Anxiety is the most common symptom of patients seeing a psychiatrist or a psychologist. About 5% to 8% of people each year are believed to have an anxiety disorder, about the same percentage have depression which often accompanies anxiety. Indeed, learning to cope with stress reduces the risk of depression. The major anxiety disorders are generalized anxiety, panic disorders, agoraphobia, and other specific phobias. Women are two or three times more likely to be diagnosed as being anxious than men are. We don't know why, perhaps because they admit fears more, see doctors more, get therapy more, have fewer rights and opportunities, are more abused and deserted, have to care for children alone and often work outside the home too, etc. Girls are also more prone to anxiety than boys, Blacks more than Whites, and the poor more than middle class.

You might think it is the busy executive who is most affected by stress. You'd be wrong. More likely to suffer from stress is the ordinary worker who is under heavy pressure to perform and has little control over decisions. Thus, the most influenced by stress is the factory worker, waiter, clerk-typist, data entry type who has fixed hours, limited breaks, rigid procedures, and little to say about conditions, solutions to problems, time off, lay offs, etc. Executives, business owners, managers, professionals may feel stressed but they are less affected by it. They are more motivated, more flexible, more challenged, and they can make decisions and run their own lives; this seems to be related to their being 2 to 4 times less likely (than the clerk) to become sick from the stress of their job. Still, in any job there are ways to relax (breaks, exercise at lunch, support from peers, calming fantasies, deep muscle relaxation, having hopeful positive thoughts, keeping a journal of your feelings, etc.).
An anxious person usually also has a history of associating with stress-related disorders, i.e. older relatives have been tense or fearful, poor social adjustment in the past, poor school adjustment (especially refusing to go to school after age 10), and general over-reactions to pressure or threats.

Panic attacks are thought of as being different from general anxiety; they respond to medicine differently. When the anxiety or panic is severe both medication and psychotherapy are advisable. I will briefly discuss a few of the anxiety-related psychological problems, such as worry, shyness, insomnia, burnout, phobias, panic attacks, obsessive-compulsive behavior, and psychosomatic disorders. There are others, such as Post-traumatic Stress Disorder, Dissociative States, and Multiple Personality, which usually require psychotherapy and so the details of treatment will not be discussed at length here. However, a considerable amount of general information about Dealing with Trauma has already been provided. If you have been traumatized, read this material and you will realize that several recent writers have provided help in understanding and getting over a traumatic experience.

Anxiety previews bad happenings; depression reviews bad happenings. Worry is anxiously anticipating that some awful, scary, unpleasant events are going to happen. Worry also involves trying to think of ways to avoid these unpleasant happenings (Borkovec, 1985). Worry is an unpleasant, upsetting activity that we'd like to stop but we can't; sometimes we can hardly think of anything else and can't sleep. Worrisome fretting is an effort to solve problems that results in our imagining more problems than solutions; thus, we never find a good place to stop worrying. The stream of worries goes like this: "I have to get that report done this weekend... what if the boss gets mad about what I said... if I lost my job it would be awful... I saw a homeless family on TV today... we should be saving more money... I wonder if my marriage would survive hard times... Oh, God, what if I couldn't take care of the kids..." Each little worry expands into a three hour, award winning movie or flows into an unending elaboration of other worries.

A chronic worrier estimates that he/she frets unconstructively like this for several hours a day! That's about 15% of our population! On the other hand, the non-worriers, about 30% of us, say they worry less than a hour and a half a day or benefit from their worries (planning). Borkovec says the chronic worrier thinks so much about possible troubles that he/she doesn't have the time to carefully and completely solve problems. The chronic worrier is more emotional in general (anxious, sad, angry, scared) than the non-worrier. They tend to be particularly afraid of being criticized and, thus, try to foresee every possible mistake. There are so many ways to go wrong--to make a mistake--that the worrying person may have great difficulty finding solutions to his/her very complex problems.

How can a worrier stop worrying excessively? One approach is to try to get worrying under situational control, i.e. set aside a time (perhaps 1/2 hour each day) and a place to worry, and only worry there. To do this you also have to detect the onset of worrying and tell yourself to put it off until the appointed time and place. Thought stopping or focusing your attention immediately back on the task at hand might help avoid the continuous worrying. Use the "worry period" to develop at least a crude plan (not the perfect plan) for current concerns. Writing your worries in a journal can help.

A reduction of the worrier's stress level might reduce the pressure to think, so any of the anxiety reduction techniques by using relaxation might help. Clearly, decision-making and goal setting planning would help the indecisive worrier cope and move on. Worries are often useless; this awful event that might happen, often doesn't happen. Thus, the worrier needs to use the cognitive methods to straighten out his/her thinking, making it more realistic and stopping the "awfulizing" or "catastrophizing." Also, the worrier should be reminded that half of the formula for anxiety is self-doubt about being able to handle the expected crisis. Building self-confidence in coping with problems will reduce the unproductive fretting. Finally, one should always wonder if the worries serve some secret purpose, such as proving "I'm a good worried father" or distracting you from some deeper, more basic fear (better to focus on protecting my daughter from boys than to think about my own sexual problems with my wife).

Laboratory studies as well as clinical observations have shown that worriers under stress tend to over-estimate the degree of risk they face. If you think of more risks and threats, then your anxiety and worry levels go up. Worry is not a simple reaction, it is complex, including conditioned emotional reflexes possibly learned even in childhood, ingrained habits of responding, and cognitive processes that exaggerate the dangers ahead, set impossible or unrealistic standards, and reflect low self-confidence.

So how a worrier could possibly stop worrying excessively might include: directly countering the worrying behavior by relaxing in any one of several ways, by rewarding more confident and happy self-talk, by exercising, using massage, and thought-stopping, or by diverting attention with music, TV, reading, and socializing, and by practicing successfully facing stressful situations over and over again. One could also reduce worrying by changing one's thoughts, such as correcting unwarranted negative expectations, reducing tendencies to falsely view current situations negatively ("awfulizing"), giving up overly demanding perfectionistic standards ("I must always be right") and by correcting the refusal to accept the lawfulness of all behavior ("It's got to be different"). There are a lot more ways of reducing worries: one can learn new skills and problem-solving or decision-making methods, which can change things and strengthen the belief that one can cope with difficulties that might arise. Moreover, one might gain insight into his/her negativity, train oneself to be more optimistic, higher in self-esteem and self-efficacy, or perhaps even happier, and develop an inspiring life plan. Worry can be controlled but often not easily.