be calming, have a post-use backlash of intensified anxiety. Stimulant drugs make anxiety worse and can sensitize the brain to trigger panic.
“What if?” Thinking Keeps Brain Searching
When people are anxious, particularly suffering with generalized anxiety, they feel the anxiety and then wonder why it is there. The natural assumption is that something MUST be wrong. And then their thinking brains go on a search for an explanation. Remember: if you can figure it out, anxiety goes away. However, because the anxiety is NOT caused by a real, objective problem, the what-if thinking spins without a solution. I am reminded of the symbol for “computer loading” that spins and when the computer can’t find a solution, it just keeps on spinning. The thought process of anxiety is like that. Without a solution, it keeps on searching.
Then the sense of anxiety begins to grow. When you cannot explain away the anxiety, you start what-if worrying in earnest. It is anxiety-provoking to not know what is wrong. Worry may try to focus on some particular thing just to see if relief from anxiety will emerge. For example, you may start to worry that you have forgotten something, and then mentally go over and over tasks that could be undone. Or you may start to worry that your headache signifies a serious condition, and thus health anxieties are born. You may ruminate over what you have said to other people during the day, in which case you will inevitably find that you might have made a remark that another person might have misinterpreted so now you can worry about how to find out if that is true.
The worry is a maladaptive attempt to get rid of anxiety and makes it much worse in the long run.
So if this problem exists because people feel anxiety first and worry second, how does one intervene to eliminate both worry and anxiety? There are some simple tools that can help.
First ask if the problem you are worrying about is objectively a real problem. If it is, then it has a potential solution. You can handle that by making a plan. Plans involve several specific steps.
- Identify the problem.
- Identify a goal (desired outcome to the problem).
- Find a few possible ways you might achieve that goal—and get brainstorming help if you need it.
- Then select one (and only one) of the paths to try.
- Develop a list of steps to achieve that outcome via the path you have chosen. Then do each step in order.
- When the steps are completed evaluate if they have worked. If those steps do not work then choose a different path. You don’t evaluate as you go because that becomes worry in disguise of re-planning your plan.
One characteristic of brain structure is that the more you think a thought—any thought—the more your brain reacts as if the thought is important. It does not matter what the content of the thought is. It is the frequency of thinking it that matters. So your brain starts to physically change, bringing in more blood vessels and glial cells to support activity with oxygen and energy and speedy processing. That means that worry reinforces itself. Stopping that process can be done deliberately, once you make a decision that worry is not important, and is more trouble than benefit.
Replace Negative Thoughts
The next option is a process I call “Stop and Swap!”
- When a worry begins to bother you, ask yourself if it is necessary for you to worry. People will often say that worry helps them to be more careful or even helps because they absolutely know that the things they worry about never happen. In this case worry has a sort of magical function that they will have to deal with before getting rid of the worry.
- When you can say you do not need the worry, and then it is necessary to tell yourself “Stop!” Necessary is not the same as sufficient.
- Once you say “Stop!” then you must swap in a different thought. Replacing the negative thoughts with thoughts that are pleasant or at least productive is necessary. It can be as simple as pulling your attention back to the task at hand—your work or studies or the people with you—and you can also plan for what to think about: recite a prayer or positive affirmation or plan to think about the plays in a sports event you just watched or participated in, or even just think about your plans for later in the day.
- As people often say, these ideas are simple, but not easy. Persistence and consistency are both necessary to turn off the worry. When you decide to stop a worry, you will get the best result when you interrupt it every time, not just once in a while. And you will also get the fastest reprieve from worry if you do it day after day. In a few days you will see a change with far less worrying.
- Worrying can become a habit. Your brain makes anything you do efficient by repetition. You must consciously decide to change habits or they become your default. When you are in the habit of worrying, going over and over the same material as if there is more to learn or decide, you tend to do it with everything. There are other ways to eliminate the habit of worrying.
- Try doing the “worst first.” Your habit of worry may cause you to put things off and think them over. So if there is something you do not want to do, you tend to have it in the back of your mind and have to keep shoving it out of your attention. That just encourages ruminative thinking, i.e., worry. Get it over with. Do the homework you dread. Once it is done, then you are relieved of the worry. Do the part of your job that you like the least so that the rest of it is more pleasurable. If there is a phone call you do not want to make, don’t cop out by texting or avoiding it. Just make the call. Your feeling when the worst is over will make the effort to get it out of the way well worth it.
- You may find yourself preoccupied, habitually ruminating about one thing or another as you leave the house or leave your work. Then you get halfway to wherever you are going and start to worry about whether you closed things up or turned things off. The way to get out of this loop is to pay attention and talk out loud to yourself, “Here I am closing the windows.” “See, I turned off the computer.” “Yes, all the burners on the stove are turned off.” “And I am locking the door.” “The garage door is coming down.” That way you will vastly increase your ability to know those things are done and you won’t become preoccupied by a new reason to worry.
There are many reasons why a person may develop the kind of anxiety that includes ruminative worrying. And there are many tools to control that kind of worry. Give the above ideas a try— you might be surprised that you can eliminate worry.
Dr. Margaret Wehrenberg is the author of six books published by W.W. Norton, including her popular “10 Best-Ever” books and the forthcoming Anxiety Casebook: Treating Anxiety in Complex Mental Health Conditions. She blogs for Psychology Today Online, and speaks internationally on topics of clinical psychotherapy. Dr. Wehrenberg may be contacted at (630) 248-3092 or on her website.
