FATE OF PRO WORRIER
The Fate of the Professional Worrier       

I see worried people.

And I see them everywhere -- not just in my practice, but in everyday life. At the post office this week, I saw an obviously frantic mom trying to keep her wandering toddler from putting pennies in his mouth while simultaneously trying to decide if it was worth the extra eighty three cents to send the package first class. This mental debate and near-gymnastic effort went on for some time. Those waiting in the growing line were not amused. I understood her struggle.
Most likely she was debating far more than the expense of the less-than-a-dollar charge. Do I want the package to arrive on her birthday, or the day before? Will it be less likely to break if it goes first class? Do they mean three business days, or does that include weekends? Will she think I forgot if she doesn’t get it on her birthday? Meanwhile, she wonders, How many pennies did he put in his mouth? What if he gets a cold and I can’t leave him at daycare tomorrow? Could Mom stay with him Friday? What if she can’t? Are these people getting angry with me? This barrage of thoughts leads to more anxiety, and less functioning. She becomes tense, less able to concentrate, decisions cost more and more time, and, of course, the line grows longer.

Welcome to the harried world of what I’ve dubbed the Professional Worrier, or, in clinical terms, Generalized Anxiety Disorder (GAD). The disorder is surprisingly common, affecting about 5 percent of the population, and, left untreated, can last many years, even decades.

Individuals with GAD worry about a variety of events or activities, to the point of incurring physical and cognitive symptoms, such as restlessness, fatigue, trouble concentrating, irritability, muscle tension, and sleep problems. Themes for worrying often include common concerns, such as the safety of loved ones, finances, social interactions, health issues, and work performance. Everyday issues, such as obtaining car repairs, being late for an appointment, evaluating conversations over and over, or thinking about possible job responsibilities take on more significance than they should. GAD sufferers have trouble controlling their worries and consequently their school, work, health, or home life suffers.

It is not difficult to see how people can evolve into Professional Worriers. Our ancestors clearly had more to worry about than we do. Contrast the eighty-three cent decision with whether to follow the buffalo herd, prepare for the bitter oncoming winter, or ready spears to defend your family from the neighboring warring tribe. Thus, our brains have developed highly skilled ways of anticipating catastrophe in order to be prepared.

Unfortunately, our highly able mental powers can imagine much more horrific consequences than typical reality ever brings. And much of our brain may not understand the difference, responding to real and imagined threat similarly. The result is that the GAD sufferer feels under constant attack physically, emotionally, and mentally.

Generalized Anxiety Disorder was originally considered a relatively minor disorder, perhaps due to the fact that those with GAD often suffer in silence. The last few decades have seen a change in our clinical view, as we learn more about the hectic internal world of the over-anxious individual. Clinicians now recognize the time, sleep, and workdays lost to the disorder’s effects, not to mention the impact it can have on relationships.

Fortunately, there is effective treatment for GAD. The best shot at help comes in the form of a two-pronged approach that includes medication and Cognitive-Behavioral Therapy for the disorder. Medications help by calming the physiological or cognitive effects of GAD, depending on the type of drug used. However, many studies demonstrate that the effects of medications for anxiety disorders can be short-lived, with Cognitive therapy outperforming pharmacotherapy in the long run. This appears due to the fact that individuals with anxiety must learn to understand and change their worrying tendencies in order to achieve full relief.

Cognitive-Behavioral Therapy for GAD focuses on many skills, including understanding the mechanism of anxiety, learning “selective” worrying, letting go of unnecessary concerns, thought-stopping, relaxation skills, and lifestyle changes, to name a few. With help, GAD sufferers can retire from Professional Worrying, and move on to more rewarding pursuits.
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