Today’s guest post comes from our colleagues at the Causey Law Firm of Seattle and is a follow to their previous post on worry.
Worry is increasingly pervasive in our society as insecurity about the economy and safety, nationally and personally, grows daily. Worry is compounded in the daily lives of those who are injured or disabled, as they struggle with the added burdens of medical costs and loss of income, all of which engenders a bleak outlook on their future.
“At its worst, [toxic] worry is a relentless scavenger roaming the corners of your mind, feeding on anything, never leaving you alone.” This was the description of “worry” by Edward M. Hallowell, MD, in Worry, 1997, with a 2002 introduction. (This study is still considered the “bible” in lay literature and often quoted in scientific research.) Long ago, Dr. Charles Mayo said, “Worry affects circulation, the glands, the whole nervous system and profoundly affects the heart.” Indeed, worry appears to be, at worst, of genetic origins, and to a lesser degree a learned or environmental response.
Hallowell defines worry as two types: toxic worry and good worry. He likens toxic worry to a virus, insidiously and invisibly attacking you and robbing you of your ability to work, your peace of mind and happiness, your love and play. On the other hand, good worry, or adaptive worry, is necessary to avoid real danger and life-threatening situations.
Worry is categorized as part of Generalized Anxiety Disorder (GAD) in most lay and scientific literature. The National Institute of Mental Illness (NIMH) defines GAD as people who go through the day filled with exaggerated worry and tension, even though there is little to provoke it. NIMH literature states that people with GAD anticipate disaster and are overly concerned about health issues, money, family problems or difficulties at work. GAD is diagnosed when a person worries excessively about everyday problems for at least six months. Worry, as part of GAD, is commonly treated with medication and cognitive therapy.
The everyday worry of the disabled or injured worker is direct, with anxiety and fear over money, physical abilities, medical care, vocational options, housing, food, and family disintegration. It does prey upon so many, compounding their physical health problems and environmental lives.
The physical reactions to excessive fear and anxiety (worry) initiate a chain or cascade of pathological events by stimulating the amygdala area of the brain (fight/flight response), releasing neurotransmitters to the cortex. There, the fear or anxiety, whether real or imagined, is analyzed in detail and the analysis is returned to the amygdala where, in normal situations, the fear response is shut off by amino-butyric acid (GABA). GAD worriers may not have high enough GABA levels to shut off this pathway. Consequently, there are constant marked secretions of glucocortocoids and catecholamines that increase blood sugar levels. Marked levels of epinephrine and norepinephrine dilate blood vessels in skeletal muscles and other adrenergic (adrenal) stimulations that in turn create modifications in breathing, increased temperatures, sweating, decreased mobility of the stomach, bowels, and intestines, constrictions of the sphincters in the stomach and intestines.
The scientific literature is now implicating constant stress, such as constant work stress or toxic fear and anxiety, in causing large weight gains in the midriff area which can greatly exacerbate orthopedic injuries, particularly of the spine or knees, and can lead to increased incidences of diabetes and cancer.
Simply said, constant fear and anxiety result in debilitating amounts of stress hormones like cortisol (from the adrenal glands) and hormones that cause blood sugar levels and triglycerides (blood fats) to rise significantly. This process, if not shut off or modulated, can cause premature coronary artery disease, short-term memory loss, digestive problems, and suppression of the natural immune system. The scientific literature is now implicating constant stress, such as constant work stress or toxic fear and anxiety, in causing large weight gains in the midriff area which can greatly exacerbate orthopedic injuries, particularly of the spine or knees, and can lead to increased incidences of diabetes and cancer.
Worry causes increased mortality and morbidity. It is that simple. Much of the time treatments are simply medications that increase GABA. Cognitive therapy is prescribed depending upon insurance coverage. Addressing the physical and mental effects of excessive worry can aid in recovery from an injury or disability and can increase levels of success in vocational retraining efforts. In rare cases, worry and anxiety can become permanent fixtures in a person’s life, and the effects of this condition can result in ratable permanent impairment. But, the greater part of lay and scientific literature lists non-medicine tips to reduce worry, fear and anxiety to a more modulated level, thereby providing some relief from this constant invader that often creates unproductive and hurtful periods in life.
Here, summarized, are six tips cited in the literature to help manage worry without medication:
- Separate out toxic worry from good worry: Good worry amounts to planning. Toxic worry is unnecessary, repetitive, unproductive, paralyzing, frightening, and in general, life-defeating.
- Get the facts rather than letting your imagination run away. Analyze the problem and take corrective action.
- Develop connectedness in as many ways as you can: family, social, information and ideas, organizations and institutions. Never worry alone.
- Touch and be touched: in addition to massage therapy, seek out hugs and laughter – being around children or family can help.
- Be good to yourself. Exercise, eat well, get enough sleep, meditate, do yoga and be aware of over consumption of substances detrimental to your health, such as alcohol.
- Sing, read, cry, do what you love, look for what’s good in life and don’t sweat the small stuff.