Despite being a normal human behaviour, when worry is excessive, chronic and subjectively uncontrollable, it can be debilitating. When worry causes significant difficulties in someone's life, it is called Generalised Anxiety Disorder (GAD). People who meet criteria for GAD often report that they worry about a wide range of things that they understand they have little control over.They also often describe an unpleasant physical feeling (physiological arousal) characterised by elevated heart rate, rapid, shallow breathing and muscular tension. This physiological arousal can interfere with sleep which in turn can exacerbate worry.
There are a rage of psychological strategies that can reduce a person's tendency to worry. These techniques assist clients to gain greater control over their physical state (slow breathing techniques, progressive muscle relaxation) and challenge the content of specific worries (cognitive therapy).
A factor that maintains excessive worry and its associated distress are problematic beliefs about the worry itself. For example, many worriers believe that it is irresponsible not to worry about concerns that they have in their life (a positive belief about worry). This naturally reinforces worry behaviour. In contrast, worriers will often become very concerned that their worry will contribute to heart disease or severe and intractable mental illness. A relatively new therapy, meta-cognitive therapy (MCT),targets these unhelpful beliefs about worry in order to undermine a clients investment in the behaviour.
Other, evidence based treatments that clinicians use when treating GAD include:
- Acceptance and Commitment Therapy
- Worry Time
- Mindfulness based Cognitive Therapy.
- Schema Therapy
GAD can be a difficult condition to treat due to the fact that most clients have invested in worry as a coping strategy since their early childhood and because worry does at times give rise to elegant solutions to problems. This can certainly be true however it fails to consider the time wasted, the distress that accompanies worry, the lost sleep and the impairment in problem-solving ability that can occur after a period of frenetic rumination.
At Peter Walker and Associates, we have a number of clinicians who specialise in the management of excessive worry.