The Big Difference Between Anxiety and Worry

How I learned to stop worrying and start "reverse worrying"

If exploring each of the five personality traits has been an epic voyage, then neuroticism is my white whale. On the personality tests that I took at the start of this project, I charted scorchingly high on neuroticism, the trait associated with depression and anxiety. It was also the trait I most wanted to change.

For the past year-plus, I have tried virtually every anxiety-busting strategy known to (wo)man. I have read the books with “fuck” in the title. I have read the books without “fuck” in the title. Neither category has been especially helpful. But one principle keeps coming up over and over in all the different books and apps and meditations that I’ve tried, and I’ve found it strangely reassuring. Or if not always reassuring, at least interesting. Perhaps you will, too:

It’s that worrying and anxiety are not the same thing. Worrying will not stop bad things from happening to you. In fact, your worrying might be doing little other than making anxiety worse.

This concept was best explained to me by something called the Unified Protocol, which is a therapeutic program that aims to treat all types of neuroticism. I found it to be a bit like CBT, exposure therapy, and mindfulness combined.

The Unified Protocol suggests that emotions, like anxiety, are different from the behaviors we use to cope with them, like avoiding parties (for those with social anxiety) or worrying (for those with generalized anxiety). According to this view, you should allow these negative emotions, but stop using harmful coping behaviors. That means allowing yourself to be anxious, but not worrying endlessly about whatever it is that’s provoking your anxiety. (If that sounds hard-to-impossible, that’s because it is. Or at least it was for me.)

Like many mindfulness practices, the Unified Protocol recommends cultivating a nonjudgmental attitude toward one’s emotions. That might mean allowing uncomfortable thoughts to enter your mind, acknowledging them, and then going back to whatever it was you were doing. “And that might happen 100 times, and that's okay,” says Shannon Sauer-Zavala, a University of Kentucky psychologist who helped develop the Unified Protocol.

The Unified Protocol also involves some exposure therapy. If you suffer from panic attacks, for instance, you might breathe through a straw in order to purposefully simulate the feeling of hyperventilation. Doing so allows you to grow accustomed to these uncomfortable sensations, so they are less frightening when they occur.

When I spoke with Sauer-Zavala, I told her that I was having trouble coming up with “exposures” for my own coping behavior of worry. The suggested exposures for other forms of anxiety, like taking an elevator or talking to a stranger, don’t really stress me out. Instead, my anxiety is more thought-based, which makes it harder to actually face my fears. My fears are very theoretical!

Sauer-Zavala suggested I might try to write a script of my worst-case scenario and then read it out loud over and over again. Doing so makes you realize, “these are just thoughts, and just because I'm thinking it doesn't mean it's gonna happen,” she says. Sauer-Zavala told me about one patient who worried obsessively that she wouldn’t be able to find a job and would have to move back in with her parents. She had the patient write a detailed scenario that described her moving home, laying on her childhood twin bed, and looking up at her high-school boy-band posters. After repeating the script over and over again, the idea stopped being as distressing to the patient. She internalized that these were just thoughts, not reality.

This reminded me of a story I once did about Songify, an app that therapists were using to help their patients turn their worry-scripts into auto-tuned songs. The idea was that the patient could record their worry-song and play it over and over in order to reduce the power of their worries.

When I was reporting the story, I had written a little ditty called “I’m worried I’m going to get leishmaniasis and my nose will fall off,” because, well, that’s what a neurotic person thinks after they sustain 40 mysterious bug bites while hiking in Rio. The therapists I interviewed for that story found that treating repetitive, fearful thoughts as a silly little song could help make the anxiety less frequent and less believable. And it worked—I hardly ever think about leishmaniasis anymore. (Though I confess that, while writing this paragraph six years later, I googled its symptoms again.)

The main issue with the Unified Protocol is that it really works better if you do it with a therapist. I ordered the program’s workbook off Amazon, but I struggled to stick with it on my own. Sauer-Zavala said she could help me come up with exposure activities if she was seeing me as a patient, but she’s not. I asked my own therapist if this kind of exposure therapy might be a good idea, but since I have a tendency to fixate on unlikely, negative possibilities, she wasn’t so sure. 

So I still faced a quandary: Since resistance only makes things worse, I didn’t want to resist feeling my anxiety. But I also didn’t want to worry constantly in an attempt to quell my anxiety. So how is it possible to accept anxiety without worrying about it?

I took this question to Tracy Dennis-Tiwary, a psychologist and author of the book Future Tense, which is about how to use your anxiety for good, rather than for self-torture. I told her about some tools that I’d been using to try to contain my worry, like worry periods — where you purposefully set aside some time to worry. The idea is that your worrying will stay confined to those five minutes or so, without spilling out into the rest of your day. Except I found that, for me, these worry periods were more like a worry warm-up. I’d get started worrying, and then my brain, thrilled to be doing the thing it does best, would really dig in, coming up with wilder and wilder possibilities.

She gave me an interesting suggestion: As you’re worrying (since if you’re anxious, you’re probably going to worry sometimes anyway), think not only about the worst-case scenarios, but also about the best things that could happen. What are your hopes for the situation?

Hope, she explains, usually exists alongside anxiety. You wouldn’t feel anxious if you weren’t also hopeful. “Maybe spend an equal amount of time articulating, ‘Well, what is it I want to happen? What exactly would that look like?’” Dennis-Tiwary told me.

I like to think of this hopeful thinking as reverse worrying. When I’m worrying, I’m thinking about the traps and nightmares that lurk around every corner. But … but … I also have to acknowledge that good things have happened to me, too. What are some ways this could turn out like one of those good things?

Alongside worry, I purposefully try to think about the off chance of a good outcome. What would it look like? How can I help secure it? I remember that the fact that I’m anxious means I haven’t given up hope. I try to give that hope a name.