In this series of articles, Stress Illness: The Complete Guide, you’ll learn everything you need to know about Stress Illness/Psychophysiological Disorder/Mindbody Syndrome. Each article addresses a different aspect, the principles of recovery, physical symptoms, emotional aspects, the cognitive elements, the behaviours of those suffering, the losses they face, and the remedies and therapies that are gaining research backing as effective treatment choices. The articles build into a useful reference for those wishing to understand more about the complexities of Chronic Pain and Stress Illnesses.
This article is the 7th of the series and will focus on the most prolific behaviours we engage in when experiencing Chronic Pain or Stress Illness. We also why it’s essential to address this to supercharge recovery.
What is Worry?
Worry is a process. It’s something we do with some of our thoughts. Therefore, it is an action.
Worries tend to be ‘sticky’, with the same ones being played out time and again. Sometimes in different disguises. But always creating a negative emotion. Most commonly anxiety, but sometimes frustration, or upset.
They focus on the future and usually create a seemingly realistic set of possibilities or predictions about the outcome of events.
Example:
A thought could be: “I have back ache.”
The worries that follow might be: “What if it doesn’t go away?” What if it gets worse?” “What if I can’t carry on working?” “I’ll have to give up work.” “I won’t have any money.” “I’ll end up homeless.”
Without awareness, the worries escalate, multiply, and cause more negative emotions.
The catastrophising leads the mind to recognise a possible threat to survival (physical or moral). This initiates the adrenaline response in the body and the fight/flight/freeze response is instigated.
Imagine being called to the start line for the 100 meters sprint. “On your marks”. You are then told to, “Get set.” As you take up the position. Fingers on the line, body bent over and supported on your toes. And you wait. Hypervigilant and eager to hear the word, “GO!”
But it doesn’t come. You are suspended there, waiting. Looking and listening. Ready to run as soon as you’re told to. But there is no further instruction. Your body starts to ache. Your shoulders get stiff. Craning your head around, you look for any sign the order might come. Your heart is beating harder and faster. You are breathing harder and faster. Unable to take in the air to your lungs effectively due to the position you are stuck in. You become fatigued, anxious, and alert. It's like having your foot on the accelerator (gas) and the brake at the same time.
Worry is a type of freeze response. You can’t run or fight the situation. You are stuck.
The impact of this on our body at that moment is unpleasant. But with extended time, and the repetitive nature of worry comes the escalation of, and sensitisation to, these feelings.
Being a worrier means increases in adrenaline and cortisol more frequently than others in the population.
How is Worrying Linked to Stress Illness and Chronic Pain?
Cortisol, the chemical designed to keep us safe becomes so common it affects aspects of the body it was supposed to support.
Endorphins are reduced, increasing the sense of pain.
Insulin is overproduced, increasing the risk of diabetes.
Serotonin is depleted over time, meaning mood and sleep are affected in adversely.
The immune system is disrupted and inflammation increases.
All these results in further pain and anxiety.
The unrelenting nature of worry is stickiness. The way it comes back time and again undermines the person's autonomy. They feel helpless against the worry and anxiety, And thus the resulting physical symptoms. This further compounds mood and the motivation to make changes.
And with increased pain, comes increased worry. That is why chronic pain seems to escalate over time.
So, if worry is so bad for us, how and why did it evolve?
Since humans evolved to have a prefrontal cortex, they've had the ability to imagine the future. This has been a blessing. Allowing us to survive as a race. It enabled the advent of fire, the wheel, and the Internet. Every intervention started with someone imagining a different future.
But with this amazing capacity comes the ability to imagine the bad as well as the good, the negative as well as positive solutions.
The brain provides the resources to construct several possibilities from just one input, which includes what we see, hear, taste, touch, and feel, internally or externally.
The stimulus sparks a thought. With no further attention, that thought will evaporate (and any emotional tone with it). With positive curiosity, it will develop into various hypotheses. And if the emotional tone is negative, it has the possibility of becoming worry.
Worry may have been learned vicariously from parents or caregivers. Or as a survival strategy, as a way to solve problems when young. This is especially true if the individual wasn’t taught emotional intelligence.
Without the knowledge gained from emotions, a person doesn’t have the body to provide answers and ground them in the present. They instead learn to live in their head, in the future, to overthink, and form beliefs about the practical benefits of worrying.
They think that worrying proves that they care. That it increases their thoroughness or effectiveness. Or they believe that worrying helps them to stay safe. Worry becomes a habit.
How Can We Stop Worrying?
Habits can be learned and unlearned. New habits can be created. To be able to change anything, all we need is hope, the right skills, and the motivation to do the work.
Hope comes from the curiosity to become aware of and understand the status quo and the alternatives. The right skills can be learned from someone that has been there before you. And the motivation to change comes from the willingness to invest time and energy into making the change, knowing that it will pay dividends.
If you think that worry contributes to your pain and stress illnesses, then I’ve created a short quiz to check if you worry too much.
Next time I'll be discussing the losses that are experienced when we suffer chronic pain or stress illnesses.