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Worry-Prone Patient
Aka: Worry-Prone Patient, Excessive Worry, Meta-Worry
- See Also
- Anxiety Disorder
- Anxiety Secondary Cause
- Anxiety Symptoms
- Generalized Anxiety Disorder
- Obsessive Compulsive Disorder
- Body Dysmorphic Disorder
- Panic Disorder
- Social Anxiety Disorder (Social Phobia)
- Acute Stress Disorder
- Post-Traumatic Stress Disorder
- Anxiety Non-pharmacologic Management
- Anxiety Pharmacologic Management
- Pathophysiology
- Worry is a normal short-term response to uncertainty
- If Worry persists it becomes maladaptive, dysfunctional
- Provoked by sense that worry prevents serious events
- Also may be coping mechanism, blocking other emotions
- Symptoms: Presentations
- Presentation for worry itself is uncommon
- Patients will admit to worry if asked
- Patients usually present for other secondary concerns
- Insomnia
- Irritable Bowel Syndrome
- Fibromyalgia
- Signs: Distorted assumptions
- Belief that over-thinking issue offers benefits
- Certainty or sureness
- Relief of pain or discomfort
- Prevents bad events
- Worry shows that I care
- Sense of guilt, lack of control that led to mistakes
- Feels need to be hypervigilant about every thought
- Differential Diagnosis
- Generalized Anxiety Disorder
- Hypochondriasis
- Major Depression
- Dysthymia
- Obsessive-Compulsive Disorder
- Panic Disorder
- Post-Traumatic Stress Disorder
- Social Phobia
- Management
- Medications (start at half dose and increase slowly)
- Selective Serotonin Reuptake Inhibitors
- Venlafaxine (Effexor)
- Cognitive Behavioral Strategies
- Worry is not an effective warning or control method
- Re-evaluate: What is the real risk of bad events?
- Re-frame: Will this matter to me in a month?
- Perspective: I do not have control over most events
- Frequent search for reassurance is temporary relief
- Ask others to withhold reassurance and break cycle
- Worry does not need constant and immediate attention
- Set appointments to deal with worry and concerns
- Do not try to suppress worries or emotions
- Spend 20 minutes focusing on concern
- Follow appointment with Exercise or social time
- Learn strategies to handle over-powering episodes
- See Relaxation Training
- Meditation
- Breathing Exercises
- Relaxation Techniques
- Write down worry, address at "worry appointment"
- Recognize worry as a problem to resolve
- Worry causes tension, stress, and somatic symptoms
- Worry is an unhealthy habit
- References
- Hudson (2005) Pediatr Ann 34(2):91-106 [PubMed]
- Pigott (2003) Pyschiatr Clin North Am 26(3):621-72 [PubMed]
- Shearer (2006) Am Fam Physician 73:1049-56 [PubMed]