Most of the time, even after we’ve done all we can to prevent a bad outcome, we can’t eliminate the possibility that something could go wrong. Maybe it’s missing a flight, or getting sick, or messing up at work, or losing someone we care about. We don’t have ultimate control over whether these things might happen. When we have a hard time living with this uncertainty, we might return to the situation in our mind and keep turning it over, imaging every “what if” and how we might handle it—we’re trying to control an uncontrollable situation. Worrying about uncertain future events reinforces itself.
Feeling afraid about life issues is common as you age, but if it takes over your life, you may have generalized anxiety disorder (GAD).
Everyone feels afraid or worried at times, but if these feelings begin to take over your life, then you may have crossed over into generalized anxiety disorder (GAD), which is the most common anxiety disorder among older adults, according to the Anxiety and Depression Association of America (ADAA).
“The issue with many older men is they often just endure the discomfort of GAD, or think it’s normal, and do not talk about the problem,” says Dr. David Mischoulon, director of the Depression Clinical and Research Program at -Harvard-affiliated Massachusetts General Hospital. “However, left alone to manifest, GAD may lead to serious health problems, such as high blood pressure, depression, and addictive behavior like excessive drinking.”
GAD symptoms
GAD is defined as feeling anxious, fearful, or worried about multiple unrelated events or activities every day for at least six months. People with GAD constantly anticipate disaster and are overly concerned about issues like health, money, and family, even when there is no apparent reason for concern.
GAD tends to run in families and may be something you have always dealt with, but it also can be triggered by sudden changes, says Dr. Mischoulon. For instance, the death of a spouse or friend may make you feel vulnerable about being alone.
A minor health issue might cause anxiety about serious problems later. GAD also can keep you from engaging in a healthy lifestyle — you may refrain from any exercise for fear of injury, or avoid social outings.
One of the main issues with GAD is that men have trouble acknowledging it as a problem. Many believe it’s natural to worry more about life issues as they age, and often they can function well enough with a moderate level of anxiety. They even may rationalize their constant worrying by believing it prevents bad things from happening. This may explain why only about 43% of GAD sufferers get treatment, says the ADAA.
The first step to dealing with GAD is to acknowledge you have it. “Many men understand what’s causing their fear and worry, but often don’t want to face it,” says Dr. Mischoulon.
Other times, the source is not clear. If you suspect your worrying is excessive, consult with your doctor. He or she can determine if it may be related to another health issue, and if not, refer you to a psychologist or therapist for further evaluation, diagnosis, and treatment.
As we get older and look back on our lives, many of us will think, “I wish I’d worried less.” We come to recognize that worry isn’t worth what it can cost—tension, poor sleep, irritability, fatigue, problems concentrating, and general unhappiness. After all, most of what we worry about never happens. If worrying has so many drawbacks, then why do we do it? When some future outcome is uncertain, we want to make sure it turns out well.
How can a mental state tied to so much anxiety be rewarding? Each time we worry and nothing bad happens, our mind connects worry with preventing harm:
Reasons We Worry, and Ways to Worry Less
- worry → nothing bad happens.
And the takeaway is, “It’s a good thing I worried.” (We probably aren’t consciously aware of this thought process.)
On top of the self-perpetuating nature of worry, there are five common beliefs about worry that compel us to keep doing it:
- If I worry, I’ll never have a bad surprise.
Nobody likes to be blindsided by bad news, so we might worry to preempt disappointment. Unfortunately we can’t foresee everything that will happen to us, so it’s impossible to avoid upsets. In the meantime, how much are we suffering by fearing the future?
- It’s safer if I worry.
Our beliefs about worry can have a superstitious element because we believe that the act of worrying itself somehow lowers the likelihood of a dreaded outcome. We might think that if we stop worrying we’d be inviting trouble. But if we constantly worry, we never get to test out this belief to see if it’s true. Most of the time our worries are about as impactful as mentally “keeping the plane up” when flying in an airplane (assuming we’re not the pilot).
- I show I care by worrying.
We might tell ourselves that worrying says something good about us: “I only worry because I care.” This may be true, but we too often turn it around and think, “If I didn’t worry it would mean I don’t care.” We need to distinguish between caring about a situation—including doing everything in our power to help it turn out well—and worrying needlessly and fruitlessly about it. If in doubt, we can ask family members if they’d rather we worry or show we care in other ways.
- Worrying motivates me.
It’s not uncommon to believe that if we stop worrying, we’ll become complacent or unproductive. Think about a recent time you were gripped with worry: Can you imagine yourself being motivated to take care of the situation, even if you weren’t worrying so much? We need to differentiate between unproductive worry and productive concern and problem-solving.
Worrying helps me solve problems.
We might tell ourselves that worrying is how we find solutions to our problems. However, extreme worry is more likely to interfere with problem-solving. Once more, we need to be aware of the difference between productive problem-solving and wheel-spinning worry. Consider these two modes in your own experience: How does it feel to be taking care of a problem vs. worrying about all the what-ifs?
At this point, you might be thinking, “This is all well and good, but how am I supposed to worry less?” Let’s be honest: It’s really hard to stop worrying, so it helps to have multiple tools to assist us with the process. Here are five:
Calm the nervous system.
When we’re constantly worried and on edge, our nervous system is on high alert. Mental tension translates into physical tension, which can make us feel like we really should worry because we’re feeling so physically agitated. It can help to have ways to quiet our mind and body and find a sense of ease. There are multiple ways to do this, such as guided muscle relaxation, meditation, and exercise. (Here’s a simple, one-minute exercise that you can practice virtually anywhere).
Notice when you’re worrying and any beliefs that reinforce worry.
We often don’t recognize what our mind is up to. We might be aware of feeling anxious and stressed but we don’t realize that we have some degree of choice in letting go of worries. Awareness of the process gives us more choice in how we respond.
Embrace uncertainty.
Most of the things we care about in life involve uncertainty. We can’t be absolutely sure we’ll do well in school, that people will like us, that we’ll always have our health, or that we’ll have a happy marriage. And yet we don’t have to allow this uncertainty to stop us from living the life we want. Beyond simply tolerating uncertainty, we can embrace it as an inherent part of living. We spend so much time trying to eliminate uncertainty that it takes considerable practice to begin to embrace it.
Live in the present.
Training in mindful awareness is often a part of the treatment for excessive worry (as in generalized anxiety disorder). Mindfulness emphasizes focusing our mental energy on the present, with openness and acceptance—an attitude that is helpful on many levels. Worry is by definition about the future, so training your attention on the present is a powerful way to reduce your worries. We can practice focusing our attention on the present in everyday activities like taking a shower, walking, or talking with a friend, as well as in more formal practices like meditation or yoga.
Face your fears.
Worry is intended to protect us from our fear, and yet it can lead to dwelling on things that will never happen. When we face our fears head-on, they tend to diminish. Rather than worrying uselessly, we can practice deliberately accepting that what we’re afraid of could happen: “It’s possible I’ll miss my flight.” “I can’t know for sure that this sniffle won’t turn into a nasty cold.” “I can’t be entirely sure I won’t lose my job.” At first, it will probably feel frightening. With repeated practice, though, our fears become less gripping and we can confront them with greater equanimity.
It takes practice to worry less when we’re in the habit of worrying. Even when we’re determined to leave our worries behind, our mind will almost certainly will return to them. Dropping our worries is a lot like meditating: Our thoughts will return to our worries, just as our minds will wander from the breath when we meditate. We can set an intention, and then return to it when we notice our mind has drifted. We can’t eliminate all worries, but we can choose where we direct our attention.
Seeking help
Cognitive behavioral therapy (CBT) and medication are the standard ways to treat and manage GAD. With CBT, a psychologist or therapist works with you to uncover past experiences that may be the source of your anxiety.
Next, he or she explores negative thinking patterns that trigger your feelings of worry and helps you develop strategies to limit destructive thoughts and reinforce positive ones when anxiety occurs. Anti-anxiety medication is also used to help increase certain brain chemicals that are associated with a person’s ability to relax and feel calm.
The type of treatment that is tried first is often guided by how long your fear or worry likely will last. For example, if it is related to some specific situations, such as a recent move to a new neighborhood or struggling to pay off a mortgage or other debt, then CBT alone would be a reasonable first step. If the source is more long-term, like a chronic illness or other health issue, medication is often prescribed along with CBT.
Lifestyle approaches are sometimes added to a person’s treatment to help alleviate GAD. These might include exercise, mindfulness meditation, art therapy, or expressive writing (in which you write about your fears and worries).
When it comes to GAD, you should never feel pressured to “tough it out” and expect it to go away on its own, says Dr. Mischoulon. “GAD can worsen and lead to more complicated problems, and they certainly reduce quality of life. For older men, the right treatment can help them to maximize their golden years.”