MY SON IS A POLICE OFFICER. EVERY DAY, I WORRY I WILL GET A CALL THAT HE IS HURT OR DEAD. HOW CAN I LIVE A HEALTHY LIFE WITH THIS CONSTANT WORRY?

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Anybody with a loved one working in dangerous conditions such as police work or the military would feel concern. The degree of concern, however, depends on how you think about this situation. Keep in mind that it is not really your loved one's work that causes your constant worry. Rather, it is what you tell yourself about his work. If you are saying to yourself, “Today will be the day I get the call that he's been killed,” here's what might be going on in your head:

You are telling yourself something is going to happen at a certain point in time. This type of thinking (self-talk) is called fortune-telling.

You are also jumping to the worst conclusion about what could happen. This is called catastrophizing.

At the same time that you are overestimating the danger and threat of the situation, you are underestimating your own or a loved one's ability to cope.

One of the best ways to deal with constant worrying is to learn to challenge negative predictions and develop more realistic views of situations and coping resources. For example, you might remind yourself that your loved one is doing the job she wants to do, that she is skilled, that she works with competent colleagues, and that she has handled difficult situations well in the past. Also note that there is a difference between possibilities (it could happen) and probabilities (it's likely to happen). You could get a call that your loved one has been hurt or killed, but that's not the most likely outcome. We're better off when we resist turning small negative possibilities into probabilities. Life has no guarantees, but learning and practicing more realistic self-talk can help you better tolerate uncertainties.

Further, it's important to realize that we can't see into the future—you are not God, and no one has a crystal ball. The truest statement we can make about the future is that we don't know what it holds. Therefore, it is best to try to live in the moment. Sometimes our focus on someone else's well-being can be a way of avoiding attending to our own lives. Start focusing on spending your time in ways that feel meaningful and productive—maybe through becoming more engaged in your own work, getting together with friends, or starting something new, like a hobby or volunteering.

Finally, we sometimes worry because we believe that our worry magically protects others. Or, we believe the person we're concerned about not only wants us to be concerned about them, but to worry about them. We think that he will feel better in a dangerous situation if he knows we are constantly worrying about him. These ideas overestimate the effects of worry for any benefit. In fact, these beliefs are akin to believing in magic. We have no evidence that worry benefits anyone, but we do know that it causes the worrier harm. If you want to help your loved one, focus on what you can control. Send a care package, help out, express your love. It's generally better to control those aspects of your life you can actually control than those aspects of your life where the only control is through magic.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

EVERY ONCE IN A WHILE, I HAVE A THOUGHT ABOUT DOING SOMETHING "OUT THERE" LIKE THROWING SOMETHING AT MY NEIGHBOR OR TELLING OFF MY BOSS. DOES THIS MEAN I'M CRAZY?

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Studies have shown that 85-90% of ordinary people experience intrusive thoughts or mental images that they consider distressing or disruptive. Just because negative thoughts come into your mind, that does not make you crazy or abnormal. What distinguishes normal intrusive thoughts from psychotic or delusional thoughts is that the latter involve a break with reality. For example, a psychotic person may believe that the thought originates from a higher authority, such as Jesus Christ, and may even hear the thought as an actual voice (auditory hallucination). The person may then feel that he has no choice but to obey.

It is normal to have thoughts about things you would not actually do. You will become needlessly anxious if you attach great significance to the negative thoughts. If you have a negative and impulsive thought like “I'm going to embarrass my boss in front of everybody,” and then you say to yourself, “Because I have this thought, I'm a horrible person” or “That was terrible of me,” you are going to be a lot more bothered than if you can say to yourself, “It's just a thought, and I know I wouldn't act on it.”

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

IS IT NORMAL TO WORRY ABOUT WHAT PEOPLE WILL THINK OF ME?

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In the way that the outdoor temperature is reflected in degrees on a thermometer, it's helpful to think of worry as occurring at different levels instead of as an all-or-nothing emotion. It is completely normal to be concerned about what people think of us. We live in a social world, and interaction with other people is vital. Naturally, we want others to think well of us. Getting along well with others feels good and often helps us reach our social and professional goals.

Yet, focusing on the views of others can make us overly cautious and anxious. Here are some signs that your focus is excessive or unhealthy:

You don't feel good about yourself, and are projecting your negative feelings. For example, you imagine your boss is unhappy with your work rather than admitting that you aren't happy with your performance.

You may be engaging in a thinking mistake known as mind-reading —assuming that you know what a person is thinking about you when you actually have no evidence for your conclusion.

You tell yourself that it's terrible if someone doesn't like you, when maybe it's just inconvenient. Another person's view of you is not a measure of your worth unless you allow it to be.

To shift these tendencies, give yourself credit for your strengths and practice learning to accept your mistakes—we all make them! And keep in mind that most people are more focused on their own priorities and interests than on thinking about you. To illustrate this point, try writing down all the topics that others could be considering or discussing, besides you! You'll find that this list is endless!

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

MY MOTHER WORRIED ALL THE TIME, AND I TEND TO WORRY A LOT TOO. DOES THAT MEAN THAT I'M GOING TO BE A WORRIER FOR THE REST OF MY LIFE LIKE SHE IS?

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Worry is based on self-talk. Often when people worry excessively, they overestimate danger in the world and underestimate their ability to cope. Just because your mother worried a lot does not automatically mean you are going to be a worrier for the rest of your life. Worrying can become a habit, but all habits can be changed with hard work. When you start to worry, instead of letting your mind toss around “what if this and what if that?” it is a good idea to flesh out what is most likely to happen. Focus on probabilities (likelihoods) rather than remote possibities. Also, ask yourself, “What's the worst- case scenario and how would I deal with it?”

Perhaps your mother was afraid to drive and never drove her car. This is a behavior that can change if a person is willing to question some of her negative assumptions. Your mother might have said to herself, “I can't drive—I'll crash…What if I totaled the car?…What if I hurt somebody else?…What if I became paralyzed?” If that is what she believed, it makes sense she would feel anxious about driving and probably avoid it. However, it might have been good for her to question, “Why can't I learn to drive a car?” and “Even though car accidents happen, what makes it certain I'm going to have a car accident if I try to drive?” Worrisome thoughts can be identified, evaluated and disputed, but it takes consistent effort. Remember also that life contains hassles, problems, and nuisances, so an absence of any distressing emotion is not going to be realistic. However, if you notice yourself worrying excessively, you might decide you prefer appropriate concern to excessive worry. The difference between worries and concerns depends on your thinking!

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

I ALWAYS WORRY ABOUT MY HEALTH. PEOPLE TELL ME I AM A HYPOCHONDRIAC. WHAT CAN I DO ABOUT THIS?

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Hypochondriasis is a disorder where someone fears developing, or believes she already has, a dreaded disease and repeatedly seeks medical attention. She is preoccupied with her health and commonly misinterprets harmless bodily sensations as indicative of serious illness. In her mind, something is really wrong with her, and the doctors keep missing the problem. She continues to pursue appointments with physicians to increase the chance of “getting to the bottom of the matter,” and she hates to be called a hypochondriac. Despite the accumulated evidence suggesting no dangerous illness, the hypochondriac doesn't consider her beliefs to be irrational or unreasonable. Most individuals with hypochondriasis are so focused on the idea of having a severe medical problem that the other matters in their life take a back seat. The vocational, romantic, family, and recreational aspects of their lives are often in shambles, and they don't recognize it.

Whereas patients frequently visit their doctors to feel better, hypochondriasis actually persists because of repeated medical examination and reassurance. People seek temporary relief strategies that ultimately keep them from disconfirming their incorrect, unhelpful, exaggerated illness beliefs. Getting better means learning alternative explanations for bodily sensations and practicing believing more accurate, realistic explanations related to one's health. Additionally, it is essential to decrease the “safety behaviors” (e.g., looking on the internet, reading medical texts, taking blood pressure and temperature) and reassurance-seeking (e.g., visiting a doctor, calling the doctor's nurse) that actually maintain the excessive worry over time.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

AS LONG AS I CAN GET REASSURANCE FROM ONE OF MY FAMILY MEMBERS ABOUT MY WORRIES, I FEEL BETTER. DO I STILL NEED TO SEEK TREATMENT FOR MY WORRYING?

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This depends on the extent and severity of your worrying. If the following statements are true for you, then it might be a good idea to seek professional treatment:

1.My worry feels out of control.

2.I feel like I can't stop worrying.

3.My worry causes me a great deal of distress.

4.My worry causes problems with my family, social, work, and recreational activities.

Reassurance from a family member or even a close friend can be helpful in the moment, but over time your problems with worry are likely to persist. Reassurance-seeking is recognized by professionals as a “safety behavior,” or a short-term coping mechanism. Let's say I worry that my husband has been in a car accident, even though there is no evidence for that. I ask my sister, “Is he okay? Did anything happen to him?” and she tells me, “He's fine…everything is fine.” I might feel better at the time, but I haven't learned anything as far as how to look at my negative thinking in a more realistic manner. What I've learned is that every time I worry about my husband, I can ask my sister about it to feel better. To really begin to make a dent in your worrying, you don't want to have to depend on anyone's reassurance. You want to learn to be your own rational coach or reassure.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

WHY DO I WORRY?

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Many factors contribute to worrying, including your biology, past experiences, the current environment, and your thought processes. To understand worry, it can be very helpful to explore self-talk (what a person is saying to himself moment-to-moment and deeper beliefs that may be creating or fueling anxiety). Worrying is usually associated with “what if?” thinking in which a person consistently overestimates threats or danger and underestimates his ability to cope. Many individuals also have superstitious or magical beliefs about worrying. For example, some people hold the false assumption that worry protects them or loved ones. Here are some of the thoughts individuals may use to justify worry:

If I stay worried about Joe, he will feel better knowing that I am thinking about him. People like to know you have them in your thoughts and prayers. It's the proper thing to do.

Worrying about others shows I'm a caring and unselfish person.

Others may be harmed if I don't keep them in my thoughts. I have to worry to protect them and me.

God will see what I sacrifice to make others happy and reward me.

As indicated above, some people view worry as a way of producing results in the world, when in reality, action is required to produce results. Repeated reassurance-seeking as well as avoidance behaviors may also maintain excessive worrying. These strategies offer short-term gain at the cost of long-term pain. When a person constantly relies on others to make her feel better, the worrisome thoughts might subside temporarily, but they tend to be strengthened over the long-run. This also happens with the use of avoidance behaviors. Repeatedly calling your daughter at college to make sure she is safe or not going to work because you are afraid you made a mistake on a report are examples of behaviors that actually give worry more power over you. Resisting making the call to your daughter and going into work despite the mistake are ways that you show yourself “It wasn't as bad as I thought” and “I can handle this even if it is uncomfortable.” These thinking and behavior changes are essential for chipping away at your worry!

There is no simple answer to the question “Why do I worry?” but do keep in mind that worry is a habitual way of negative thinking that can be improved.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

ARE THERE ANY MEDICATIONS THAT ARE OKAY FOR SOMEONE OVER 70 TO TAKE FOR ANXIETY?

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The SSRI antidepressants are effective for treating many anxiety disorders and are generally safe for older adults. However, they can have some uncomfortable side effects. For example, taking Paxil, which has more anticholinergic properties, may result in mild interference with memory. In general, the main drawbacks of SSRIs are that they can induce more anxiety at first, and they take a fairly long time to work (anywhere from 2 to 10 weeks). Doses for older individuals may also need to be lower than usual starting amounts.

The benzodiazepines are commonly used to treat anxiety, but they can create problems for older individuals. These medications may interfere with memory when memory may already be failing. If taken before bedtime, they may make it difficult to wake up and use the bathroom at night. Benzodiazepines may increase the risk of stumbling and falling. If there are any breathing problems, these medications may over-sedate the breathing muscles and cause problems with more shortness of breath. Increased anxiety may follow when people feel like they can't breathe adequately.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD