Worried Sick: The Physical Toll of Worry

By Dr. Linda Mintle –

Chapter 4 excerpt

Heavy thoughts bring on physical maladies;
when the soul is oppressed so is the body.

—Martin Luther

Worrywart is a label given to someone who worries constantly about everything. You may have used the term to describe someone you know—or yourself. Though the origin of this term is not clear, the Oxford English Dictionary first used it to describe a neurotic group of residents in a mental hospital. That should tell us something!

Later, the word was used in popular culture by cartoonist James R. Williams in his 1922 to 1957 comic strip, “Out Our Way.” The character who was considered to be a worrywart was not the one who worried. He, the worrywart, caused worry in others.

Today we joke about worrywarts and do not take them seriously. But we should. The truth is, worry does damage to body, soul, and spirit. Holistically, worry is wearisome. It depletes the body, discourages the soul, and dampens the spirit. Overall, worrying interferes with the joy of everyday living. No one wants to be a worrywart.

In this chapter, we will look at the impact of worry on the physical body and how a lack of self-care can trigger worry. Because worry affects our physical health, it is time to re-evaluate the way we live and make changes if needed.

Women worry more than men

It turns out that worrywarts are more often women than men.1 Some of you may think this is no surprise, but the reason for this difference is complex. It involves the way men and women think, feel, behave, and develop biologically. There is no one reason for it; rather, a number of factors form the greater sensitivity women seem to exhibit toward worry.

In our culture, worry is often viewed as a feminine trait and seen as a behavior associated with being female. Not only is it more acceptable in our society for women to worry, but women also tend to internalize their problems, making it easier for them to worry.  And since worry is a type of internal coping, it makes sense that women worry more. We use worry as a coping skill.

However, the playing field is more equal when we consider what people worry about. Women and men have equal levels of worry about finances, the future, interpersonal relationships, and competence at work. For women, self-confidence plays a key role. Thoughts such as, “Will I look stupid?” “Will he or she approve of me?” “Will I be able to handle this?” relate to a lack of confidence and can elevate feelings of failure and powerlessness over one’s life. And because women often have lower status in the workplace and at home, the lack of confidence contributes to more stress that leads to worry. Thus lack of self-confidence, more common in women than men, creates worry.

In a study published in the Journal of Anxiety Disorders, researchers concluded that women win the worry game because they engage more in what is called thought suppression (avoiding thoughts). Thought suppression will be discussed in a later chapter because it is often used to try and stop worry. It does not work—but women still use it. Here is how it works.

Because the content of worry is usually negative (for example, my child could die, I could crash my car, and so on), women try to suppress the thoughts. But attempts to suppress a thought usually result in preoccupation with that thought (worry). The more you try not to think about a worry, the more you do. So telling yourself to stop worrying usually does not work.

In contrast to men, women tend to obsess more about their thoughts and think more about feelings. Men avoid worry thoughts and use distraction to cope. Distraction focuses thinking away from a specific worry.

Men do win the worry game when they believe that worry works for them in some useful way, as we discussed in the last chapter. So, when men believe worry helps them or is beneficial, they worry more than women. What you think about worry matters. (All of chapter 6 is devoted to the issue of worried thoughts.)

Finally, worry may be related to hormones. There is a biological difference that may impact the way men and women deal with stress interpersonally. Author Holly Stevens contends that the hormone difference between men and women plays a role in why women are better worriers. In her book Women Who Worry Too Much, she says that female hormones dampen the “fight-or-flight” response that occurs with stress. Instead of fighting or fleeing stress, women use a “tend-and-befriend” strategy. When they perceive danger or stress, their instincts are to take care of others (tend) and turn to social networks of supportive women (befriend). This tend-and-befriend coping style results in women avoiding threats more than men, and thus it reinforces anxiety and worry.

Worried sick

As mentioned, anxiety is a normal reaction to stress. When your body perceives a threat or danger, it tries to flee from that danger or stay and fight—the fight-or-flight mechanism mentioned above. During worry, the body behaves like it does when a threat is perceived. The body believes danger is present even though it is not. The brain triggers the fight-or-flight response in order to protect you. Your brain then remembers that trigger for the future, and anxiety is born. Chronic anxiety damages the body.

If you hold on to anxiety once the perceived threat or danger is over, you move from normal anxiety to worry. Worry keeps the mind in overdrive, and the physiological reaction of fight-or-flight (the surge of adrenaline that puts our bodies on alert) remains. The sympathetic nervous system continues to release stress hormones such as cortisol. These increased hormones raise blood-sugar levels and triglycerides, which can result in headaches, irritability, muscle aches and tensions, dizziness, difficulty swallowing, shortness of breath, dry mouth, fatigue, inability to concentrate, nausea, nervous energy, sweating, trembling, twitching, and others. And when stress triggers excessive worry, a chronic state of anxiety leads to immune suppression, digestive problems, muscle tension, short-term memory loss, premature coronary artery disease, and even heart attack.

Ken’s doctor believed a state of worry was the source of his heart problems. After going over multiple stresses in his life, the doctor asked Ken, “So what do you do to release all that stress?” Ken could not come up with an answer. The more he thought about it, the more he realized he mostly worried and had no outlet to reduce stress. He had never considered that worry could be placing him in physical danger.

Rachel had a similar experience with her doctor. After several rounds of sickness, her doctor felt that her constant worry was suppressing her immune system, making her more susceptible to illness. Until she learned how to let go of negative thoughts and relax more, illness would be a part of her life.

Worry is bad for your heart

Worry impacts every system in the body. It raises blood pressure and cholesterol, increases blood clotting, and creates headaches; back pain; stomachaches, and more. As Ken found out, the heart is no exception. Worry activates the cardiovascular system in a negative way. Here is why.

When we worry, we keep stress at the forefront of our thinking. Worry creates a cognitive representation (a thought) about stress that keeps this negativity going in our minds. Continuing to think about the negative thought through worry arouses our bodies. The result of this arousal is an elevated heart rate.

Worry is also a form of self-talk. It is made up of thoughts and is an internal monologue. It works to avoid feared events this way. When you visualize an image of something feared, the impact on your body is stronger than if you simply think about the feared event. Specifically, researchers found that mentally picturing a feared event elicits a stronger cardiovascular response than thinking about that event. Thus, your body gets less physically aroused when you think worried thoughts than if you picture the feared event. In essence, worried thoughts calm the body more than visualizing problems. Worry lowers physical arousal because it involves thoughts not images.

Job worries especially stress the heart

Researchers in the Netherlands and at Ohio State University found that the strongest effects on the heart came from worry involving work- related stress and worry about future issues. In terms of job stress, it was the moment-to-moment worries on the job that were the source of concern. When our worries are specific to work, the impact to the heart is shown to be as great as smoking (a risk factor for cardiovascular disease). And anticipatory stress (worrying about things that have not yet occurred) causes cardiac activation regardless of whether or not the stress ever pans out.

A group of researchers associated with a study at the Harvard School of Public Health also concluded that high levels of worry increase coronary heart disease. Since worry is part of anxiety and anxiety is related to increased incidence of coronary heart disease, it makes sense that it would increase the risk for this disease. The point is that worry does more than produce an anxious feeling; it wreaks havoc on the heart and the rest of the body.

Five changes to eliminate the negative

Not only does worry put you at risk for cardiovascular problems, it can actually lead to unhealthy habits that make you likely to die younger than a non-worrier. Researchers at Purdue University found that men who are natural-born worriers drink, smoke, and develop other unhealthy habits to deal with their worry. These habits raise mortality rates. So if you are prone to worry, evaluate your lifestyle. You may need to make a few adjustments in order to reduce your tendency toward anxiety and worry. Here are a number of suggestions.

Eating habits

Begin with your eating habits. Sugary snacks and high amounts of refined sugar can cause blood sugar to rise and then fall sharply, leaving you feeling emotionally and physically drained. So eliminate as much refined sugar from your diet as possible. This means saying no to sodas, fruit drinks, and coffees and teas loaded with sugar, eating fewer desserts, and monitoring portion size when you do indulge.

Simple starches are also quickly converted to sugar in the body, so reducing or eliminating pastas, refined cereals, chips, and white bread and eating more whole grains, vegetables, and other complex carbohydrates helps. Do not skip breakfast or other meals. Eat small meals during the day. When you go too long without eating, blood sugar falls and you can feel anxious and irritable.

Excessive use of salt also stresses the body. It can deplete potassium, a mineral you need for proper functioning of your nervous system, and it also raises blood pressure. Raised blood pressure puts extra strain on your heart and arteries. Sodium (salt) is in a number of processed foods. Look for foods that are labeled low sodium or salt free. And go easy on that saltshaker sitting on your kitchen table.

Using caffeine

Caffeine can increase anxiety, interfere with your sleep, and even trigger panic attacks in some people. It is a stimulant that aggravates anxiety. When I was in college, I used to drink black coffee every night in order to stay awake to study. Some nights I would down as many as ten cups. The coffee kept me alert and awake, but it also put my body in a state of stress. I began to notice that I had overall feelings of anxiety and worry. This was directly related to the amount of caffeine I was ingesting. I stopped drinking coffee and my symptoms of anxiety disappeared. Too much caffeine can make a person tense and vulnerable to increased anxiety.

Caffeine is found not only in coffee and teas but also in sodas and a number of medications. Be sure to check the packaging to know if you are getting a dose of caffeine. And if you are sensitive to caffeine, lower your daily dose.

Sleepless in Seattle and every other city in America

It will come as no surprise that according to researcher Thomas Borkovec at Penn State University, worry plays a role in insomnia. Borkovec and his colleagues found that intrusive thoughts create sleeplessness. When you chronically worry, it does not matter how sleepy you are. The worried thoughts marching around in your head keep you on active alert.

Jennifer knows this all too well. A single mother with an autistic son and an active daughter, Jennifer’s day is beyond busy. Her mental activity is in overdrive: How will she will pay her bills, find services for her child, deal with day care, and be productive on her job? At night, she is unable to shut off the thoughts of the day and tosses and turns most of the night, rehearsing ways to bring in more money and cover her family’s needs.

Because of Jennifer’s constant worry, her adrenaline stays high, causing her sympathetic nervous system to go into overdrive. Dr. Donna Arand of Kettering Hospital’s Sleep Disorders Center in Dayton, Ohio, describes what is happening to Jennifer this way—she is running in fifth gear instead of second. Given Jennifer’s genetics, childhood experiences, her poor diet, lack of exercise and support, and the number of stressors she experiences every day, it is no wonder she cannot sleep at night. Her mind does not turn off the concerns of the day. She has developed a pattern of chronic insomnia. And according to Dr. Arand, even when stress is eliminated, insomnia can continue because it has become a pattern.

Worry must be turned off. Sometimes it helps to keep a pad of paper near your bed and simply write down the things that concern you at night. This strategy puts the concerns on paper and helps you remember to address them in days to come.

Another way to help clear your mind is to develop what doctors call good sleep hygiene. Sleep hygiene is a series of steps you can take to assist you in falling asleep. Sometimes the lack of getting rest has to do with the way we approach sleep. Sleep hygiene recommendations include the following:

1. Avoid or limit caffeine, nicotine, and alcohol at night.
2. Drink enough water to keep you from being thirsty but not so much that you get up during the night.
3. Check all your medications to see if there is a side effect related to sleep.
4. Make exercise a regular part of your life, but do not do it late at night.
5. Avoid eating heavy meals at night.
6. Relax before bed with a quiet activity. Maybe read a book, listen to soothing music, soak in a bathtub, and so on.
7. Arrange your bedroom to be quiet, dark, and cool. Bright light and stimulating colors can keep you alert.
8. Use your bed for only sleep and sexual intimacy.
9. Purchase a comfortable mattress and pillow.
10. Develop a routine of waking and going to sleep at the same time every day and night. It is best not to nap during the day. And if you cannot sleep, get up and do something rather than tossing and turning for hours.

Good sleep hygiene sets the stage for a good night’s rest.

Smoking

Have you ever said, “I smoke because it calms me down. I need cigarettes to relax me”? You may be surprised to learn that this is not true. Smoking does not calm you or relieve stress. In fact, smokers have higher rates of stress than nonsmokers. Why? Nicotine dependency actually exacerbates stress. Yet most smokers surveyed believe smoking relaxes them.

Since we know that nicotine does not calm people (it is not a sedative), why are smokers more irritable and feel they need to smoke to relax? It is the lack of nicotine between smokes that causes a regular smoker to be irritable and stressed. In other words, irritability and stress build up during periods when you do not smoke. Smoking reverses the tension and irritability that comes from nicotine abstinence. As you withdraw from nicotine between smokes, you feel irritable. Smoking stops that temporary withdrawal.

In a study by researchers Parrott and Garnham, smoker stress was found to be the same as nonsmokers. During periods of nicotine abstinence, however, smokers actually had worse stress levels. So instead of reducing anxiety, smoking caused more.

Now you’re saying, “Okay—but when I quit, I am more stressed.” Again, not so. According to research, quitting reduces stress. No studies found former smokers more stressed than those who continued to smoke. What researchers did observe was that in the first few days after quitting, people have more anger, anxiety, and restlessness. Two weeks later, people settle down and eventually report improved mood.

So the next time you think, “Smoking relaxes me,” you are misinformed. Not only is nicotine highly addictive, but it can create stress as well. Hopefully, this will give you another good reason to stop smoking. And if someone tries to tell you he or she cannot quit because of stress, help them understand that quitting is exactly what he or she needs to do to reduce stress.

Alcohol

The use of alcohol can also bring on worry. Even though a small amount relaxes you for the moment, the long-term effects of using drinking to cope are serious. Drinking to curb anxiety or worry can lead to alcohol abuse and even dependence. And if the reason you drink is because you feel insecure or inadequate, alcohol may make those feelings even worse because people do things under the influence they would not normally do.

Also, while small amounts of alcohol may relax you, high amounts promote anxiety and interfere with sleep. Bottom line: Alcohol is not a treatment for worry. Consuming too much can lead to an irregular heartbeat and lowered blood sugar, both of which can bring on increased symptoms of anxiety. Using alcohol as a relaxation method carries the risk of dependence and abuse. You may want to ask yourself, “Do I drink too much?” and be honest with yourself.

Three changes to add the positive
Exercise

Exercise is a natural stress-reliever. You may know how important exercise is but still do not do it! Yet its benefits are enormous. It can reduce muscle tension and frustration and naturally relaxes the body. So why don’t we regularly exercise? Either we do not have a moment to fit it in our day or we do not enjoy it. For some of you, both reasons may be true.

The solution is to make time and choose exercises you enjoy. In terms of time, you probably think it is impossible to commit to exercise. So the best strategy is to think about exercise like taking your vitamins. Don’t think too much about it, just do it! Do not make excuses or talk yourself out of doing it. Make exercise a scheduled activity that is nonnegotiable. Fit it in somewhere. We make time for things that are important to us.

In terms of how you exercise, it is important to choose something you enjoy or at least can tolerate. For example, I tried running. I gave it six months, did it six days a week, and hated it. I am not a runner, but put me on a pair of Rollerblades and I can have a good time. For me, rollerblading or playing tennis is enjoyable—running is not. If running is my activity, the likelihood of my exercising is low. I will find an excuse not to do it.

Experiment with different types of exercise to find activities you like. There are so many options: bike riding, dancing, skating, basketball, tennis, skiing, walking, table tennis—anything that gets you active and off that couch. Try to do at least 30 minutes of exercise every day. It will boost your energy and activate brain chemicals that make you feel good. It does not have to be drudgery. And even if it feels like drudgery, you will notice an improvement in worry. Sometimes we do things we do not like just because we are grown-ups!

Find ways to relax

We all need downtime. Therefore, identify ways to relax and rejuvenate your body and mind. Relaxation is not something you do once a year on a cruise to the Bahamas (although this can’t hurt). Relaxing should be a regularly practiced part of your life. You need balance in all things. Even God rested on the seventh day of creation! Relaxation prevents stress from building up and provides an avenue for releasing tension.

Take a moment and think about how you relax. Is it with TV and a shot of alcohol? Or do you mindlessly eat while sitting in front of your computer? Whatever you do, try to think of ways to relax that are healthy and calm the body, soul, and spirit. Ideas include a meditative walk, a hot bath, reading a portion of Scripture, resting on a beach, listening to relaxing music, playing golf.

Do you use time wisely?

Poor time management can be another source of lifestyle stress. You have only so much time in a day, so it is important to learn to prioritize and be realistic about goals. If you are a person who spends energy on things that are unproductive or take too much time, you may need to learn better time management. Time management maximizes your efforts. There are books and websites dedicated to learning it, but here are a few tips to get you started.

Plan your day. A “things-to-do list” helps organize and prioritize activities. Write down what you need to accomplish for the day. Then prioritize the list so you do not spend time on activities that are not that important for the day. And for those of you who tend to put things off and then find yourself rushing at the last minute, a list can prevent procrastination.

Be assertive and set boundaries

Learn to say no to things that distract you and take too much of your time. If you find yourself saying things like, “Sure, I’ll cook for the spaghetti dinner”;“Yes, I can babysit your children for the day”; “Yes, I can chair another committee”; “Since no one else will volunteer, I guess I’ll do it,” you may be overcommitting. As a result, you become stressed and kick yourself for not saying no.

Too many of us take on too much and fail to set healthy boundaries because we do not use the word no. We are afraid to speak up, do not feel we have the right, need to please others, want to be loved for what we do, or think we have to be superhuman and do it all! Time to turn in your cape! Learn to say no and not feel guilty. You will reduce stress in your life.

Saying no requires assertiveness. Assertiveness is behavior that falls somewhere in the middle between giving in and aggressiveness. It is not giving in to the wants of others or keeping silent and expecting people to read your mind. It is also not yelling at people and demanding your way. It is a practiced skill that helps you manage stress. Contrary to popular thought, you do not have to be angry to be assertive. In fact, I prefer you stay calm.

There are two parts involved in being assertive: 1) know what you want 2) say it. One of the reasons people are not assertive is because they do not know what they want. They are wishy-washy, unsure, and undefined in what they think or feel. They allow others to manipulate them into doing things and then feel resentful because they have too much to do. Or they feel guilty and do not believe they have the right to speak up. They ask, “Who am I to say no?” You are someone important. You are also responsible for managing stress that comes your way. When you can do something about stress, take the initiative—speak up! Know what you want and take a reasonable position. Do not feel guilty setting limits. Reduce stress by taking control where and when you can.

If you do not speak up and let your voice be heard, anger and resentment will grow. Oftentimes, these are roots of depression, anxiety, and eating disorders. Many of my female patients have to be taught how to be assertive because it is a skill they never learned. It is also something that has to be practiced. The benefits from speaking up are improved physical and psychological health. Your relationships will improve and you will better manage stress. In addition, you will gain respect from people. They may not like your stand, but they will respect you for taking one.

Worry and emotional well-being

Not only does our physical health suffer when worry turns to anxiety, but our emotional well-being is affected too. When worry takes over and becomes what is called a generalized anxiety disorder (GAD), it makes life difficult. People with GAD know they are excessive worriers but have difficulty stopping worried thoughts. Worry becomes an illness, an illness that is mental in origin but impacts the physical body.

John was recently diagnosed with GAD. His life was unmanageable because worry intruded on his ability to do his job. As an architect, he worried about making a mistake on his drawings, miscalculating numbers, forgetting important information, losing jobs for the company, being laid off, losing promotions to younger men, pleasing his bosses, and carrying enough of the load for the entire team. These types of thoughts flooded his thinking to the point that he could hardly complete his drawings and was late turning in projects. He spent his off hours worrying about his ability to perform at work. He could not relax at home, was irritable with the kids, and found himself turning to alcohol to relax his body and thoughts.

John’s family noticed how worry impacted all areas of his life and decided to call a mental-health counselor for an evaluation. During the interview, John admitted feeling out of control but not able to stop obsessing on that feeling. He was not sleeping at night and his marriage was falling apart because he could not relax enough to be with his family and enjoy life. His wife described living with him as constantly being on edge. His level of anxiety was taking a toll on everyone.

John’s story is typical of the symptoms associated with GAD. They include restlessness or feeling keyed up or on edge, fatigue, difficulty concentrating or having your mind go blank, irritability, muscle tension, and sleep disturbance. There may also be cold, clammy hands, dry mouth, sweating, nausea or diarrhea, urinary frequency, trouble swallowing, depression and exaggerated startle response.

When a person suffers with GAD, anxiety disrupts work, social life, and family life. The amount of anxiety felt is excessive and chronic. Worry feels completely out of control, and professional help is usually needed. Treatment involves a type of therapy that looks at worried thoughts with the intent of challenging those thoughts and changing them. In addition, making lifestyle changes such those discussed above are recommended. Furthermore, learning and practicing relaxation techniques, knowing how to soothe yourself and quiet your mind, are all part of the treatment. If you need help, contact a mental-health professional.

Medications to calm the body

I am often asked about the use of medications to relax the body. I usually recommend that people first try nonmedication strategies to lower anxiety. With changes in nutrition, exercise, and self-talk and a more relaxed approach to life, most people can move out of worrywart status. However, depending on the level of anxiety and panic you experience, there are times when antianxiety medications can be useful.

In my own practice, I would recommend that people be evaluated for medication when they were so flooded with anxiety they could not work on making changes or concentrate on learning to cope differently. Medication often helped to accomplish the above. Once armed with new tools and coping skills, their medication was gradually discontinued. I say this because I do not want anyone who is using antianxiety medication appropriately to feel condemned.

Once a level of control is found that allows a person to work in therapy, the person can eventually discontinue the medication. This is especially true when treating panic attacks and phobias. This does not mean that medication must be used. It is simply a tool in the strategy box. Medications have proven to be effective for the treatment of obsessive-compulsive disorders (OCD). OCD is a psychiatric mental disorder classified as an anxiety disorder. It is characterized by unwanted thoughts and compulsive behavior that interfere with living. It involves a number of fears, such as fears of contamination, being harmed, making mistakes, or behaving in socially unacceptable ways; doubt, religious concerns, and sexual concerns. Compulsions can include hand washing, checking, collecting or hoarding, counting and repeating, and touching or tapping.

Specific areas of the OCD brain have been identified to be overactive, so there appears to be an organic basis. Current thought is that OCD is predisposed genetically and dormant until major stress activates it. Best practice is that medication be used in conjunction with cognitive behavioral therapy. Medication is not a cure for OCD and its long-term effectiveness is not always consistent.

The use of medication for any anxiety issue is usually a personal decision related to your values. There is much to consider when taking a medication. Medications provide symptom relief but do not get at the root cause of a disorder. And they have side effects that must be weighed. Some people cannot tolerate the side effects or are not willing to take the associated risks. Medications can also be expensive. If you do decide to use a medication, you should always be under the care of a physician and be regularly evaluated. I strongly recommend evaluation by a psychiatrist to discuss antianxiety medications if you choose to go that route. Psychiatrists are medical doctors trained in the use of these medications. They are familiar with side effects and dosing.

How to relax your body

When I was in full-time private practice, I had a couch in my office. I used it mainly to help people learn to relax their bodies. Over the years, I noticed that people who grew up in the homes of an addict, alcoholic, abuser, or mentally unstable person carried a great deal of tension in their bodies even when that stress was no longer present. Growing up in an unpredictable household often led to a chronic state of physical tension. Most adults who came for therapy knew this tension as a normal state of being. So the idea that they were tense and could relax was often a foreign thought.

To help a person learn to relax, I would have him or her lie down on my couch with a soft blanket over his or her body. Then we would begin something called progressive muscle relaxation. This technique is based on the idea that muscles can be relaxed by tensing them for a few seconds, and then releasing the tension. For example, clench your right fist and hold the tension…now relax it. Do it again. Do the same with each muscle in your body. Progressively work through all your muscles and relax each of them. As you work through the various muscle groups by tensing and releasing, relaxation occurs. You can do this exercise any time of day or night. The more you practice tensing and relaxing your muscles, the easier it becomes. Then when you are aware of tension in your body, you can cue your body to relax. Practice makes this easy to do.

This type of relaxation can be used in everyday situations. In fact, I used this technique to overcome a bad experience at the dentist office. I used to be afraid of going to the dentist because, as a child, I had had a number of bad experiences. My cue to start feeling anxious was scheduling an appointment. By the time I arrived at the dentist and sat down in the chair, my body was very tense. I would think thoughts like, What if it hurts? What if I need to have work done and get a shot? What if he misses and hits a nerve? In order to change this, I practiced progressive muscle relaxation.

After several weeks of practice, I could cue my body to relax by telling myself “relax.” Then when I sat in the dental chair, I did the relaxation. Once I knew I could relax my body and stay calm, worry was no longer a part of the time leading up to my visits. To this day, I do not look forward to going to the dentist, but I no longer worry ahead of time. And when I am in the chair and begin to feel tension in my body, I cue myself to relax and focus on doing so. A side benefit is that the more I relax, the less it hurts.

Progressive muscle relaxation is an especially effective technique for people who carry tension in their muscles. Tension and relaxation cannot coexist. Although I practiced progressive muscle relaxation with clients in my office, you can purchase a CD that will lead you through this exercise as well. Moreover, there are free downloads online that can be used to practice. The goal is to learn to relax the various muscle groups.

In therapy, clients are asked to practice progressive relaxation daily until they have a sense of how to relax their physical bodies. Then, whenever tension rises, they know how to cue their bodies to relax. This technique can be used while sitting in traffic, in a waiting room, at a work desk, and so on. The more you practice, the easier it will be to cue your body to relax when tension is noticed.

Self-soothing

Another way to calm your physical body is to engage in activities that are self-soothing, which involves using the senses to calm down. Self-soothing activities lessen stress by providing positive stimulation. So, for example, lighting an aromatic candle, petting the dog, drinking a cup of warm tea, watching the sunset, and so on are positive ways to engage the senses. When stress hits hard, you can choose to do something in the moment that will calm you down. Self-soothing activities can relax you immediately and contribute to your well-being.

Here are a few more ideas. They are similar to relaxation activities:

• take a relaxing bath or hot shower
• organize something
• pray
• take a walk
• listen to soothing music
• clean
• go for a car ride
• phone a friend
• write a note to someone you care about
• watch a sunrise on the beach
• get a massage
• watch a funny movie
• play the piano or other musical instrument
• sit in a park and enjoy the beauty of nature
• visit a pet store
• try a new food recipe
• study a painting
• go for a swim

The idea is to exercise self-care when tension builds and engage in something soothing to the senses. Instead of shopping, drinking, gambling, numbing yourself with pain medication, or using some other unhealthy quick fix for stress, choose an activity that will calm you immediately and soothe your body and soul.

In sum, chronic worry takes a toll on our physical and emotional health. Do not become a worrywart or allow worry to rule your life. Instead, learn to calm your physical body. A good night’s sleep just might depend on it!