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

Should I have therapy?

In Spring 2014, The Huffington Post published an article on the ‘Eight signs you should see a therapist’. This sounds a little dictatorial, because no one (and certainly no newspaper!) has the right to say that someone ‘should’ see a therapist. There are no rules about seeing a therapist, and in fact one of the things people find most useful about therapy is the complete lack of ‘shoulds’ – there is no right or wrong way to do it, and no perfect person to ‘be’. The therapy hour is a unique space in that respect: this is a place where people are valued, respected, and free to talk about whatever they wish, at a pace that feels right to them, in a space that is calm and confidential.

There are many reasons that people seek help through some form of therapy. Problematic situations or difficult emotions may loom large or seem acutely pinpointed. People visiting a therapist may be feeling overwhelmed, anxious or depressed, or worried about feeling nothing at all. They may be wrestling with relationship problems, looking for ways to cope with chronic pain or simply feeling irretrievably ‘stuck’ in a painful place,for reasons known or unknown.

As author Scott Peck said, way back in 1978, ‘Life is difficult’, and sometimes our coping methods and support systems aren’t able to carry us through. When daily life becomes a struggle, sometimes therapy can help.

And those ‘eight signs’? They’re here, along with my suggestions of what someone might wish for in their place:

  • You have unexplained and recurrent headaches, stomach-aches or a rundown immune system (you want to feel physically better)
  • You’re using a substance to cope (you want to be able to feel good without self-medicating)
  • You’re getting bad feedback at work (you want to achieve more and feel good about yourself at work)
  • You feel disconnected from previously beloved activities (you want to feel joy as you go about your life)
  • Your relationships are strained (you want your relationships to be rich and fulfilling)
  • You’ve suffered a trauma and you can’t seem to stop thinking about it (you want to find a way to deal with a past event so that you feel peaceful and easy once more)
  • Everything you feel is intense (you want more balance in your life)
  • Your friends have told you they’re concerned (you want time and a place to work things out for yourself)

These are all good reasons for considering therapy. As are these:

  • The wish to find a way to forgive others, or yourself
  • The desire to stop feeling like you’re on ‘autopilot’
  • The wish to turn an ok marriage into a great one
  • The desire to find a different way of parenting
  • The desire to find out what you really want from life

Therapy isn’t a cure-all, but it is a safe place to work out what’s happening now, where you’ve been, where you’re going, and where you want to go. In your own time.

Here’s that Huff Post article in full:

http://www.huffingtonpost.com/2014/02/12/8-signs-you-should-see-a_n_4718245.html

Sarah Tomley is a counsellor working in Suffolk, UK, at Insight Counselling Ipswich.