We live in a society where advancements in medicine and technology are made almost daily.  Today, people are safer from natural disasters, natural predators and diseased states than ever before in the history of mankind. Yet in light of this, people worry now more than ever.

What I??e discovered over the past 40 years as a psychiatrist is that people worry for three basic reasons. First, people worry because they??e been told it is a caring and compassionate thing to do.  When a person hears someone?? problems, or that someone is not doing well, they??l often say ???? worried about you.??nbsp; It?? spoken as an expression of caring.

The second and greater reason people worry is that it makes them think they??e doing something, when in actuality there?? nothing to do.  Most people don?? like feeling impotent.  If a friend is stressed or a loved one faces a significant illness, this type of worrier wants to do something.  Since there really is nothing they can do directly, they worry. 

The third reason people worry is because they feel they have a legitimate reason to worry. Some real problem may be happening, but these problems are often situations over which they have no control. These situations are what psychologists call antecedents. Examples are a friend going through a divorce, or a parent dying, or a colleague struggling with school.  These conditions/situations/behaviors are the basis or cause for worry.  Antecedents are the justifications for why people worry.  Like depression, this form of anxiety is another ??ommon cold??for depression.

How can a person overcome worry, especially when it?? been ingrained in their life since they were young?  There are a few practical steps a person can take.  The first step is to separate worry from problem-solving.  Problem-solving is a two-step process:

• Change what you can change. If a person is under financial strain, getting a second job might help to resolve this.  If a relationship is going poorly, a person might be able to reflect on their own behavior and make changes that will help the relationship. If a person is depressed, they can seek psychotherapy, antidepressants, or TMS Therapy.  In other words, there are some aspects of our lives that we worry about where making behavioral changes can improve the situation.  So we change what we can change to improve the situation, thereby reducing the antecedent causing the worry.
• If there is nothing you can change, you must reframe the situation. The process of reframing and cognitive behavior therapy will be discussed in a future blog.

It?? important to problem-solve first because there are legitimate worries and concerns in our lives that need to be taken seriously.  But this is different than general worry, which is defined as repetitive, ruminating, obsessive thoughts about situations that not only fail to help the situation, but makes the worrier sick. 

     “”WORRY IS FINE AS LONG AS IT WORKS AND IT DOESN?? MAKE YOU SICK””

This is a very reasonable guideline for those who worry.  Unfortunately, people can spend a lifetime engaging in behaviors of worry that never improve the situation and make the person sick, yet they insist on continuing to do it.  Some of this is based on the concept of having an antecedent (a cause or reason to worry), in spite of the fact that it does no good.  In fact, it?? fascinating to see how much resistance a person will muster to avoid parting with their worry.  For 40 years, I??e offered a steak dinner to anyone who can describe any other aspect of their life where they repetitively engage in a behavior that does not work, makes them sick, yet refuse to change.

The problem in part is that people are focused on the antecedent and not the consequence or outcome of their worry.  For example: a loved one is making a 5 hour drive on highways and interstates that can be potentially deadly.  When people focus on the antecedent condition (a loved one driving 70 miles an hour on a crowded highway), they feel their loved one is in danger and can?? help but worry.  When asked if the worry keeps the traveler safe, makes the roads less busy, or produces a protective cocoon around the person, they correctly answer that their worry does none of this.  And they freely admit that worry causes them stress, upsets them, and could make them less responsive in case of an emergency.  If people know they shouldn?? worry, they say they don?? know how to stop and continue worrying anyway.

The goal of bringing up this scenario with patients was not to keep them from worry, but rather to help patients stop doing things that don?? work.  For the most part, patients basically don?? engage in behaviors that don?? work.  For example, a person doesn?? try to fish in their bathtub.  If it?? a hot summer day, people won?? put ice cream in a freezer that doesn?? work.  If a family member is injured and needs to get to the hospital quickly, they won?? get in a car resting on cement blocks.  People don?? do these things because they engage in almost instantaneous mental experiments where life experience tells them that placing ice cream in a broken freezer won?? keep the ice cream frozen.  When I use these examples with patients, I??l ask how much therapy it took for them to come up with these answers.  Of course, they all answer none.

Continued in Part 2. Coming Next Week!

If you are suffering from treatment-resistant depression…if your anti-depressants aren’t working, or are giving you unwanted side effects, consider TMS Therapy as an alternative. With offices in Colorado, Idaho, Utah, Washington and Wyoming, we’re here to help.

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