HOW TO ... sto p w o rryi ying ng
Mental Health Prom o tio n Seri es
HOW TO... stop w orrying
“”
“I think of m yself as a born w orrier. I’ ve alw ays w orried, ever since I w as little. I’ d w orry about w hat people at school thought about m e and about hom ew ork and all sorts of things.” “I w orry so m uch that for m y last birthday a friend bought m e a plaque w ith the slogan ‘ W orrying is like riding a rocking horse – it doesn’ t get you anyw here’ .” “A s a child, every night w hen I w ent to bed I w ould w orry about m em bers of m y fam ily dying. I am not religious but I ended up saying a prayer each night that w as basically a list of m y w orries,w hich Iasked G od to take care of. This helped m e to go to sleep.A s I grew up the list of w orries becam e so long that I used to w orry about going to bed . The ‘ prayer’took so long and there w as so m uch to rem em ber. In the end it w as a w orry off m y m ind w hen I stopped saying the prayer.”
Almost everybody worries. A certain amount of worrying is a healthy response to life. It can prevent us from being reckless, or stimulate us to do our best or to take control of a situation. But some people worry a lot more than others and sometimes to the point where worrying becomes a problem in itself. This booklet explains the problem and its effects, suggests ways of tackling it and how to find more help.
2
M e n t a l He a lt h P ro m o t i o n
?
What is worrying? W orrying m eans spending a lot of tim e thinking about bad things –being preoccupied w ith negative possibilities. The m ore you w orry the larger your w orries becom e. You m ay even find yourself w orrying ab out all the tim e you have spen t w orrying. There are m any different types of w orries; they include w orries about things that m ight happen in the future, w orrying about things that are actually taking place, and retrospective w orry ab out events that have already passed . Wo r rie s a b o u t w h a t m ig h t h a p p e n Th ese w orries include concerns about things that could possibly happen, and things that very probably w on’ t happen. For exam ple, despite the fact that it is statistically unlikely, you m ay w orry about w hether you w illhave a car accident, or catch a fataldisease. W orries about w hat m ight happen in situations over w hich you have som e control can also be very troubling. You m ight be very w orried that you’ re going to failan exam or not m eet a deadline because o f not putting in enough w ork. If you w ere able to stop w orrying and do som e w ork, the outcom e m ight be better. Worries a bo ut t hing s tha t a re happe ning A gain, these can include feelings of anxiety both about situations that you can change, and those you are pow erless to change. Exam ples of the latter w ould be w orrying about the fact that you are caught in traffic, or that your train has been delayed. A n exam ple of the form er w ould be w orrying about a persistent cough; if you go to the doctor your m ind could be put at rest, or you could get treatm ent; both are b etter than w orrying. Worries a bo ut t hing s tha t ha ve ha ppened There is often nothing that can be done about these w orries. A n exam ple of this w ould be w orrying about w hether you have failed an exam , or m ade a m istake at w ork.
3
HOW TO ... stop w orrying Why do we worry?
?
“ Ithink m y w orrying has a lot to do w ith m y lack of self-confidence. A lthough it’ s hard to adm it, it’ s often easier for m e to w orry about som ething than to do som ething about it. O ver the years I’ ve learnt that the less tim e I give m yself to w orry, and the quicker I act, the better. I m ay feel ill before I m ake that phone call and shake a bit afterw ards but w hen it’ s over I feel so m uch better, having blasted a w orry –how ever sm all –into oblivion.” W orries are basically fears. Everyone gets scared, but w e all handle fear in different w ays. Som etim es it is easier to dw ell on a fear than to do som ething about it, or to accep t that there is nothing to be d one. This m ay be b ecause of a lack of con fidence –w e m ay not believe w e are capable of taking action or handling a bad situation. (If this seem s to be the case for you, you m ight find M ind’ s booklet How to A ssert You rself useful; for details see Further Reading on p.14.)
?
What effects can worry have? Physical effects O ur bodies react chem ically to the fear that w orrying entails. W hen w e are scared our bodies release adrenalin in w hat is called a‘ fight or flight’reflex that evolved to enable us to counter or to escape threats. This adrenalin affects the digestive system , and can m ake you feelill. The m ore you w orry the w orse it gets, and a real ‘ rush’of adrenalin can lead to ‘ butterflies in the stom ach’ , a headache, or feeling very sick and unable to eat. Psycho lo g ica l eff ects W orrying can m ake it very difficult to go to sleep, as w orries often com e on at their strongest at night. W hen you’ re trying to go to sleep there’ s nothing to distract you from the w orries that m ay have been lurking in the background. It is then very easy to start feeling anxious about the sleep you are m issing
4
M e n t a l He a lt h P ro m o t i o n
through having these thoughts. In addition, at night, especially if alone, it is easier for concerns to get out of perspective, and of course harder to do som ething about them . W e also w orry m ore w hen w e are tired. (If w orrying affects your sleep, you m ay find M ind’ s booklet How to Cope w ith Sleep Problems helpful; see Furt her Reading on p.14.) W orries can m ake you feel very helpless; the m ore w orries you have the less ab le you feel to cope w ith them . Th is red uces confidence and m akes us m ore vulnerable to feelings of anxiety. A lack of self-confiden ce can affect how peo ple relate to you, and how you feel in response. In this w ay a kind of negative spiral sets in, and som e people experience panic attacks as a result of the build-up of these kind of feelings. (See Useful Organisations p.12 and Furt her Reading p.11 for help w ith panic attacks.) W orries also m ake it very difficult to concentrate and carry on w ith everyday life, so that problem s build up. It can be very em otionally draining to feel constantly anxious. Som etim es it can feel as though w orries have taken over your life. In order to assert som e sort of control, som e people m ay develop behaviour that could be described as obsessional. A n exam ple of this w ould be checking that a door w as locked m any tim es before being able to leave the house. Som e people m ay also develop eating disorders as a w ay to control their anxiety (see Furt her Reading on p.14.)
?
Is worrying ever helpful ? “M any people think that w orrying is a com plete w aste o f tim e. Personally I don’ t think that’ s true. It seem s to m e that if I w orry and think about the w orst that could possibly happen the outcom e is rarely as bad as I’ ve im agined.”
5
HOW TO ... stop w orrying If som ething is ‘ niggling’at you and you try to disregard it but it keeps bringing itself to your attention, this can be a helpful push to do som ething about it. For exam ple, you m ight have a m ole o n your skin that you are w orried about; you try to ignore it but can’ t, and this forces you to visit the doctor. Som etim es w orry m akes us act an d this can be positive. A lso, w orrying about the w orst that could happen can help us to deal w ith and prepare for w hat does take place. The adrenalin that is som etim es released through w orrying can be h elpful. For exam ple, if som eone is w orried about a race they are about to take p art in, the adrenalin m ight give them the extra push they need to succeed. H ow ever, if they get too w orrried it could m ean that they feel ill and unable to perform . H aving the occasional w orry for a short period of tim e is very different to w orrying about several things every day or having a w orry that seem s to dom inate everything. These w orries can m ake u s too anxious to be able to think and act in a useful w ay –and this is w hen the w orries them selves becom e the problem .
?
How can I help myself to stop worrying? Co n f ro n t in g t h e w o r st t h a t co u ld h a p p e n It can be useful to visualise the w orst thing that could happen in any w orrying situation. O ften a w orry is a fear of the unknow n, an d trying to define that fear can help overcom e it. H aving confronted the w orry or fear for w hat it is, it is som etim es easier to know w hat to do about a situation. If you confront the w orst that could happen you can then look at how you could cope, w hat you cou ld do and w ho you could turn to.
6
M e n t a l He a lt h P ro m o t i o n
Ta lkin g “W hen I w as a child, m y m um really helped w ith m y w orrying. She w ould notice w hen I w as quiet and w hen I couldn’ t eat because o f the b utterflies in m y stom ach an d she’ d take m e to one side. She’ d ask m e w hat w as w rong and suddenly facing the w orries w ith som eone else really helped. She could help m e to see w hich ones didn’ t m atter and w hat Icould do ab out others.”
Som e people find that talking to som eone about their w orries really helps. Sim ply bouncing a w orry off an other person can help to put it into perspective; you m ay realise that even the w orst possible outcom e really isn’ t the end of the w orld. Talking ab out w orries can also help w hen trying to think of a possible course of action to take, as discussion can often throw up solutions or actions that w e can’ t form ulate o n our ow n.
“
”
You m ay feel the need to talk ab out your w orries w ith som eone w ho is not involved in your life. For exam ple, you m ight w an t to try talking to a counsellor. C ounselling can help you to gain understanding of your w orries and their effects, and it can also support you in doing som ething about them . A nother kind of therapy that can be effective in dealing w ith w orries is cognitivebehaviouraltherapy, w hich looks practically at the w ays in w hich our thought processes affect our lives, an d how w e can try to solve the problem s they cause by learning to alter destructive patterns of thought (see Furt her Reading , p. 14). People w ho have a religious faith can find praying useful in dealing w ith their w orries.
7
HOW TO ... stop w orrying Writing w o rries do w n It can help to try w riting dow n all your w orries. Som e people find it m ore useful to w rite their w orries as statem ents rather than questions. So for exam ple ‘ W hat w ill happen if I don’ t get there o n tim e?’m ight be m ore u sefully exp ressed ‘ I am w orried that I w on’ t get there on tim e.’In this w ay it is possible to focus on precisely w hat the fear is.
A s w e have seen, people often w orry about events that are very unlikely to happen. It is often difficult to realise just how unlikely som ething is w hen you are preoccupied w ith it. It m ight be a good idea to keep your list of w orries for a w hile, before going back to it after a few w eeks. You m ay find that you can cross out som e w orries, because the event that you w ere w orried ab out didn’ t happen or because the w orry sim ply isn’ t im portant any m ore. O f course, you m ight feel you have a w hole new set to replace them w ith, but if you keep w riting them dow n and then going back to the lists you m ay see that w orries can just ‘ dissolve’ . So m e peo ple find that it helps to tear up, burn or otherw ise destroy the piece of paper on w hich they have w ritten their w orries. A nother constructive w ay to put w orries into perspective is to try to w rite dow n the reasons w hy som ething bad m ight not hap pen . Th is m ay h elp you to see m ore realistically w hich situations are w orthy of w orry, an d w hich are not. Prioritising and taking action There is often som ething w e can do about a situation w e feel anxious about. C onsider each preoccupying thought one by one, and then con sider w hether there is som ething that cou ld be done about it. M ake a list of these possible actions, w ith the actions for the m ost concerning w orries at the top. It can then be possible to w ork slow ly through the list, concen trating on one thing at a tim e. C ross out the action once it has been com pleted , to reflect the fact that you have acted positively and dealt w ith a w orry.
8
M e n t a l He a lt h P ro m o t i o n
If you’ re not sure w hat w ould be the best action to take, you could try m aking a list of possible actions along w ith their advantages an d disadvantages. A s w ell as helping you m ake a decision, this could help you feel m ore confident about w hat you decide to do. Assert ing yo urself You m ay feel that there is som ething that you could do about a particular w orry but that you are n ot confident enough to do it. In this instance self-assertiveness classes m ay help. (See, also, M ind’ s booklets How t o A ssert You rself , details on p.14). Co nt rolling w o rries You could try allocating certain tim es and places to your w orries. For this to w ork it is im portant to be strict, and not let w orries intrude on your thoughts at other tim es. It m ight be helpful to try to visualise a box to put your w orries in that you can open at a later date or tim e. Som e people set aside, say, thirty m inutes a day for w orrying, taking quite literally the phrase ‘ I’ llw orry about that later’ . It is helpful if you set this period at the sam e tim e of the d ay/w eek, and have it in the sam e p lace. Relaxation Relaxation exercises are useful in dealing w ith anxious feelings, often involving trying to replace negative w orrying thoughts w ith positive ones. This can include im agining som ew here you w ould like to be –an idealbeach, garden or hom e. You could also try seeing your w orries as actual objects that you can discard –for exam ple,stones that you can throw into the w ater.U nfortunately, trying to do a relaxation exercise can in itself be w orrying. You m ight feelthat it’ s not w orking or that you’ re doing it w rong. It’ s best to take the attitude that you’ re just ‘ giving it a go’and that these negative thoughts are norm al. It m ay sound surprising, but relaxation can take a lot of practice som etim es.
9
HOW TO ... stop w orrying W hen you are about to go into a situation that w orries you, such as a doctor’ s appointm ent or a job interview , it can be useful to focus on som ething other than the problem in hand. This could be as sim ple as picking up a good book or listening to a personal stereo. If you feel a w orry taking hold you could push it out of your m ind by looking at other peo ple and im ag ining their lives, or by really exam ining your surroundings in a very detailed w ay. Ph ysica l e xercise W orrying m eans w e are overly concerned w ith w hat’ s going on in our heads, and exercising can help to focus us on our physical side instead. It can also help to relieve the tension associated w ith w orrying by using up the adrenalin produced. You don’ t have to go for a long run or to the gym ; a good steady w alk can be just as effective, and it’ s good for your heart as w ell as your head. W orry beads and stress toys can be u seful as a kind of ‘ portable exercise’ . They can be used both as a distraction and to relieve tension. D ie t a ry ch a n g e s It helps to cut dow n on tea, coffee an d other caffeine-based drinks such as colas and canned drinks. These are stim ulants, an d can heighten the physical effects of w orries such as headaches and stom ach-aches.
10
M e n t a l He a lt h P ro m o t i o n
Medication Som etim es antidepressants or m inor tranquillisers are prescribed for people, w hen extrem e w orrying has m anifested itself as anxiety. Both form s of m edication have side-effects and m inor tranquillisers especially can be addictive. M edication can be effective in easing the burden in tim es of extrem e anxiety, but do not help to get to the root of continuous and perpetual w orrying. (See M ind’ s booklets M aking Sense of Treatments and Drugs : Antidepressants , : M ino r Tranquillizers M aking Sense of Treatm ent s and Dru gs and Underst anding A nxiet y , details on p. 14). Co mplement a ry the ra pies A grow ing num ber of people use herbalrem edies such as the Bach flow er rem edies, or hom eo pathic prep arations (now availab le in m any high street chem ists). There are also physicaltherapies such as acupuncture, reflexology and arom atherapy w hich som e people find useful. Yoga or m editation classes can be effective. They teach people how to relax their m uscles and breathe m ore deeply in order to controlthe shallow breathing and rap id heartbeat often associated w ith w orrying. (See Usefu l Organisatio ns overleaf and Further Reading on p.14).
11
HOW TO ... stop w orrying Useful organisations
British Association for Behavioural and Cognitive Psychotherapies (BABCP) PO Box 9 A ccring ton BB 5 2G D tel/fax: 01254 875277 e-m ail: info@ babcp.com w eb: w w w .babcp.com Send an SA E for details of practitioners in your area
The British Association for Counselling and Psychotherapy (BACP) 1 Regent Place Rugby W arw ickshire C V 21 2PJ tel. 0870 443 5252 fax: 087 0 443 516 0 m inicom : 08 70 4 43 5 162 e-m ail: bacp@ bacp.co.uk w eb: w w w .counselling.co.uk Send an A 5 SA E for details of practitioners in your area
Institute for Complementary Medicine (ICM) PO Box 194 London SE16 7Q Z tel: 020 7237 5165 fax: 020 7237 517 5 e-m ail: icm @ icm ed icine.co.uk w eb: w w w .icm edicine.co.uk Send an SA E for a list of practitioners
12
M e n t a l He a lt h P ro m o t i o n
No Panic 93 Brands Farm W ay Randlay Telford Sh ropshire TF3 2JQ helpine: 01952 590545 inform ation line: 0800 7831531 fax: 019 52 2 709 62 O ffers advice, inform ation an d support
Stress Management Training Institute Foxhills 30 V ictoria A venue Shanklin Isle of W ight PO 37 6LS tel. 01983 868166 fax: 019 83 8 666 66 e-m ail: adm in@ sm ti.org w eb: w w w .sm ti.org Produces leaflets and cassette tapes on relaxation. List of teachers also available
13
HOW TO ... stop w orrying Further reading A-Z Com plement ary and Alt ernative Therapies (M ind 2000) £3.50 The Com plete Guide to M ental Healt h E. Farrell (M ind/Verm ilion
1997) £8.99 Copin g w ith An xiety and Depression S. Trickett (Sheldon Press
1997) £6.99 Essent ial Help f or your Nerves D r C laire W eekes (Thorsons 2000)
£8.99 Factsheet: Cou nselling (M ind) 50p Fact sheet: Cog nit ive-behaviou r t herapy (M ind) 50p How t o A ssert You rself (M ind 200 0) £1 How to Cope w ith Panic Att acks (M ind 2 000) £1 How t o Cope w ith Sleep Prob lems (M ind 2 000) £1 How t o Increase you r Self-est eem (M ind 2001 ) £1 How t o Loo k Af ter Yourself (M ind 2 000 ) £1 Learn to Relax M . G eorge (D uncan Baird 2000) £10.99 (additional
audio-tape £3.99) M anage Your M ind: The ment al healt h f itn ess gu ide G . Butler,
A . H ope (O xford U niversity Press 1995) £8.99 M aking Sense of Treatm ent s and Drug s series (M ind) £3.50 each The M ind Guid e to M anaging St ress (M ind 2000) £3.50 The M ind Guide t o Yoga (M ind 200 1) £1 Overcom ing A nxiet y H . K ennerley (Robinson 1997) £7.99 Overcom ing Panic D . Silove, V. M anicavasag ar (Robinson 1997) £6.99 Panic Disorders: The f acts S. Rachm an, P. de Silva (O xford U niversity Press 1996) £10.99 Underst anding A nxiet y (M ind 2 000) £1 Und erst andin g Depression (M ind 200 0) £1 Und erst andin g Eatin g Disord ers (M ind 20 00) £1 Und erst and ing Obsessive-compu lsive Disorder (M ind 2000 ) £1 Und erst andin g Talking Treatm ent s (M ind 2000 ) £1
14
M e n t a l He a lt h P ro m o t i o n
For a catalogue o f publications from M ind, send a A 5 SA E to the ad dress below .
If you w ould like to order any of the titles listed here, please photocopy or tear out these pages, and indicate in the appropriate boxes the n um ber of each title that you req uire. Please add 10% for postage and packing, and enclose a cheque for the w hole am ount, payable to M ind. Return your com pleted order form together w ith your cheque to: M ind M ailO rder 15-19 Broadw ay London E15 4BQ tel. 020 8221 9666 fax: 020 8534 6399 e-m ail: publications@ m ind.org.uk (A llow 28 days for delivery)
Please send m e the titles m arked above. Ienclose a cheque (including 10% for p& p) payable to M ind for £ N am e A ddress
Postcode tel.
15
Mind w o rks fo r a b et t er life fo r everyo ne w it h experien ce o f m en t a l d ist ress M ind does this by: •
advancing the view s, needs and am bitions of people w ith experience of m en taldistress
•
prom oting inclusion through challenging discrim ination
•
influencing policy through cam paign ing and education
•
inspiring the developm ent of quality services w hich reflect expressed need an d diversity
•
achieving equalciviland legalrights through cam paigning and ed ucation
Th e values and principles w hich underpin M ind’ s w ork are: autonomy, equality, knowledge, participation and respect
For details of your nearest M ind association and of localservices contact M ind’ s helpline, M ind info Line: 02 0 8 522 1 728 (w ithin Londo n) or 08 45 7 66 0 1 63 (ou tside London ) M on-Fri9.15am –4.45pm . For interpretation, M indinfo Line h as access to 100 lan guages via Language Line. Typetalk is availab le for peo ple w ith hearing or speech problem s w ho have access to a m inicom . To m ake a callvia Typetalk d ial 0800 959598, fax. 0151 709 8119. Scottish A ssociation for M en tal H ealth tel. 0141 568 7000 N orthern Irelan d A ssociation for M ental H ealth tel. 02890 328474
This booklet was written by Louise Flory ISBN 1-874690-73-1. First pu b lishe d by Mind 1998 © Mind 2001 No reprod uction w ithout permission Mind is a registered charity No. 219830
Mind (Na tiona l Associa tion f or Ment a l Hea lth) 15-19 Broa dw a y, Lon do n E15 4BQ tel. 020 8519 2122, fax: 020 8522 1725 w e b : w w w . m in d . o rg . u k
