When is a worry actually an anxiety obsession? 

In my specialty working in the field of perinatal mental health, I often work with new parents who are experiencing an increase in worrying. Some of this is normal--a new baby is tiny and vulnerable and requires a great deal of care. But how do you know when worrying has tipped into something more serious? 

In therapy, we talk about worries and obsessions falling on what we call the “distress scale.” A worry might register as a 2, 3, or 4 on this scale. Anxiety triggered by obsessive thoughts gives you an intense reaction: more like a 7, 8, or 9 on this scale. 

It may help to have some examples of worrying to compare with examples of anxiety obsessions. 

Worry: 
The baby’s on the grass--I’m worried she’ll get bitten by ants because I saw some beds out here yesterday.

Anxiety Obsession: 
The baby touched the grass--what if it has fertilizer on it and now she’s going to get cancer?

Worry:
My kid is a pandemic baby, and I am worried she’s going to be extra upset when I drop her off at daycare for the first time. 

Anxiety Obsession: 
My kid is a pandemic baby, and I am worried she’s never going to know how to interact in a group and will struggle with this the rest of her life. 

Worry: 
I’m afraid I’m going to hit traffic and not get to the pediatrician’s office on time. 

Anxiety Obsession: 
What if I get into a car accident on the way to the pediatrician’s, and I am injured and can’t care for my baby anymore? 

Worries tend to be about regular things: what if I’m late, what if my kid doesn’t get into college, what if I never meet someone? 

Obsessions tend to be about catastrophic things that are either highly improbable or impossible. They often come along with intense, scary imagery. 

You can begin to figure out whether you are experiencing a worry or an obsession by paying attention to your anxiety levels and to your behavior. Does a worry immediately launch you into a high-anxiety state? Are you continuing to check on the thing you’re worried about, looking for reassurance, or spending a lot of time mentally processing this worry? If so, you could be experiencing an anxiety obsession. 

Especially in new parents, catastrophic worries can pop into your head out of, seemingly, nowhere. They might shock you for a moment, but if your body is remaining calm and you are able to then put the thought out of your mind and continue with your day, this is likely not pointing towards a problem. But if you notice that your body goes into a state of high anxiety (heart racing, fast breathing, sweating) and you are spending a lot of time ruminating on the thought, this may be a sign that you need some extra support. 

While it may sound scary to classify what you thought of as worries as something like an “obsession,” these patterns of intrusive thinking are treatable. 

Reaching out for help from a licensed therapist ensures that you won’t have to tackle this alone. I also realize that it’s hard to find a therapist in our current climate, and after the year and half we’ve had, you may need some tools right now. 

PRACTICING MINDFULNESS

The goal is to be able to encounter the obsessive thought and stop yourself from spiraling down the cycle of mental checking. Things like “what if…” thinking, suppressing emotions, and calculating potential outcomes may feel like “just thinking through it,” but can actually be compulsive behaviors. Obsessive thoughts often lean towards the future and what might happen. Practicing mindfulness means bringing your mind back to the present moment. Use your five senses to ground yourself in your body, and re-enter the here and now. 

What do you see? What do you hear right now? What can you smell, or taste? Feel the surface of the furniture or the fabric of your clothes. In this moment, is there any immediate danger? What if I am safe right now? Feel the air pulling slowly into your lungs. Place a hand to your chest. 

Another exercise that might help is to close your eyes and imagine yourself sitting by a stream with leaves floating on the surface of the water. Take each thought that enters your mind and place it on a leaf, letting it float by in the stream. Do this with every thought—intrusive images or obsessive thoughts, regular worries, but also: “I’m not doing this right,” “this isn’t helping,” or “I’m bored…”. This will help you begin to shift from viewing the world through your thoughts to viewing your thoughts as entities that exist separately from yourself or (sometimes!) reality. 

If the stream imagery does not feel safe or comfortable, consider visualizing a container for your thoughts. Imagine that you can put your thoughts into the container and close it. 

KEEP A LOG

Keep a log of all of the times you find yourself engaging in obsessive thoughts. This will help to make you aware of your patterns, but also help separate these worries: obsessions are a symptom, not a reflection of who you are as a person. As you chart your emotions, you may begin to notice that the behaviors you engage in around your intrusive thoughts don’t actually make you feel better or more in control. 

Click here to download a free log.

LEARN MORE

The term “OCD” is thrown around too casually. You’re not “being so OCD” if you like your apartment to be clean and neat, or if you check and re-check an email before you send it to your boss. But on the opposite end of the misunderstanding spectrum, Obsessive Compulsive Disorder is not just about washing your hands 50 times a day or counting or tapping things to reduce anxiety. People with “Pure O” OCD engage in mental rituals to deal with obsessive thoughts, and these ritual compulsions are often invisible. You can read more about Pure O and other forms OCD can take here. 

If you are realizing that your worries aren’t so harmless, help is available. You are not your intrusive thoughts, and these obsessions do not have to rule your life.