Well at this stage in your life, I'd ask you what constant vigilance and guarding has done to benefit you? At the end of the day, have you found it to be even remotely productive? Patients used to make references very similar to your own and my answer was always the same; People are not trained to be anxious, but rather develop perspectives which generate anxiety.

Anxiety is not a disorder, but a persistent state of mind that is manifested by inaccurate perspectives. Habitual thought patterns draw conclusions that are forward-looking rather than in the present, thus creating the habit of exercising outcomes which have not transpired.

People with significant anxiety typically have a lack of trust in themselves and others, often combined with lack of self-confidence in many instances. The insight must be established wherein such patients realize that they are establishing a plan for life that is most often constructed using irrational predictions. Thus, the period of apprehension simply moves from event to event, never reaching any type of conclusion, for once one potential crisis point in time has passed, their vigilance simply moves to the next point in time.

You have to come to the realization that if you simply stopped trying to constantly prepare for life as a series of potential crisis events, your life will become far less effortful and the outcome would be the same. By same, I mean that crisis events simply don't happen to people with the regularity envisioned by the individual with significant anxiety. Realize that all the time spent in apprehension of life's unfolding is pure speculation.

You also need to realize that life is not as fragile and dependent as you believe. People with anxiety live in a world where they believe absolutely anything is possible and therefore, the range of possible outcomes has no boundaries and need not even comply with laws of nature to occur. It is the persistent gut instinct that something is wrong and must be corrected in order for you to feel safe. That sort of urge is a purely biological consequence of being fearful.

You are in no danger whatsoever. Only you believe that imminent and unpredictable risk looms ahead and that your defense is constant vigilance to detect it before it strikes. Throughout all your years with anxiety, you must realize that such a practice has not provided you with even one instance of salvation.

As you age and become more familiar with life, you need to adopt an approach more like that of actress Kathy Bates, whose portrayal of a middle-aged woman in the film Fried Green Tomatoes came to deal with life at that stage by comparison to young girls by exclaiming "Yeah, well I'm older and I have more insurance." In other words, there's a benefit and wisdom in aging that the youthful are helplessly restricted from by lack of exposure and what constitutes worry and apprehension in youth, ultimately becomes a provocative stand-off and cavalier bravery to consequences.

The point is that you need to realize that living life wrapped so tightly is what gives the appearance of danger and risk looming so close, when in fact it's nothing more than a misperception. It's okay to color outside the lines, to act spontaneously and to risk a little of yourself in life.

You need less time in the hospital trying desperately to find something wrong and instead go out on the town with your husband and go dancing for the evening. Stop forfeiting the very life that you work so desperately to protect from calamity. Don't live your life on a canvas of paint-by-number, but rather one where you create the scene.

There is not one advantage being demonstrated in your own approach to life. Not even one. Your problems, in fact, grow as a result of the rigid beliefs you have established as necessary to proceed through life and I'm here to tell you that at 90 years of age myself, I offer testimonial that you are living in the wrong direction.

Life force is at its strongest when challenge is made to it, never in the context of fearful apprehension. You've had all your years to practice your own method with obvious disappointing results. Don't you think by now that you should simply choose a turning point and pose a challenge to life rather than worry it may end too soon?

Patients with anxiety always hold themselves to ultimatum; "If these darn palpitations and other symptoms would go away, I'll get back to my normal life." I'm constrained to point out that the symptoms in such cases are generated by the anxiety over the symptoms and thus, life just continues to bear out disappointment.

Take command of your life and pose a challenge to yourself. Do not let your harmless symptoms create fear in you. Push through the fear and stand your ground rather than give way. You'll find that the years spent in toil over such perceptions have been for naught. There is nothing wrong with you and nothing is going to suddenly take your life from you. All the psychiatrists and counselors in the world can't help you if you don't want to be helped.

A life spent waiting for change rewards only the time spent waiting.

Best regards,

Rutheford Rane, MD (ret.)