What keeps you up at night? Agonizing over some thorny decision? Overthinking possible outcomes? Tormenting over the possibility of failure? You are not alone. The hyper-competitive work environment in which we live feeds our imaginations overtime, and, hence, our worries. The effects on our bodies can be toxic.

The great Samuel Johnson, a chronic worrier, labeled worry a “disease of the imagination.” We are capable of imagining the worst, allowing a stream of dark thoughts to crowd our mind. Is it worth it? Is worry its own reward? If we fret about an upcoming presentation in front of a large, forbidding audience and it turns out well, do we attribute it to all that effort we invested in imagining the worst?

Mark Twain wisely observed that he “lived through some terrible things … some of which actually happened.” According to Dr. Martin Rossman, a faculty member at the University of California Medical School, research shows that 85 percent of our worries never come true.

If that’s the case, if 85 percent of our worries are a waste of energy, depleting us of a joy in living, how can we manage them so that only the 15 percent of worthwhile worries capture our attention?

When we let our imaginations take over, even simple interactions become psychological time bombs. During my days at the White House, where I served for more than 11 years, we conducted a daily meeting to coordinate the operational requirements to ensure flawless presidential support. The protocols associated with this meeting were anchored in military tradition. Rank, discipline and a sense of mission ruled the agenda.

I remember one morning in particular that was going along as I expected until a moment just before the formal briefing began. My boss looked at me and said: “Come see me after the meeting.” Without knowing what this was about, my first reaction was, “I had nothing to do with it!” I was worried and anxious and throughout the duration of the meeting my mind sabotaged my ability to focus on the agenda. I engaged in unproductive worry. As Alfred Hitchcock once said in talking about the psychological effect of his films, “There is no terror in a bang, only in the anticipation of it.”

The walk to his office had never felt longer. As it turned out, the meeting was important, but not life-threatening nor career-ending. He was merely seeking my advice. However, with my imagination running amok, I endured for several minutes the paralyzing forces of worry.

Is the impact of worry always negative? I posed the question to a group of U.S. Customs and Border Protection executives, and one commented, “Worry is just like prescription drugs. In the appropriate doses it is beneficial, but in excess it’s poison.” Indeed, not all worry is negative. In manageable “doses,” it can warn us of potential danger and become a catalyst for positive action. Undoubtedly, fear and worry can generate short bursts of brilliant performance from time to time, but in general the results are not usually better.

Great leaders and strategists use worry to imagine potential implications and unintended consequences of their decisions. Successful entrepreneurs masterfully use worry to sense, respond, anticipate and effectively deal with uncertainty and risk. Other executives see worry as a catalyst to prevent obsolescence or stagnation.

When worry escalates and becomes omnipresent, it can lead to postponement, paralysis, fear, distress, all forms of dysfunction, and even medical problems. The intensity, frequency and duration of your own worries can serve as a kind of barometer in helping you determine if all of it is affecting your physical and mental health. The U.S. Office of Occupational Health and Safety has said that 75 percent to 90 percent of all visits to primary doctors are directly attributable to stress and anxiety. If your worries appear to be chronic, endemic and more pervasive than those of your peers, consider seeking professional help.

How can we manage our worries? Recoding our apprehensions each day is a good way to start. Keep an inventory of worries and become mindful of the things that we can influence and the ones beyond our control. Revisiting our journal will help us assess the actual danger from the imagined peril. We may find that it was never as bad as we imagined it to be. Get the facts and look for evidence since worry is often rooted in misinformation. Avoid the paralysis of perfectionism and learn from failure. Stay socially engaged and share your worries with your executive coach or a trusted colleague. Doing so can help us see our worries within a new context and help us calm down.

Can we worry less but worry better? Yes, but first we must acknowledge that worry is a type of thinking that is self-imposed. We must own it. Since worry results from our own mental creations, we must shift our thinking in a serious way, even turn it upside down, and instead imagine positive outcomes, and believe in them. It is our choice: We can be immobilized by fear of failure or motivated by a vision of success, even if success doesn’t actually pan out as we wished. At least we can sleep at night.

J. Gerald Suarez is professor of practice in systems thinking and design and a fellow of the Center for Leadership Innovation and Change at the University of Maryland’s Robert H. Smith School of Business. He is also an executive coach and author of “Leader Of One: Shaping Your Future through Imagination and Design.”