Excessive worry is part of many mental health disorders and can lead to physical illness. Sometimes it's smart to worry. It can force us to plan or to take safety precautions. Worry can lead to wellness. If we didn't worry some about our health, would we eat right and exercise? Probably not.
But worry can also escalate so it's excessive, chronic, or both — anything but healthful. It's a common thread running through many mental health disorders. In depression, worry may take the form of guilt (worrying about having done something wrong) or distress about feeling incompetent. Obsessive-compulsive disorder is well-known for its intrusive, uncontrollable fears of contamination and losing control. Health anxiety is excessive worry about becoming sick. The extreme form is hypochondriasis, which often involves seeking unnecessary care for imagined illnesses.
General anxiety disorder is an officially recognized psychiatric condition in which worry is the dominant feature. People with the disorder are tormented by worries about ever ything from daily events to interpersonal relationships to potential disasters that are completely out of their control. For them, it's as if worry has become an irresistible habit, says Steven Shearer, a psychologist at the Franklin Square Hospital Center in Baltimore who has written about excessive worry.
Getting physical
Excessive worry isn't always experienced as a mental health problem. For some, it shows up as fatigue, headaches, stomachaches, and vague pain. In the past, doctors were perhaps too quick to think that a patient's unexplained physical problems were "all in his head." But not to consider poor mental health (of which worry is often a part) as a possible source of physical ailments is also misguided.
Medications can help. Doctors prescribe fluoxetine (Prozac) and the other selective serotonin reuptake inhibitor (SSRI) antidepressants and newer drugs like venlafaxine (Effexor), which influence levels of the brain chemical norepinephrine as well as serotonin. Talk therapy is also effective for many. The most studied approach is cognitive behavioral therapy, which aims to fix unhealthy patterns of thinking and associated behavior.
A heads-up maneuver
When we feel threatened, the fight-or-flight response kicks in, and our bodies get ready: The heart starts pounding; blood flows to major muscles; hormones like epinephrine (adrenaline) and cortisol flood the bloodstream. It is a strongly physical response. If a danger is immediate, or seems so, you can take action: You can jump out of the way of a speeding bus, notes Thomas Borkovec, a Penn State psychology professor and expert on worry.
