I Worry About Not Worrying--Then I Worry More!

Somehow Still-Alive Guy is not a doctor, and he does not provide medical advice. But he has seen all the doctors! And is currently still alive, and here to answer questions from you. Remember, there are no stupid medical questions—only answers that can get you killed.

Dear Somehow Still-Alive Guy,

I tend to worry a lot. But then sometimes I notice that I haven’t been worried for a while. And then I get worried that there must be something wrong with me if I’m not worried—perhaps a tumor on the part of the brain that usually causes me to worry? Now, you might think that the fact that I am worried about not worrying should put to rest my concern, as I clearly still have the ability to worry, and thus don’t have a tumor on the part of my brain that causes me to worry. But then I wonder if it’s possible that the tumor on the worry part of my brain only causes me to not worry some of the time. All of this is to say, the more I don’t worry, the more worried I become. Help!

Worried You Won’t Reply

Dear WYWR:

An adult life of worrying was always impossible for me not to worry about. I hail from an American family of risk-averse worriers, who hailed from an Eastern European family mostly killed by Nazis. So, in addition to worrying about when the next malignant shoe will drop while I live a post-multiple-cancer life, I may know where you’re coming from, even if I’m generally happy when I don’t have something pressing on my mind, which is not always the case.


We’re both in luck, however, because my wife, a psychologist who works with neurology and cancer patients, some who have been in war zones, tells me that a part of the brain related to worrying, the anterior insula, a subcortical physical clue that we were once reptiles, actually has been shown to increase in size when one meditates. And that kind of growth isn’t cancer. So it stands to reason that the anterior insula is not expanding of its own volition in people who don’t meditate. Although worrying can be practiced in a meditative fashion, I suppose.

Another point of interest: Research shows that people who worry also tend to make better decisions in tense financial situations. So don’t worry if in the process of treating your worry with meditation your income takes a hit and you are hence considered less reptilian. (Obviously, this information suggests a correlation between the financially savvy and the slimy, and as I hope to achieve something approaching that former state, and therefore to worry more, I shall not dog such a progression.)

I’m in no position to tell you if you have a tumor, but I can suggest that you’re not the first person without truly concerning symptoms to worry about the presence of one (see my most recent column, which tackled a question about MRIs and included a link to a scene featuring Woody Allen’s hypochondriacal character in Hannah and Her Sisters). Lest I harp on the obvious, there are plenty of fine physicians who will investigate your neurological health.

My thinking? You’re probably worrying more intensely now that you’re “not worrying” than you did when you thought you were simply worrying all the time. That’s the way anxiety disorders work. They’re like the mafia. Just when you think you’re out… [fill in the blank]. Then, once they “pull you back in,” they feel like they pull you harder, and your worrying has hit a peak level because you think you’ve beat it but also that it could be watching you at all times, perhaps from behind the bushes.

You’ll truly beat your anxiety—and few of us ever completely do, so let’s say “treat” (and “exist healthfully in concert with”) instead of “beat”—when you don’t think about it as much and just live mindful of what’s in front of you, in the moment. So, again, meditation. Don’t join a pyramid scheme or cult devoted to it, unless you’re into that sorta thing, but maybe get an audiobook or mindfulness app. Steve Jobs meditated, and according to his biography, he was fairly cool, unless he was trying to crush you.

What you should be concerned about is if you’re worrying less and engaging in risky behaviors, aside from writing to advice columnists in our age of NSA surveillance (although, please note, readers: sending me a question for this column to alive [at] theawl.com is as confidential endeavor as we can make it without government connections).

Worrying is an anticipatory function and survival tactic: it prevents us from putting ourselves at risk for danger. If you start engaging in bizarre and dodgy behaviors—robbing American Doll stores, say, or stalking Christopher Walken to force him to play chicken with you on an empty highway, and if you’re worrying significantly less at these times—there’s at least one oddly bad thing going on for you upstairs.

For now, why not seek out a therapist, and an MD if recommended, and try some deep breathing and long walks in nature. If you end up on psychotropic meds after seeing a doctor, make sure you don’t get the kind that might increase anxiety, like Wellbutrin, and that you stop drinking those triple espressos—except, that is, when you and your parole officer are simultaneously concerned that you’re not worrying enough.

Dear Somehow Still-Alive Guy:

What are the different diseases I can get from my dog sleeping in my bed?

Animal Insomniac

Dear AI:

I have never co-habitated, much less slept with, a dog. A German shepherd once attacked my mother as a teenager in a locked piano practice room, and we were subsequently raised to fear most animals, including some hirsute people. It’s been huge progress for me simply to get to the point where I want to be around animals, and I still don’t want them to lick me, although I can’t say that also applies to all humans.

That said, here’s a comprehensive list from the CDC of diseases you can get from dog germs. Interesting to note is that if you’re in any way immunocompromised—which doesn’t just apply to people with HIV but to those being treated for cancer, recovering from organ transplants, taking immunosuppressants, young children, or pregnant women, among others—you’re at a higher risk for getting Spot’s possible leptospirosis, a.k.a. “Rat Catcher’s Yellows,” “Black Jaundice,” or any other variety of terms used to describe just one dog infection that begins like a flu but could end with meningitis. If your dog goes outside, there are a few other things on that list to worry more about, like tick-borne diseases. Talk to your vet about Frontline and other anti-tick and anti-flea treatments.

My general rule—if only because I’m not ready for all the licking and wet-dog stuff, and like to travel—is to not be a dog’s “father” but a dog’s “uncle.” I visit, with hand-sanitizer in tow, the dogs of my friends, pet them, bring them gifts. Then I leave after a few hours without any same-bed sleepovers. If you’re at all concerned about these things, you might look into how you can live without a dog. Most people, however, tell me that their lives are much better with a dog than without one (that whole unconditional-love thing).

I mull this over now and then, but despite my desire for more adoring and obedient companions I have not changed my attitude about the dog-parenting business. It’s so hard to take care of oneself that some of us get to write advice columns in which we can discuss medical problems because of our breadth of experience with them. I advise you in the meantime to eat the immune-boosting superfoods compiled and commented on regularly by hard-working magazine writers. Blueberries, I have found, are the answer to many of life’s problems.

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Adam Baer (a.k.a. Somehow Still-Alive Guy) is The Awl’s vexing medical questions advice columnist. He’s not a doctor but a functional post-cancer young survivor of too many potentially fatal and mysterious maladies/treatments that include classically funny words like “stem cells,” “endoscopic neurosurgery,” and “bone-marrow transplant.” Adam’s written essays and stories for NPR, the New York Times, and Harper’s, among other publications. He lives in Los Angeles, and seems curiously normal. Top photo by Luca Vanzella. Dog photo by Sheri.