Worry and anxiety

Summary

Worry and anxiety can take over the life of some people. Constant and excessive worrying is known as generalised anxiety disorder (GAD). GAD may occur following a stressful life event or a period of high stress. Self-help strategies include relaxation and meditation, exercise and practising the technique of structured problem solving.

The normal worries of everyday life are usually easy to control or 'switch off'. Worrying can be constructive if it helps you to work out possible solutions to a problem. However, some people are troubled by excessive worry and anxiety that seems difficult to control.

This type of excessive worrying is known as generalised anxiety disorder (GAD). Worries associated with GAD are distressing, last a long time and may appear for no apparent reason. GAD is characterised by a feeling of apprehension and constant irrational worrying about potential threats to the person and their loved ones.

The main feature of GAD is excessive anxiety and worry, occurring more days than not for at least six months. Worries are often about a variety of minor issues and events that are unlikely to occur. Generally, the worries are future oriented - , about what might happen rather than what is happening.

Even when there is no cause for alarm, you might worry about health, finances, family issues, and work or study performance. GAD affects about five per cent of the population and onset can be at an early age with one third of people with GAD experiencing onset in childhood or adolescence.

GAD may occur following a stressful life event or a period of high stress. It is more likely to develop if a person is predisposed to high anxiety due to a combination of genetic factors and environmental influences. It is often chronic, but may have only a moderate impact on a person’s ability to function in daily life and so can remain undetected.

There are various self-help strategies you can use to reduce your tendency to worry. Other options include seeking professional treatment.

Symptoms of worry

People with generalised anxiety disorder experience several mental, emotional and physical symptoms, including:

• Excessive and unreasonable worry over events or activities, such as work, school or health
• Excessive worry about their capacity and confidence to deal with situations
• Inability to control or stop their worrying
• Feelings of apprehension
• Muscle tension
• Restlessness or feeling keyed up or on edge
• Easily fatigued
• Tension headaches
• Problems with concentration or mind going blank
• Irritability
• Shallow, uneven breathing
• Increase in heart rate and blood pressure
• Sweating
• Feeling nauseous or sick
• Trembling and shaking
• Sleep disturbance (such as difficulty falling or staying asleep, or restless unsatisfying sleep).

A range of causes of worry

Biological, psychological, social and cultural factors all appear to influence the development of GAD. The contributing factors may include:

• Personality – research suggests that people who were inhibited or reserved as children may be more likely to develop GAD as adults. Personality traits such as emotional sensitivity and shyness also make worrying more likely.
• Learned behaviour – our habitual ways of thinking are learned over many years and are influenced by a range of environmental, social and family influences. A tendency to be preoccupied with imaginary worries can train our mind, over time, to habitually worry.
• Family – anxiety (as a trait) may be inherited and the family environment (including the role models provided by parents) may influence the development of GAD.
• Brain chemistry – some research indicates that anxiety is associated with altered brain chemistry. However, it is unclear whether anxiety causes the physical changes or whether the physical changes cause the anxiety.

Self-help strategies

Self-help strategies that can help a person to control or reduce their worrying include:

• Structured problem solving
• Relaxation and meditation
• Exercise.

Structured problem solving

Structured problem solving is a method of turning fruitless worrying into strategies to find solutions. It is best to practise first on small worries or problems, and limit yourself to working on one problem at a time. As you become proficient at the technique, you can tackle larger, more complex problems. You should write down all the steps. The steps of structured problem solving include:

• Step one – identify the problem and be precise. For example, 'I am afraid of being alone in the house at night.'
• Step two – brainstorm every possible solution you can think of, without censoring any idea at this early stage. Give yourself permission to list even absurd or outlandish possibilities.
• Step three – evaluate the solutions one at a time, noting the advantages and disadvantages of each.
• Step four – decide on the most appropriate solution(s). It is sometimes better to choose a solution that can be implemented immediately, even though it might not be 'the best'. Avoid choosing solutions that are too ambitious or hard to fulfil.
• Step five – make a plan for how you intend to implement the solution. Include factors such as the required resources (like money), help required from other people, time limits or deadlines, possible difficulties that may be encountered along the way, coping strategies for those anticipated difficulties, rehearsal (like practising what to say during a job interview), and methods of monitoring and reviewing the effectiveness of the plan.
• Step six – review the plan as necessary, perhaps adding or deleting points.

Relaxation and meditation

Many people who experience excessive worry report that they don't know how to relax. Regular practice of a relaxation technique, such as progressive muscle relaxation (systematic tensing and relaxing of the various muscle groups), can help to reduce the physical symptoms of anxiety.

Meditation involves both physical relaxation and creating a calm and peaceful state of mind. During meditation, the brain's activity – when mapped by a device called an electroencephalograph (EEG) – is different to any other measurable state of consciousness, including sleep. The brain waves produced are called alpha waves, and this brain state has been found to promote relaxation of the entire nervous system. Scientific studies show that the regular practice of meditation can be a powerful tool in anxiety management. 

Exercise

Exercise is proving to be an effective strategy to help people recover from depression and anxiety. There are various theories to explain how exercise can lift a person's mood. These include:

• Altered brain chemicals – Queensland researchers have found that regular exercise, and the subsequent increase in physical fitness, alters levels of a brain chemical called serotonin, which leads to improved mood and feelings of wellbeing.
• Reduced adrenaline – physical activity burns up stress chemicals like adrenaline, which promotes a more relaxed body and mind.
• Distraction – an enjoyable bout of exercise may be distracting enough to break the vicious cycle of worrying.

Professional help

Treatments that are helpful to alleviate GAD include a variety of psychological therapies and medications. A combination of cognitive behavioural therapy, anxiety management techniques and improving physical wellness have been found to be successful in bringing the worry process under the person's control.

Medication is sometimes used to relieve anxiety symptoms; however, if it is used, it is generally only recommended as a short-term measure. The health professionals who can help treat GAD include psychologists, psychiatrists and general practitioners.

Don't hesitate to seek professional advice if your self-help strategies don't seem to be working for you.

Things to remember

• Some people are troubled by excessive worrying that seems difficult to control.
• This type of worrying is known as generalised anxiety disorder.
• Self-help strategies include relaxation, meditation, exercise and practising the technique of structured problem solving.
• Professional help includes psychological therapies and medications.