What is generalised anxiety disorder?
Generalised anxiety disorder, GAD, is a type of anxiety disorder where the person worries about many things. For most people, worrying is just a normal part of life. It’s that nagging feeling in the back of your mind that something might go wrong, and it can be helpful in some ways it can motivate us to take action and avoid potential problems. But for people with a generalised anxiety disorder (GAD), worry becomes excessive and debilitating, causing tremendous stress and interfering with daily life.
The primary feature of GSD is chronic worry, and it is essential to distinguish GAD from normal worry.
The difference between normal worry and GAD
What is worry?
Worry occurs when you expect and plan for potential negative events that may or may not happen in the future. For example, if you approach your bank for a loan to buy your dream house. You might worry that you will not get the loan. What if the bank turns me down? What if my credit score is not good enough? I can check my credit score and improve it if needs be, and check if I can afford the loan repayments before approaching the bank manager.
The type of worry has two parts; one, where the person predicts all the things that could go wrong, and the second, solves the problem.
The key to distinguishing between productive and unproductive worrying is understanding the function that it serves for you.
Productive worrying is when you worry about something and then take action to resolve the issue. For example, if youre worried about an upcoming presentation, you might rehearse your speech or research the topic.
Unproductive worrying is when you worry about taking no action to resolve the issue. This worrying can be very harmful because it leads to stress and anxiety, providing no solutions.
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CHARACTERISTICS OF WORRY
- They are thoughts about the future. Read more on anticipatory anxiety.
- They are always negative.
- Contain ‘what if’ type of questions. These types of questions are known as cognitive distortions.
Worrying is not a problem. We all worry when presented with a situation where the outcome is unclear. For example, during the last job interview, worry helped me prepare. I did not know what they would ask me beforehand, so I predicted all plausible scenarios and prepared answers for them. Read more on worry.
When do worries become a mental health problem?
If you worry and run through all negative outcomes, use this information to problem-solve and move on. You do not have a problem. For worry to become clinical, it has to:
Affect your ability to problem solve, i.e. you worry so much or feel so much stress that you cannot concentrate on the task. For example, cancelling appointments as you worry so much.
The worry interferes with your daily life; for example, your sleep is affected.
When your daily life is affected for at least six months, meet with a mental health professional for assessment.
What does GAD look like?
Content of worry
The hallmark of GAD is excessive worry about many things. A person could worry about one or two things and not be diagnosed with generalised anxiety disorder. For example, if the content of a persons worry is solely focused on health-related issues, the person might have health anxiety as opposed to GAD. It is called generalised anxiety disorder for a reason, in that the content of the worries in general. Not that a person with GAD cannot worry about their health, they can. But they can spiral into worrying about non-related things.
What do people with GAD worry about?
They worry about the same things as the rest of the population; work, health, and money, but the difference is that the worry is uncontrollable and affects their day-to-day functioning.
THE FUTURE
Because of the nature of GAD, i.e. chronic worry, people with the condition live in their heads, worrying about the negative consequences of imagined future events. This means that they miss most chances to feel okay; for example, you could be on holiday that you planned last year but not be able to enjoy it, as you are stuck in your head worrying about future events; the only difference is that you are doing it sitting on a beach.
How do I know if I have GAD?
If you suspect you have a generalised anxiety disorder, getting a diagnosis from a licensed mental health professional is essential. Before discussing diagnosis, GAD has specific signs and symptoms that you might recognise in yourself.
Intolerance of uncertainty
People with GAD have negative beliefs about uncertainty, which proves difficult, as worry is about something that may occur in the future where the outcome is uncertain. For example, you can worry about passing an exam, as the outcome is uncertain. You would not worry if you knew beforehand that you would pass.
For someone to worry, there has to be a situation where the outcome is uncertain. Most people do not relish uncertainty but can cope better than someone who has a high intolerance of uncertainty, where they make catastrophic predictions about the uncertain future outcome.
For example, if two people are interviewed for a job, the first might worry about how they did in the interview but could carry on with life until they find out how they did. Besides catastrophically predicting they wont get the job, the second person has difficulty tolerating not knowing the outcome for sure. They feel stressed and agitated and could have difficulty sleeping. In other words, they find it difficult to cope with feelings of uncertainty.
What are the symptoms of generalised anxiety disorder?
Feeling restless or on edge
fatigued
difficulty concentrating
irritability
muscle tension
sleep disturbance
worrying about everyday problems
How is generalised anxiety disorder diagnosed?
GAD is diagnosed when a person experiences uncontrollable worry that is present more days than not, lasts for at least six months and has at least three of the following symptoms.
Restlessness/nervousness, easily fatigued, poor concentration, irritability, muscle tension, or sleep disturbance.
How is generalised anxiety disorder treated?
Different treatment options are open to you if you have been diagnosed with GAD, depending on the severity of your symptoms. I should present the following using a stepped-care approach, where you start the least intensive treatment and move up to the next step if your current treatment is ineffective.
Self-help
The HSE recommends books or online courses to help with GAD and exercise and lifestyle changes. Much evidence suggests that exercise can effectively manage symptoms of generalised anxiety disorder. Exercise has been shown to help relieve tension, reduce stress hormones, boost feel-good chemicals such as serotonin and endorphins, and change the brain in ways that make it less anxious. Whether you choose books or a course, the therapy model should be cognitive behavioural therapy, as this therapy lends itself well to self-help and working on your own.
Read more articles on how to use CBT to help with anxiety.
Psychological (talking) therapy
You can seek professional help from a mental health professional, or your GP may refer you for talking therapy. Like self-help, the model of therapy will be CBT.
CBT for GAD
People with GAD worry about and predict the future in catastrophic ways. CBT shows people how to reappraise these catastrophic interpretations and manage uncertainty better. Read more on CBT.
Mindfulness.
Mindfulness. Focusing on the present moment, with no judgement, can help with the worry associated with GAD.
Medication
If self-help and talking therapy did not work, your doctor may discuss medication options with you, which could be selective serotonin reuptake inhibitors and beta-blockers
Outlook
People with GAD can learn to manage their worries and change their faulty catastrophic thinking styles with CBT, thus increasing their quality of life.