Generalised Anxiety Disorder

DR JANA JENKINS explains what is Generalised Anxiety Disorder (GAD).

You are unlikely to be surprised that ‘Anxiety’ and ‘Worry’ are both very common but manageable for many people.

GAD on the other hand is characterised by excessive, uncontrollable and often irrational worry accompanied by high levels of apprehension about events or activities. Furthermore, people with GAD tend to be constantly preoccupied with their worries about health, money, death, family issues, interpersonal relationship problems, or work difficulties.  They anticipate that ‘something bad is going to happen’. This excessive worry causes significant distress and interferes with one’s daily functioning.

Excessive worry further results in many symptoms of anxiety which affects our body and can lead to many unpleasant physical symptoms such as palpitations, shallow or fast breathing, feeling nauseous, headaches, sweating or shaking.   Feeling tense and irritable, unable to relax, problems sleeping and difficulties with concentration. worry about anxiety itself are also common symptoms.

Most of us would have experienced some of these symptoms at some point.  However, for people who experience GAD, these symptoms can be persistent and severe and therefore understandably very distressing.

It is important to emphasise that ‘Anxiety’ is a normal reaction to danger and an important survival mechanism.  However, it can become a problem when our mind and body are constantly prepared for danger and get stuck in the ‘threat’ mode. For example, many people with GAD experience hypothetical worries (problem is not real but often imagined) such as ‘What if I get burgled or What if I or my loved ones get involved in a traffic accident and die?’, it is understandable that their bodies will produce a ‘fight or flight’ response to prepare for danger even though it is not real. Think about it like a test fire alarm, the sound is the same but there is no real danger of fire.

Most people I see who present with GAD experience unhelpful thoughts about their physical symptoms and they report being frightened by these symptoms.  For example, it is common that people think that there is something physically wrong with them, they are feeling ‘out of control’ or believe that they are going ‘mad’.  There is no wonder they may start fearing anxiety symptoms for such reasons.

If you live with someone with appears to have GAD, encourage them to get professional help.  From my clinical experience, it can be frustrating for the relatives who cannot make sense of irrational worries or need to constantly provide reassurance.  Try to be patient if you can and try to refrain from the phrase: ‘Don’t worry’ as GAD sufferers find it dismissive.  Also, try to avoid giving reassurance as it tends to keep anxiety going and reassurance is very short lived.

GAD can become disabling for many people as they start avoiding events and their life may become very restrictive.  If you think you may have GAD which is negatively impacting on your life, you may benefit from the evidence-based therapy (recommended by NICE guidelines) such as Cognitive Behavioural Therapy.