Worried about Worrying
We all know what worrying means, but it can sometimes be difficult to disentangle worry from anxiety, ruminations or even obsessive concerns. There are however differences between normal and pathological worry. So, what is the tipping point from a position of feeling you fret about everything to one where worrying becomes so all-consuming that it takes over your life completely?
A start point is to consider some of the terminology associated with worry. At its mildest worry refers to what are generally thought of as day-to-day concerns such as keeping appointments, paying bills, meeting a deadline and so on. Ruminations are quite similar but a person who ruminates will find their thoughts are more intrusive, more persistent, and sometimes even at odds with how the person views themselves. Worries are commonly spoken about, are more voluntary and much more likely to be associated with some form of action. A worrier tends to focus on future events whereas a ruminator typically focuses on past events and experiences.
Most people worry, but some people worry about worrying. These same people seem typically to be preoccupied with issues involving family, relationships, finances, work or school, illness, injury and a variety of other concerns. When worry becomes uncontrollable, all-consuming and lasts for months, it is likely the person has Generalised Anxiety Disorder (GAD).
Everyone can relate to GAD at some level because its central feature is worry. Many GAD sufferers also experience physical symptoms like headaches, poor sleep, muscle tension and fatigue. They also find that despite an awareness of their situation they are unable to control the worrying. This lack of control over worrying is a key diagnostic feature, as is the persistence of the problem (most days for more than six months).
Pathological worry is also characterised by a form of worrying known as catastrophising. A catastrophic worrier is someone who predicts the worst of possible (and often implausible) outcomes, typically in the form of, but what if ? questions. The worry builds and builds in scenarios, like:
‘but what if I lose my job today? If I lose my job I could lose my home and if I lose my home I’ll have to sleep on the streets. But what if I then get robbed and beaten up . . .’
Perhaps the one thing that distinguishes a person with GAD from other people is the fact that they worry about worrying. They worry that other people don’t worry the same way they do. They worry that their worrying might drive them insane. In fact the content of the worry is no different from anyone else’s but the persistence of worry shares many characteristics of obsessional-compulsive disorders.