Generalised Anxiety Disorder (GAD)
Updated: Jul 24
There are many types of Anxiety disorders
Anxiety is a broad term for a number of disorders. The 2016 report from the National Institute of Mental Health (NIMH) have come up with a list of these disorders:
- Generalized Anxiety Disorder (GAD)
- Panic Disorder
- Obsessive-Compulsive Disorder (OCD)
- Obsessive-Compulsive Personality Disorder (OCPD)
- Acute-Traumatic Stress Disorder (ATSD)
- Post-Traumatic Stress Disorder (PTSD)
- Social Anxiety Disorder
- Separation Anxiety Disorder
- Illness Anxiety Disorder
So as you can see, there is basically an Anxiety Disorder to suit everybody. The list keeps on growing. There must be a person sitting around thinking about new names for disorders.
What really is Anxiety?
Anxiety attacks are created when one has thoroughly trained their body and brain to become hyper-vigilant and prepared in anticipation of the next stressful experience.
If we could trace anxiety back to the beginning, for most people it starts off with a situation or an event that caused intense emotional pressure. After the event, the memory of this experience causes the person to think about the episode again and again in anticipation of a similar event occurring again. This constant negative mental rehearsal of the past makes the individual anxious and afraid about their future moments and potentially about what could happen.
From a bio-chemical standpoint. Their negative thoughts about the past produce negatively charged peptides (chemicals) in the Pituitary Gland in the brain, which are released into the blood stream. These peptides then make their way to the Adrenal Gland and other cells. The Sympathetic Nervous System is switched on and the body prepares to fight or run away. Blood is taken from the digestive system and sent to the muscles, blood sugar levels and the heart rate increase as other emergency services within the body are turned on.
When the body’s cells are subjected to prolonged negative anxious thoughts, the cells become addicted to this habitual negative chemical cocktail. Therefore, when the brain starts to think positively, the cells in the body feel uncomfortable, unusual because the cells are not receiving the same negative chemicals.
Because the cells in our body want normality, they begin to send signals to the brain instructing it to deliver more of the same negative cocktails. The brain then reaches back into its memory bank located in the Hippocampus, finding these old memories of anxiousness. The brain starts mulling them over and over again in the present moment, releasing the negatively charged chemicals into the blood stream so the cells once again can feel normal. This vicious circle of thought and chemical can be injurious to your health and long term can be the catalyst for disease and other behavioural problems but it also explains why it is so hard to break free of anxiety on all levels.
When we continue to think in a certain way, be it positive or negative we build more and more synaptic connections within the brain. The neural pathways become stronger. If you are always anxious then these pathways become thicker and richer, whilst positive pathways are pruned away because they are not being used. This means that it becomes easier to think negatively and anxiously and harder to think realistically and positively, so in reality you nurture a habit of anxiety. Changing thoughts from negative to positive can be achieved with time and perseverance. It isn’t easy, often times requiring the help and guidance of others but nevertheless a possibility to those who dig deep and find the courage to do so.
Now a look at Generalised Anxiety Disorder (GAD)
Most people affected by GAD are in between childhood and middle-aged. GAD impairs one’s ability to function in everyday life due to constant worrying about what might happen. This could lead to anticipating the worst or a catastrophe taking place. Many of the symptoms and physical signs of GAD may be look like a person that is under a huge amount of stress. The body and mind react in similar ways with both. GAD might co-exist with substance abuse, depression and other types of anxiety disorders.
Let’s take a closer look at worry:
A very old man once said:
"I have had so many problems in my life most of which never happened."
And the most of which have never happened are the worries that you have in your life. We consume our present moments worrying about the future, worrying up about our health, worrying about our children, our job, our car, our house, our money, our parents, our husband, our wife, finding a partner, getting into heaven and who is going to look after us we are old.
Why do we do this? Well there is some evidence that people who worry a lot came from a family of worriers. It could be hereditary or something that we were taught early in life. We were shown through behaviours and words that it is healthy to worry, that it shows that you care. We it isn’t actually healthy and may lead to anxiety disorders.
Worry steals our present moments away. People who follow mindfulness do not worry. They realize that if they have no control over it then there's no point in worrying about it. They also realize that if they do have control over it then they take control and do something about it. So, there is no point in worrying about that either.
Just telling somebody to stop worrying will not help them. But there are systematic approaches which we will look at further.
What is unique about GAD:
- It occurs more days than not
- Has been going on for at least 6 months
- The person has difficulty controlling their worrying
- The person is very restless
- The person is easily fatigued
- The person has difficulty concentrating
- The person may become irritable
- The person may have difficulty falling asleep and staying asleep
- The person may repeatedly check things just in case something happens
- The person thinks that if they worry over another then they are caring
- The person has a pessimistic nature
Some of the physical signs are:
- Muscle tension
- Gastrointestinal problems
- Cold clammy hands
- Difficulty swallowing
- Trembling or twitching
- Hot flushes
- Shortness of breath
Techniques used by a health care workers, psychologist, psychiatrist and counsellors for treating GAD may be:
1. Journaling – The client is to write down all the negative worrying thoughts for a week. Tally them up at the end of the week. Then work with the counsellor or mental health professional and try to analysis the thoughts and think of new ways of processing these thoughts.
2. Thought Stopping – The client saying to themselves or out loud STOP when a negative worrying thought comes into the mind. Then replacing it with a positive thought.
3. Designated worry time – Pick a spot in the house and set time each day to worry about stuff. Then get up and go about the day.
4. Schedule an enjoyable activity – The client to write it down, and then write “I will enjoy this activity because………….”
5. Move the Body – The client to do some exercise and stretching. This will build a fitter stronger body but also release those feel good chemicals into the blood stream.
6. Meditate – The client should practice sensations meditation which will bring about more self-awareness. Find a good meditation teacher and practice this daily.
7. Relaxation techniques – These include slow diaphragmic breathing and moving through the body relaxing each body part. Find a good meditation teacher or therapist to learn this.
8. Group Therapy – Join a group where the members are all suffering GAD. It helps to see that others have the same difficulties. It is also good to hear what they have done to tame the beast.
9. Medication - Medication might be prescribed depending on the severity of the disorder. This can kick start the recovery. This must be diagnosed and prescribed by Mental Health Nurse, Doctor or Psychiatrist. The use of medication replaces the body’s own feel-good chemicals. Prolonged use of medication will put the organs that produce the feel-good chemicals to sleep eventually. The body will then become addicted to the medicine, not being able to function normally without it.
10. Goal Setting - This wil make one look at their life from a perspective of meaning. What am I here to do? This will help one begin to plan and use postive constructive thought to move towards these goals.
11. Paradoxical Intention - This is a technique from Logo Therapy. One would do more of the thing that they are trying to stop. For example. If a person cannot sleep due to so many worrying thoughts, then they should try to stay up as long as possible without sleep. Eventually through exhaustion the body will sleep.
In summary, a variety of treatments are available for the person with GAD. They can be mixed and matched depending on the severity and response to the treatments. Even though medication has its place, I would prefer to see people use them only short term. Thus, exploring how to use the mind effectively, moving towards recovery.