Generalised anxiety disorder means having regular or uncontrollable worries about many different things in your everyday life. Because there are lots of possible symptoms of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person’s experiences.
Generalized anxiety disorder symptoms can vary. They may include:
- Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events
- Overthinking plans and solutions to all possible worst-case outcomes
- Perceiving situations and events as threatening, even when they are not
- Difficulty handling uncertainty
- Indecisiveness and fear of making the wrong decision
- Inability to set aside or let go of a worry
- Inability to relax, feeling restless, and feeling keyed up or on edge
- Difficulty concentrating, or the feeling that your mind “goes blank”
- Difficulty with finding a relationship
Physical signs and symptoms may include:
- Trouble sleeping
- Muscle tension or muscle aches
- Trembling, feeling twitchy
- Nervousness or being easily startled
- Nausea, diarrhoea, or irritable bowel syndrome
Dealing with a generalised anxiety disorder can be very difficult and the impact can be debilitating. Anxiety can stop people living the life they want – whether that means not being able to work, see friends or, in the most severe cases, even leave the house.
It is normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities may be a sign of generalized anxiety disorder.
It is possible to develop generalised anxiety disorder as a child or an adult. Generalised anxiety disorder has symptoms that are similar to panic disorder, obsessive-compulsive disorder and other types of anxiety, but they’re all different conditions.
Living with generalised anxiety disorder can be a long-term challenge. In many cases, it occurs along with other anxiety or mood disorders.
There may be times when your worries do not completely consume you, but you still feel anxious even when there is no apparent reason. For example, you may feel intense worry about your safety or that of your loved ones, or you may have a general sense that something bad is about to happen.
Your anxiety, worry or physical symptoms cause you significant distress in social, work, or other areas of your life. Worries can shift from one concern to another and may change with time and age.
In most cases, generalised anxiety disorder improves with appropriate support from a professional. Making lifestyle changes, learning coping skills and using relaxation techniques also can help a great deal.
Factors and causes behind GAD
Often, a combination of factors may be involved in the development of GAD.
- Biological factors: Some changes in brain functioning have been associated with GAD. Differences in brain functioning may increase the risk of developing an anxiety disorder. People with GAD also show differences in brain structure on neuroimaging studies using functional MRI scans. An imbalance of serotonin and other brain chemicals are also present in people with GAD and other anxiety disorders.
- Family history: People with GAD often have a history of mental health problems in their family. However, this does not mean that a person will automatically develop anxiety if a parent or close relative has had a mental health condition.
- Stressful life events: People may be more at risk if they experience a major life change that causes stress, such as the birth of a child, the breakdown/loss of a close relationship, or moving to a new house/ change of job. Physical, sexual, or emotional abuse also increase the risk of developing GAD, as do other traumatic experiences in childhood, such as the death of or separation from a parent.
- Psychological factors: Some personality traits may put a person at greater risk of GAD, including: − being sensitive − being emotional or experiencing general nervousness − inability to tolerate frustration − feeling inhibited − having perfectionistic tendencies.
Making lifestyle modifications can help people keep their worries and concerns under better control. Some examples of helpful changes to make include:
- exercising regularly
- eating a healthy diet
- reducing exposure to stressors
- prioritizing issues and events
- practicing mindfulness, meditation, yoga, tai chi, or qigong.
- keeping a journal to help identify anxiety triggers and coping strategies
- avoiding alcohol and drugs, and limiting or avoiding nicotine or caffeine
- setting a sleep schedule to ensure 7–9 hours’ sleep per night
- Specific breathing techniques.
Cognitive Behavioural Coaching
CBT is the most widely used therapy for anxiety disorders. Research has found it to be effective in treating GAD, phobias, and panic disorders, among other conditions.
The premise of CBT is that your thoughts—not your current situation—affect how you feel and subsequently behave. So, the goal of CBT is to identify and understand your negative thinking and ineffective behaviour patterns and replace them with more realistic thoughts and effective actions and coping mechanisms.
During this process, the professional working with you acts like a coach teaching you helpful strategies. For example, you might do a lot of “black-and-white” thinking, where you assume that things are all bad or all good. Instead, you would replace those thoughts with the more realistic perception that there are many shades of grey in between.
It takes practice to use these strategies. Once you start to recognize your anxiety and your triggers, you can learn to apply the coping skills that you learn in CBT to manage fear, panic, and worry.
Exposure therapy is a type of psychological therapy that can help people overcome their fears or anxiety disorders. It can help reduce feelings of anxiety, distress, or fear that a person may have due to a disorder or previous trauma.
In exposure therapy, a person will have exposure to a situation or stimulus that triggers feelings of fear or panic for them. Over time, controlled exposure to these fears in a safe space can help reduce their feelings of anxiety and distress.
A coach may use different types of exposure therapy depending on the type of fear or disorder that the person has. For example, the coach may create a real-life scenario for the person to go through, or they may use talking therapy to encourage the person to imagine situations or recall traumatic events.
This approach involves three parts:
Learning relaxation skills.
First, your coach will teach you a relaxation technique, such as progressive muscle relaxation or deep breathing. You will practice in sessions with your coach and on your own at home. Once you start confronting your fears, you will use this relaxation technique to reduce your physical anxiety response (such as trembling and hyperventilating) and encourage relaxation.
Creating a step-by-step list.
Next, you will create a list of 10 to 20 scary situations that progress toward your final goal. For example, if your final goal is to overcome your fear of flying, you might start by looking at photos of planes and end with taking an actual flight. Each step should be as specific as possible, with a clear, measurable objective.
Working through the steps.
Under the guidance of your coach, you will then begin to work through the list. The goal is to stay in each scary situation until your fears subside. That way, you will learn that the feelings will not hurt you and they do go away. Every time the anxiety gets too intense, you will switch to the relaxation technique you learned. Once you are relaxed again, you can turn your attention back to the situation. In this way, you will work through the steps until you are able to complete each one without feeling overly distressed.
The first-line pharmacological treatment for generalized anxiety disorder (GAD) is a selective serotonin reuptake inhibitor (SSRI) or serotonin and norepinephrine reuptake inhibitor (SNRI). These medications are also highly effective for depression—which is important because depression commonly co-occurs with GAD. Which means that taking an SSRI or SNRI can decrease symptoms of both illnesses.
Your doctor will likely start with a low dose of an SSRI. While it varies by individual, you will begin to feel the benefits of the medication in 4 to 6 weeks. If you are not showing much improvement, during that time, your doctor will likely increase the dose of the same medication. If that does not seem to help, that medication will be tapered off, and your doctor will likely prescribe a different SSRI (or move on to an SNRI).
It can also be beneficial to undertake some form of professional therapy at the same time, as medications will treat the symptoms but not necessarily the underlying factors behind your GAD. The reason being that therapy, unlike medication, gives you the tools to manage the anxiety yourself, now and in the future.
Coping and support
To cope with generalized anxiety disorder, here is what you can do:
- Stick to your treatment plan.
- Take medications if prescribed.
Keep therapy appointments. Practice the skills you learn in coaching. Consistency can make a big difference, especially when it comes to changing your thoughts.
- Take action. Work with your coach to figure out what is making you anxious and address it.
- Let it go. Do not dwell on past concerns. Change what you can in the present moment and let the rest take its course.
- Break the cycle. When you feel anxious, take a brisk walk, or delve into a hobby to refocus your mind away from your worries.
- Socialise. Do not let worries isolate you from loved ones or enjoyable activities. Social interaction and caring relationships can lessen your worries.
I really hope you found this information useful, and if you have any further questions do not hesitate to contact me and we can chat further about your concerns.
I offer a range of therapeutic treatments for GAD in my coaching practice, and all are evidenced to have a positive impact on anxiety and include those mentioned above.
However, if you choose to take the option of medication, I am not qualified to provide this. In this instance you would need to talk to your GP to discuss the most appropriate option for you.
Many thanks for reading and I’m here if you need me.