1. What is Generalized Anxiety Disorder?
It is common and normal to experience anxiety and worry from time to time. People usually feel anxious before a job interview, taking an exam, or having an operation. In these situations, anxiety helps us to cope with emergencies or motivates us. However, there are people who experience periods of extended worry and uncontrollable anxiety that interferes with their daily tasks. These people suffer from generalized anxiety disorder (GAD). A common characteristic in people who suffer from GAD is that they tend to regularly engage in worry, often about everyday life events, or about events that might not have happened and perhaps might never happen. Sometimes they might also worry about worrying.
2. Causes, signs and symptoms
There are many reasons why someone may suffer from GAD. First of all, anxiety problems can be inherited from parents, and this genetic predisposition sets the stage for anxiety disorders to occur. However, there are also other factors that contribute to the development of GAD, such as an anxious personality, stressful life events (e.g. divorce, death, health problems) and environmental pressure at work or home. Anxiety affects the way we feel, the way we think, the way we behave and how our body reacts. When someone is suffering from GAD, they feel anxious, worried, tense, stressed, detached and have feelings that something awful is going to happen. Anxiety can also affect cognition by altering the way we think and this can result in the development of thinking distortions. Common thinking distortions observed in individuals with GAD include mind reading, where the individual will guess what others are thinking and treat these guesses as facts, and catastrophic thinking, where the individual will imagine the worst case scenario happening regardless of the facts of the situation. People who experience GAD also regularly report a number of physical symptoms, including difficulties concentrating, restlessness, tension, sleep disturbance, tiredness and fatigue, chest and stomach pain, accelerated heart rate, numbness in fingers, a racing mind and difficulties breathing. Due to the unpleasant symptoms of GAD it is not unusual that sufferers alter their behaviour in an attempt to alleviate anxiety. Common behavioural changes include procrastination, avoidance of feared situations, and reassurance seeking. People who suffer from GAD might also portray irritable behaviour, have difficulties relaxing, and experience changes in appetite and consumption of tobacco and alcohol.
GAD can be diagnosed when an individual worries to excess about a variety of everyday problems for a duration of at least three months. For someone to be diagnosed with GAD, the person will experience 3 or more of the symptoms mentioned above, and these symptoms should be persistent for at least 3 months and affect different areas of functioning.
4. Anxiety Treatments
GAD is normally treated with psychotherapy, medication, or both. Choice of treatment depends on the severity of the disorder, and individual choice. In some cases, self-help books or leaflets may be helpful. Psychologists provide different techniques and therapies. Some of these include relaxation techniques (i.e. mindfulness meditation), others provide psychoeducation. According to the National Institute for Health Care Excellence (NICE) the recommended psychotherapy for GAD is Cognitive Behavioural Therapy (CBT). This is a type of therapy that focuses on the connection between thoughts, emotions and behaviour and teaches the person new ways of thinking and behaving that may help in reducing worry and anxiety. GAD can also be treated through the use of medication and your GP will be able to provide you with guidance on what medication to take. At present two types of medications are commonly used to treat GAD – antidepressants and anti-anxiety medications. Some of these medications start working immediately whilst others take several weeks to start working. Common to all medication is that it may cause side effects and some medication should not be taken for prolonged periods of time.