What is Generalised Anxiety Disorder (GAD)?

Everyone experiences anxiety from time to time, but sometimes it can begin to take over a person’s life. Generalised Anxiety Disorder (GAD) is characterised by a constant state of high anxiety that has continued for at least six months.
It is relatively common and is also known as ‘chronic worrying’ or ‘free-floating anxiety’, because it continues regardless of the reality of everyday life. People with GAD may find themselves worrying about daily issues such as work, health, money or relationships to an excessive degree, and be filled with a horrible sense that something very bad is going to happen. GAD can affect daily functioning in physical, mental and emotional ways, and make life increasingly difficult, as tension, fatigue and lack of sleep begin to increase the level of the worry cycle.
How anxiety differs from fear
Unlike fear, which is a response to an event, anxiety is worry about events that may occur in the future; it is an emotional state produced not by events in the external world, but by worry in the person’s mind. This is the bad and the good news: because it is fear of the future, it can be seen as potentially present all the time. On the other hand, because it is an emotional state produced by the mind, it will disappear if the emotional state ceases to create it. People with GAD may have evolved strategies for managing the anxiety; most often they prevent themselves from entering situations that could provoke anxiety by using ‘avoidant strategies’ such as distraction, excessive preparation (such as arriving very early for appointments) constant checking (that a door is locked, for instance), and procrastination (putting things off that need to be done). However, by avoiding these situations, they may be inadvertently causing the anxiety to grow, because the sense of dread and worry increases each time the feared situation is avoided.
Key symptoms
There are five main symptoms of GAD:
  1. A constant feeling of being ‘on edge’ or ‘keyed up’ which manifests as irritability and jumpiness
  2. Muscular tension
  3. Continual fatigue
  4. A tendency for the mind to ‘go blank’ and a lack of concentration
  5. Sleep problems, such as difficulty falling or staying asleep.

Other symptoms can also arise, such as impatience, feeling over-sensitive and reactive, loss of appetite, nausea, excessive urination, shallow, rapid breathing, palpitations, feeling faint, and experiencing a sense of dread or panic.

On a cognitive level, people with GAD have a tendency to ‘catastrophize’ and may find that they are expecting the worst possible scenario to emerge from situations. Confidence in problem-solving can take a dive, and decision-making can become difficult. They may also find themselves feeling hyper-alert to threatening stimuli and interpreting ambiguous situations as threatening.

Psychotherapy for GAD

Some therapies, such as cognitive behavioural therapy (CBT) focus on the perceptual biases that cause the negative thoughts and expectations, and CBT has been found to help reduce these thoughts and responses. However, when challenges to thinking patterns are combined with a therapy that also looks at emotional reactions and learned behaviour from past situations, new learning can take place at a deeper level, preventing a reaction from taking place, rather than managing an arising reaction. Recently, therapies such as Emotional Coherence therapy have suggested that anxiety can stem from a positive attempt to keep an important, learned code of behaviour in place, which may no longer be in the person’s best interest and so creates internal conflict and anxiety. Find out more about how anxiety can be serving a real but unconscious process here.
 As always, thanks for reading.
Sarah Tomley is a counsellor working in Suffolk, UK, at Insight Counselling Ipswich

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