What (worry) lies beneath

Graeme Gillespie discusses strategies to manage worry.

Living with cardiomyopathy often involves feelings of future risk and threat, to ourselves and our family. Understandably, this can lead to worrying.

My previous article highlighted the way worries can prompt you into doing something to look after yourself or your loved one, which can be helpful. But thinking about possible problematic or even catastrophic futures that we can’t do anything to prevent, can leave us in a mental stew, feeling anxious and restless.

Living with the enemy...

Ray Owen’s book, ‘Living with the Enemy’, includes a good example of unhelpful worrying about a long-term condition. On the surface, one of his fictional characters (Bill) is currently doing quite well, despite having been diagnosed with Multiple Sclerosis ten years ago. Everyone tells Bill he’s coping brilliantly, but what people don’t see is what’s going on under the surface. Like seeing only the tip of the iceberg, people don’t see Bill’s worries. They don’t know how he lies awake at night worrying about his future and thinking about lots of potential difficulties. What if his symptoms get worse? What if he ends up in a wheelchair, or becomes a burden to his family? Bill’s life has become dominated by thoughts under the surface. He can keep them at bay by being busy during the day, but at night, he can’t turn off the worry thoughts or the feelings of sadness, fear and anger they generate. His ‘unhelpful worries’ mean he is living his life now as if all the things he fears have actually already happened. It’s as though he has become tangled up or ‘fused’ with his own unhelpful worry-thoughts. Bill’s worries are understandable. And some of them may come true. But what a tragedy it would be, if in a few years’ time - should his life become more limited - he looks back and wonders why he didn’t enjoy life more when he could do the things he’d now want to do?

What might help?

For minor worry, gentle distraction, such as engaging in an enjoyable or mentally demanding activity, can be helpful. But for really troubling worries, trying to avoid unhelpful thoughts tends to keep them going. 

  • If we try to get rid of the worry - for example, through being super-busy - the worry often just keeps coming back. 
  • If worry is causing you anxiety and stopping you relaxing or sleeping, it can help to write the worries down.

Putting your thoughts in writing

Although it may seem an odd thing to do, writing down your worries and giving them careful consideration, allows you to see more clearly what’s going on under the surface. By seeing your thoughts ‘on the page’ you can see your worries more clearly. Although this may increase the anxious or upsetting feelings in the short term, if you are able to sit with them for a few minutes, they will gradually start to reduce.

And you can see that your worries are just thoughts. By labeling them as thoughts, you can become less tangled up in, or ‘fused with’ those unhelpful worries. For example, try reading them back to yourself by adding, “I’m having the thought that…” at the start of each worry.

Setting aside time to worry

Another approach involves scheduling a few minutes aside each day to focus on your worries. It may even help to set a timer for 10 to 15 minutes. During your planned worry time, write down all your worries in a list. Then consider each worry carefully. Write down if there is anything you can do to help deal with it. (Don’t forget to act on this later). If there isn’t anything, go on to your next worry and do the same. Once your worry time is over, it’s time to get on with the activities of the rest of your day.
If a worry should pop into your mind - especially at night - you can jot it down for tomorrow’s worry time.

Other strategies

Our minds can work like a time machine, hopping backwards and forwards in time. By stepping out of our own mental Tardis, we can get more in touch with our current experiences.

  • The website Be Mindful (opens new window) provides a link to online resources and local mindfulness teachers who follow nationally agreed Good Practice Guidelines.
  • It’s also important to remember that worries thrive when the body is physically agitated, such as through smoking or drinking excessive caffeine or alcohol.
  • Cardiomyopathy can sometimes cause fatigue and shortness of breath and make it much harder to take regular exercise or engage in activities you used to enjoy.
  • A trusted healthcare professional, such as your GP or cardiologist/ specialist nurse, can advise you about sensibly-paced physical activity to help both the body and the mind to feel better.
  • If anxiety and worry are dominating your life and self-help approaches don’t work or feel enough for you, your GP or nurse can guide you to other sources.

Psychological therapies

Excessive worry, alongside other symptoms such as restlessness, feeling constantly ‘on edge’ and irritability, is sometimes referred to as Generalised Anxiety Disorder. There is evidence for the benefits of psychological therapy and of medication to help manage symptoms such as these.

Worry affects us all. It is part of being human and having such wonderful, but tricky minds. While writing this article, I have become aware of my own mind’s tendency to worry. What if someone feels worse after reading or acting on it? What if these ideas are shown in the future to be mistaken? What if I’ve missed out something really important? So ‘physician heal thyself’ applies to psychologists too. And it’s helped to write that down!

Graeme Gillespie is a consultant clinical psychologist at Northumbria Healthcare NHS Trust.

This information is taken from an article in our magazine 'My Life'. You can sign up to receive the magazine.

©Cardiomyopathy UK. 2017.