For many, the “what ifs” of the world are overwhelming, a great source of stress and, at times, even debilitating. From a simple worry to weighty anxiety, there are strategies for coping and addressing your concerns so you can be free to enjoy the beauty of the journey. Psychiatrist Jay Fawver, MD, shares the research, causes and coping mechanisms for what’s troubling you.

An anonymous proverb states, “Today is the tomorrow we worried about yesterday.”

As a Psychiatrist, I often hear 3 questions:

• “What can be done about my worrying?”
• “Should I get medical treatment for my anxiety?”
• “How does lying awake at night worrying affect my physical health?”

Since most of our worries never happen, why do some of us spend so much time dwelling on them? Afterall, worry generally makes you anxious, and people who worry tend to be much slower making decisions. The main reason that people worry is due to an intolerance of uncertainty. None of us can predict what’s going to happen in our lives, however, people who are worriers tend to dwell on what might happen. They are paralyzed by uncertainty and fear the worst will happen.

Some worriers might make very quick decisions without adequately considering all options, but more commonly, they’ll deliberate so long that they’ll never come to a conclusion. When worrying gets out of control, it results in ongoing anxiety that causes problems socially and at work. A little bit of worry is good for all of us; it forces us to review our circumstances and motivates us to do something about them. However, uncontrollable worry may be symptomatic of an underlying anxiety disorder and warrant medical attention.

An anxiety disorder can cause restlessness, fatigue, difficulty concentrating, irritability, physical problems (stomach upset, muscle tightness, headaches, etc.) and disturbed sleep, which can lead to difficulty at home, at work and/or with friends and family. An anxiety disorder can be caused by a combination of:

• Genetics (which we can’t change)
• Perceived stresses involving work, school, finances, family and/or friends (which we can address)
• Physical changes occurring in the brain (which we can treat with medications)

The physical changes that occur in the brain cause consequences such as insomnia, which can affect an individual’s overall health. Researchers at the University of Pittsburgh studied 29 recently widowed men and women for 3 nights in a sleep lab and took blood samples. The individuals who slept the poorest had a decreased number of natural killer cells in their bloodstream; a type of white blood cell that gobbles up viruses and cancer cells. So it’s certainly a concern when stress in a person’s life leads to worry, which leads to intrusive thoughts and frequent awakenings while trying to sleep.

The researchers discovered another interesting finding: The more that people tried to avoid thinking about their stresses, the harder it became to sleep. The brain has a remarkable ability to force us to deal with our problems.  If it senses that something isn’t right, it keeps us awake … sometimes at the cost of our health. 

So, what can you do to prevent excessive worrying?

• Keep a diary and write down what worries you the most. Keep this diary in a room separate from your bedroom and allow yourself several minutes daily to document your worries. Periodically, open your diary and reflect on it. You might realize that many of your worries never occurred and were unnecessary. Winston Churchill said it best: "When I look back on all these worries, I remember the story of the old man who said on his deathbed that he had had a lot of trouble in his life, most of which had never happened."
• While writing down your worries, keep a list of what you can and cannot do about your situations. Take action on what you can control, and accept what you cannot control. 
• Try to get your mind off your worries. Exercise, have fun and socialize with other people to divert you from your problems.
• Talk with your physician about the possibility of treating a possible underlying anxiety disorder with medications that may affect brain chemicals such as GABA and serotonin, which regulate anxiety centers of the brain.

In the words of Dale Carnegie:  "Our fatigue is often caused not by work, but by worry, frustration and resentment." It’s important that you pay attention to what’s bothering you and try to do something about it. If the anxiety progresses to a clinically significant disorder, treating it will benefit both your emotional well-being and physical health.