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Worry that will not switch offStep 1 of 8

Before you read on

One thing before anything else. This course teaches that the strength of a feeling tells you nothing about the size of a danger. That is about a false alarm, and it is not about a symptom. Chest pain, fainting, or breathlessness that a doctor has not looked at goes to a doctor first, and nothing here should be used to talk yourself out of that. Getting it checked is how anybody finds out which one it was. If worry is taking an hour or more out of most days, if you have stopped going places because of it, or if this has run for months and is not lifting, then it has outgrown reading, and lesson six is about who to see. And if you are having thoughts of ending your life, tell someone today and contact your doctor or an emergency service.

Lesson 1 of 6 · Three things wearing one name

One word doing three jobs

Most people arrive with one word for this. Anxiety. It covers everything, so it explains nothing.

Underneath the word there are usually three different things. They share one alarm, but they differ in what they are about and in the habits that keep each one going. Worry, which is a stream of sentences about what might happen. Panic, which is a physical surge that arrives fast and peaks in minutes. And the fear of being judged, which is about what is going on behind other people's faces.

You can have more than one. Most people do. But it is worth knowing which one is taking up your day, because what helps with one is not always what helps with another.

What the research says

The manual treats these as three separate diagnoses with separate criteria, where ordinary speech uses one word for all three. Knowing which one you are dealing with changes what helps.

Generalised anxiety disorder, panic disorder and social anxiety disorder are three separate diagnoses with separate criteria. Ordinary speech uses one word for all three. The manual does not.

American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. American Psychiatric Association Publishing doi

These three conditions overlap heavily and share the same core of distress and avoidance. So you are not dealing with three separate machines, and what you learn about one will mostly carry across.

The three share a common core of distress and avoidance and overlap heavily, so this is not three unrelated machines. What separates them is what the apprehension is about and which habits keep each one running.

Craske MG, Rauch SL, Ursano R, Prenoveau J, Pine DS, Zinbarg RE (2009). What is an anxiety disorder?. Depression and Anxiety, 26(12), 1066 to 1085 doi

Three things wearing one name · Inshirah