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.




Self-Compassion and Why it is Important for Our Wellbeing

DR JANA JENKINS explains what is self-compassion and why it is important for our wellbeing

Self-compassion can be defined as self-kindness or having an ability to be warm towards oneself, especially at times of adversity.  In addition, another important facet of self-compassion is recognising that life is challenging.   Learning how to take a balanced approach to experiencing negative emotions and how to observe them with openness can be helpful.

Research shows that developing self-compassion increases our sense of well-being and general health.  You may be wondering why self-compassion can help your mental and physical health. Perhaps you are someone who tends to be hard on yourself and very self-critical. You may feel exhausted from being always on the go, judging yourself and being unable to switch off.

The good news is that self-compassion can be learnt.  You can master how to become more sensitive to your needs (e.g. the need for recognition and respect from others, the need for confidence, independence etc).

From my clinical experience, it is not uncommon that people struggle to identify their needs and recognise when they are not met.  Another tendency is to find it much easier to be kinder to others rather than to ourselves and adopt ‘double standards’ when it comes to kindness. For example, we are less likely to think of someone else as ‘useless’ when they make a mistake as opposed to judging ourselves when the same occurs.

The key aspect of self-compassion is learning how to tolerate, accept and become less frightened of our feelings.

It is helpful to know that our experiences of emotions emerge from the patterns created in our brains and bodies. It is useful to think about operating within three different systems; threat, incentive and soothing system.  Let me explain their different functions.

The function of the threat system is to pick up on threats quickly and generate feelings such as anxiety which then alerts and urges us to act against the threat and to self-protect.   Our brains can over-estimate threats because that’s how they are designed to work.

The incentive system is important to give us positive feelings that guide, motivate and encourage us to seek out things and resources in order to survive and prosper. We are motivated and pleased by seeking out, consuming and achieving nice things (e.g. food, places to live, comforts, friendships, etc). It will not surprise you that in modern societies this system becomes overstimulated and can lead to feeling overwhelmed.

Operating in the soothing system on the other hand results in feelings of contentment, social affiliation and peacefulness.  Many people struggle with self-compassion because cultivating self-compassion is not easy and we need to practice it and prioritise it. We all need time to stop, reflect, process our feelings, be with loved ones, have a cuddle and sometimes just simply ‘be’ rather than always ‘do’.

Noticing when we are harsh on ourselves and judging our feelings can be helpful. Noticing when we are not kind to ourselves is also beneficial; perhaps we are overworking, not sleeping enough, pleasing others but not recognising our needs.

When we practice meditation, mindfulness and ‘slowing down’, we are not concerned with wanting or striving, we tend to feel more connected with others and contented.  Many people I see are striving to achieve this sense of contentment and it is their lifelong ambition to achieve this state.

Do you think that you may be someone who can benefit from self-compassion?  What is the one thing that you can change to become kinder to yourself?