Generalised anxiety disorder (GAD)

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Find out what generalised anxiety disorder is and what can be done for people with GAD.

By Navit Schechter – PGDip, BABCP (Accred), BSc (Hons)

Generalised anxiety disorder, also known as GAD, is believed to affect approximately one in 20 people in the UK. It’s slightly more common in women. However, GAD does affect both men and women, and is most common between the ages of 35 and 59.

Many of us worry from time to time, and experience anxiety in certain situations. However, if you find that you are worrying most days about a number of different things, and don’t feel able to control whether you worry or not, then you might be experiencing GAD.

Navit Schechter, a qualified CBT Therapist with more than 12 years experience, takes a closer look at what GAD is, what is believed to cause it and how you can overcome it.

What is generalised anxiety disorder (GAD)?

Generalised anxiety disorder is an anxiety condition marked by a tendency to worry excessively about “anything and everything” from health, family and work to your finances, taking journeys or just a feeling that “something bad will happen”.

Most people with GAD think that worrying is beneficial in some way; for example, that it will prevent something bad from happening and also believe that their worries are uncontrollable.

Generalised anxiety disorder is an anxiety condition marked by a tendency to worry excessively about “anything and everything”.

If you are experiencing GAD, you may find it hard to cope not knowing what will happen in the future or how certain events will turn out and will therefore worry and focus on the worst case scenario in an attempt to plan for this.

This almost constant state of fear and worry can severely impact upon a person’s quality of life, making it hard to carry out day-to-day tasks and responsibilities and can affect work or school life as well as social life and/or relationships. Over time this can impact on how you see yourself and your

Symptoms of generalised anxiety disorder

Common symptoms of GAD include:

  • Persistent worrying that is out of proportion to the situation and does not lead to solutions
  • Believing that worrying is beneficial in some way, e.g. thinking that it will prepare you for the worst case scenario or show you care
  • Believing that worrying is uncontrollable
  • Feeling anxious, restless, irritable and/or on edge, often with a sense of dread or foreboding
  • Finding it hard to relax
  • Muscle aches and/or tension
  • Difficulty concentrating, thinking clearly or retaining information
  • Difficulty falling or staying asleep
  • Physical symptoms of anxiety such as shallow breathing, heart palpitations and/or feeling hot and sweaty
  • Frequently seeking reassurance from other people
  • Withdrawing from friends and family
  • Not being able to leave the house, such as for work or to go to the shops

Generalised anxiety disorder diagnosis

If someone has been feeling anxious and worrying more often than not about a variety of topics for more than six months and they find it difficult to control their worrying, then a diagnosis of GAD can be considered.

At least three of the following symptoms must be experienced:

  • edginess or restlessness
  • feeling easily tired or fatigued
  • difficulty concentrating
  • irritability
  • muscle aches and/or difficulty sleeping

These symptoms must cause significant distress or impairment in important areas of life and not be caused by substances or another physical or mental condition.

How is GAD different to other mental health issues?

Whilst other mental health conditions can also cause a person to feel anxious, a person with GAD is likely to be persistently worrying about a number of different situations.

In the other anxiety disorders, worries tend to be focused around one area only, such as the possibility of getting ill in health anxiety, having a panic attack in panic disorder or being rejected by other people in the case of those with social phobias.

People who experience GAD are also more likely than others to experience an additional mental health condition such as panic disorder, obsessive compulsive disorder and/or depression.

Causes and risk factors for GAD

There is no known cause of GAD, although it is likely that a combination of factors increase a person’s vulnerability to developing it. These could include genetics, a history of traumatic or stressful experiences in childhood, such as childhood abuse or bullying and/or growing up with a parent who is “a worrier”. Certain life events may trigger symptoms of GAD in someone who is vulnerable such as prolonged periods of stress due to a change in life circumstances, such as going to University for the first time, divorce or ill-health.

Generalised anxiety disorder treatments

Lifestyle changes

There are many things that we can do to help ourselves to feel less anxious, which in turn can then have a positive impact on our tendency to worry. Regular exerciseyogameditation and breathing exercises can all help to reduce feelings of anxiety, as can eating a healthy and balanced diet and limiting alcohol, sugar and caffeine. Getting enough sleep and time to relax can help us to feel less anxious, as can finding an outlet for our fears such as talking to a friend or family member or writing in a journal. Focusing on the present moment and what is happening in the “here and now” rather than what could happen in the future can also help to reduce the tendency to worry helping us to feel less anxious.

Focusing on the present moment and what is happening in the “here and now” rather than what could happen in the future can help.

If you are worrying and feeling anxious more often than you’re not, your quality of life is suffering as a result and your symptoms aren’t improved by making lifestyle changes then there are a number of effective treatment options out there too. You can speak to your GP who can ensure you receive the right support or you can search for a qualified CBT therapist here www.cbtregisteruk.com.

The current guidelines from the National Institute for Health and Care Excellence (NICE) recommend either a short course of Cognitive Behavioural Therapy (CBT), applied relaxation or medication use for the treatment of moderate to severe symptoms of GAD. For the more complex cases, they recommend a combination of psychological interventions and medication.

Cognitive Behavioural Therapy

Cognitive Behaviour Therapy (CBT) is a type of talking therapy that helps us to understand the problems we are experiencing by recognising that how we feel, what we think, what we do and how our body feels are all interconnected. During a course of therapy, your therapist will help you to understand why you developed the tendency to worry in the first place and how the way you are thinking and the things you are doing may be maintaining this.

Through the use of strategies that have been proven to help overcome symptoms of GAD, your therapist will work with you at your own pace to help you to:

  • Recognise the unhelpfulness and futility of worrying
  • Help you learn to control whether you worry or not
  • Show you how you can use problem-solving rather than worrying to find real solutions to your problems
  • Show you how you can increase your tolerance to the uncertainty of the future and how events will turn out and
  • Help you to deal with any core fears that you have so that they are no longer as concerning for you

Treatment usually consists of 12-15 one-hour weekly sessions (fewer if you recover sooner or more if necessary).

Applied Relaxation

Applied relaxation is a technique that helps you to notice the early signs of anxiety when you experience them as well as teaching you the relaxation skills that you can apply at the first signs of anxiety.

Medication

If you choose drug treatment, your GP is likely to offer you a selective serotonin reuptake inhibitor (SSRI), most commonly an SSRI called sertraline. If this is ineffective an alternative SSRI or a serotonin-noradrenaline reuptake inhibitor (SNRI) may be offered. These are types of antidepressant medications that have been found to relieve symptoms of anxiety as well, although they can produce side-effects, withdrawal effects, interact with other drugs and temporarily increase feelings of anxiety and distress, including suicidal thoughts in young people.

Anti-anxiety medications such as benzodiazepine may also be prescribed as a short-term measure, however these are highly addictive so are only recommended in a crisis.

Although frequently worrying and feeling overwhelmed with anxiety is a very difficult and distressing experience, with the right lifestyle changes, help and support, most people can find a way to manage and/or overcome their symptoms of generalised anxiety disorder completely.

Net Doctor

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