What is Generalised Anxiety Disorder?
Have you always been a bit of a worrier? Do you find yourself spending lots of time getting anxious about lots of different things, such as finances, relationships, health, work, or the future? Do you struggle to let the worries go? Maybe the worries affect your sleep? Do you find yourself feeling more irritable than usual?
If you can relate to some (or all) of the above questions, you may be experiencing symptoms of Generalised Anxiety Disorder (GAD). GAD is an anxiety disorder that is characterised by excessive worrying. We all worry and that's completely normal, but if you find yourself getting stuck in a stream of negative thoughts that are looping round and round, the chances are its unhelpful and excessive worry.
When worry becomes excessive, occurs on more days than not, and is more intense than what most other people would typically experience, with difficulties in letting the worries go, as well as impactful sleep and quality of life, it may be a sign that you are experiencing symptoms of GAD.
What Can Make Me Vulnerable To GAD?
GAD can be linked to childhood, for example, if you are brought up in a home where either one (or both) or your caregivers are worriers themselves, you can learn to worry excessively about things both cognitively (i.e., you learn to think in an anxious way, and behaviourally, meaning you learn to respond to anxiety in a particular way that often serves to maintain anxiety). Adverse childhood experiences can also lead you to be more anxious in adulthood.
Research also shows us that those who worry excessively are highly intolerant to uncertainty. This means that when they are faced with an element of uncertainty, such as waiting on a test result, those who are intolerant of uncertainty will become extremely anxious, leading them to worry excessively.
In my clinical experience, GAD is the most common anxiety disorder that I have found myself working with, and some research has suggested that GAD is the main underlying anxiety disorder that drives the other anxiety disorders. GAD can be experienced on its own, or can function as part of other psychological difficulties, such as Obsessive-Compulsive Disorder, and Post Traumatic Stress Disorder.
What Help is Available for Generalised Anxiety Disorder?
The most effective treatment for GAD based on clinical trials and research is Cognitive Behavioural Therapy (CBT), which involves identifying and challenging unhelpful ways of appraising and responding to worrying situations/things and learning to manage excessive worrying better. Another key feature in treating GAD with CBT is learning how to tolerate uncertainty because research suggests that when you are more tolerant to uncertainty, you tend to worry less.
You may have been prescribed an anti-depressant by your GP if you have reported worrying too much, and the research shows us that anti-depressants are just as effective as CBT for treating GAD. However, the relapse rate for those with GAD when they come off medication is very high, with GAD symptoms tending to return at some point. Studies have shown that those who have CBT to manage GAD have a much lower relapse rate. This is because the treatment effects are maintained by addressing the intolerance of uncertainty that drives excessive worry.
Top Tip - Keep a Worry Diary!
Does any of this relate to you? Do you find it hard to manage worry? Why not start to keep a worry diary - a record of the things that make you anxious. How do you know you are feeling anxious? Where do you feel that anxiety in your body? What exactly are you worrying about? Is it, “what if I do not get that job,” “will my partner be in a horrible accident on the way home from work today,” or “will the house get burgled when I go to sleep?”
These are all typical examples of worries that any one of us, including those with GAD, can experience. Keeping a record can help you to see whether there are any themes to your worries and what type of worry that you typically focus on.
Hypothetical Worries
In CBT, we focus on there being two types of worry. Hypothetical worries are things that have not happened yet, but there is a possibility that they could happen at some point and they tend to not have a current solution to them. Examples may be “what if I car breaks down on my way to see my friends today,” or “what would I do if something bad happened when we go on holiday.”
Real Worries
These are things that have happened and there is a current solution to them. For example, my car has broken down and I am all on my own, or something bad has happened on our family holiday, such as a family member having their wallet stolen from their hotel room. The solutions for these would be getting the car looked at by a professional or asking the hotel to check their CCTV to try and find who stole your family members wallet.
What tends to happen with GAD is that individuals can problem-solve particularly well when there is a real worry to work through, but they tend to get stuck on the hypothetical worries that have NO solution to them and therefore cannot be resolved.
Another way to try and manage GAD is to differentiate between whether your worries are hypothetical or real because hypothetical worries have no solution to them, and real worries do have a solution that can be problem-solved. You can do this by classifying your worries individually into one of the two types of worry. With each worry, ask yourself, is this a current problem that I can do something about now?
If the answer is yes, make a plan and implement it. If you answered no, the best way to try and disengage from the hypothetical worry is to change your focus of attention onto something else. This takes practice, like most CBT skills, so notice the worry, but purposely chose to disengage from it by refocusing your attention on the here and now. This can usually be achieved by doing an activity that you can really focus on. Doing this should mean that your mind is more present-focused, rather than future-focused, like with hypothetical, future-based worries.
Further Support
I hope this blog has helped you understand more about GAD, what it is, how it can present, and how a psychological treatment such as CBT can try and help you overcome excessive worry. I have created a worry diary that you can use so if you want a copy, contact me and I can email one over to you.
If you have tried the tips in this blog and you are still struggling, CBT can go into lots more depth to try and help you overcome symptoms of GAD. GAD responds well to CBT and I have lots of experience of using it to help people learn to take control of their worries, rather than letting their worries control them! Please contact me directly if you want to discuss your situation further.
Useful Links:
Can Childhood Adversity Cause Anxiety
Excessive Reassurance Seeking & Anxiety
What Is Cognitive Behavioural Therapy?
Overview - Generalised anxiety disorder in adults - NHS (www.nhs.uk)
