This brief guide the GAD will be discussed along with what is Anxiety, what Anxiety disorders are, what causes generalized anxiety and GAD can be treated.
When an individual is uncertain about future consequences he or she might face in an unfamiliar and new situation, there will be fear and apprehensions. This is the body’s natural response and is named as Anxiety. For instance, giving a presentation in front of the whole class or the first day of a job may cause feelings of fear and nervousness.
Certain amount of Anxiety is necessary for survival and it might actually keep some people motivated to do work and engage in problem-solving. Anxiety becomes problematic when it starts interfering in daily routine and stops the person from being productive. If the anxiety feelings cross the threshold level and last for six months, then it is called Anxiety Disorder.
Anxiety and Anxiety Disorder
There is a difference between normal Anxiety and Anxiety Disorder, having a knowledge of that will help the person treat it properly.
Anxiety is defined by The American Psychological Association (APA), is an emotion which is characterized by worrying thoughts, feelings of tensions and physical discomfort like stomach ache or increased blood pressure in the face of potential danger. Anxiety causes distress but it does not always require medical attention.
Anxiety is necessary for survival. Since the earliest days of humanity, whenever any danger approached, it causes adrenalin to rush. The adrenaline is a body hormone and it triggers the anxious reactions, ”fight-or-flight. This, in turn, causes our ancestors to either confront the danger and fight it or run to take refuge in a safe place.
Now, the anxiety is revolving around money, work, health, family life and other areas of life that require an individual’s attention. A common example of Anxiety would be looking at both sides of the road before crossing it because of the fear of being hit by a car.
When the anxiety exceeds in intensity, it turns into Anxiety Disorder. It is a mental health diagnosis given to people with excessive worry, apprehension, nervousness, and fear.
Anxiety disorders change how an individual behaves and handles emotions that consequently cause physical symptoms. Mild level of anxiety causes discomfort and unsettling feelings but severe anxiety disturbs a person’s day to day life.
As defined by the American Psychological Association, diagnosis of GAD is given when the individual is experiencing persistent intrusive concerns or thoughts. Normal Anxiety when it exceeds a level that it starts interfering in daily life, it becomes a GAD.
Symptoms of GAD
There are many types of Anxiety Disorder and with their distinguished symptoms, however, more general type of Anxiety Disorder is called GAD (Generalized Anxiety Disorder) which is most prevalent and consist of basic Anxiety symptoms such as:
· Feeling of being ”on-edge”
· Excessive worry
· Excessive irritability
· Difficulty in concentrating and focusing
· Sleep disturbances
In daily life, these symptoms are normal to experience but those with GAD experience them on a higher intensity and persistently.
Types of Anxiety Disorder
Anxiety Disorders include the following types of diagnosis classified by The Diagnostic and Statistical Manual of Mental Health Disorders: Fifth Edition (DSM-V):
Separation anxiety disorder: Excessive fear of separating from those to whom the individual is attached lasting for 4 weeks in children and 6 months in adults.
· High level of anxiety when anticipating or being away from home or attachment figure
· Persistent worry of losing a loved one
· Persistent worry of harm to oneself
· Refusal to go out, away from the caregiver
· Fear of being alone or sleeping away from home
· Nightmares with the theme of separation
· Failure to speak outside of home in social situations even in school
· They can speak at home when the parents are present
· Inability to speak even in the presence of close friends or immediate family members
· Excessive fear related to a particular object or situation, for instance, height, animals or flying
· Avoidance of the phobic stimulus
· Children might show signs of this disorder by clinging, throwing tantrums, crying or freezing
Social anxiety disorder, or Social phobia:
· Fear of being in situations where others might judge based on performance
· Fear or having conversation or meeting unfamiliar people
· The individual fears that his anxiety symptoms will show and he will be negatively evaluated
· Avoidance of social situations or endured with extreme fear
· Unexpected persistent panic attacks
· Sudden intense discomfort that reaches a peak within a minute
· Symptoms include sweating, palpitations, pain in chest, heat sensations or chills, fear of dying or losing control
· Excessive worry about having an unexpected panic attack
· Extreme fear and avoidance of situations, events or places where escape is not possible in the face of danger
· It can be fear of open spaces, public transportations, enclosed places, being in a crowd or going outside of home
· They can avoid public situations to the extent that their everyday life becomes extremely difficult.
The symptoms of GAD have been explained earlier, this is the most common disorder among the population of having an anxiety disorder. It includes excessive worry about almost everything that causes discomfort and disrupts the day-to-day life of a person and those around him.
Diagnostic Criteria of GAD
According to DSM 5, the diagnostic criteria for GAD is:
A. Excessive or uncontrollable worry for at least 6 months
B. It is difficult for the person to control worry
C. Anxiety and worry are associated with at least 3 or more of the following symptoms
b. Sleep disturbance
d. Difficulty concentrating
f. Muscle Tension
D. Anxiety and worry are causing significant disturbance in other areas of life
E. The symptoms are not because of another medical or psychological condition.
Anxiety attack is like a panic attack but its intensity is a little less and it can stay for a longer period of time and may worsen with the stressful event approaching.
Every individual with anxiety attacks experiences symptoms differently and in different severity. Because not all the symptoms of Anxiety attack happen to everyone and they change every time. The symptoms are as follows:
· Dry mouth
· Worry and apprehensions
· Failing dizzy
· Tingling or numbness
· Shortness of breath
A panic attack stays for a minute or two but an anxiety attack can stay for longer periods of time.
Causes of GAD
Like many other mental conditions, the causes of GADs are not fully understood. Those who are already prone to anxiety may develop GAD after any traumatic or extremely stressful life event.
There can be some Medical causes of Anxiety. Any underlying medical condition might be causing the symptoms of anxiety. Examples of such conditions include:
· heart diseases
· drug misuse or withdrawal
· thyroid problems
· rare tumours
· as a side effect of any medications
There are some risk factors that might be leading to the development of Anxiety-related disorders. These risk factors include
1. Personality Type
2. Stress buildup
3. Having blood relatives who have anxiety or GAD
4. Going through certain trauma
5. Other mental disorders like depression or OCD
6. Substance use
Current life situations can also cause Anxiety. Like, feeling under stress while studying or preparing for exams, losing a closed one, less sleep hours, too much work pressure, money problems or being out of work.
Treatment of GAD
Sometimes because of Anxiety, other conditions take place such as depression, substance dependence and sometimes they are the underlying cause of Anxiety. Such conditions have strong effects on the mental health of a person and need to be taken care of immediately before treating any GAD.
Medications, psychotherapy and behavioural therapies are the forms of treatments for GAD. They will be discussed one by one.
In order to manage anxiety or GAD without having to go under clinical supervision, many people choose self-treatment at home. These techniques might not be effective for a person with severe anxiety or in the long run.
Following are the techniques for people with mild anxiety and who need short term benefits:
Relaxation techniques: Relaxation techniques have great benefits even if the person does not have anxiety. These include deep breathing, yoga, resting in the dark, meditation and long baths.
Stress management: one of the main reasons for elevated anxiety is stress-related work. Learning stress management techniques helps in limiting the trigger. These include organizing beforehand for the upcoming deadline, making to-do lists and committing to take time out from work or study
Support network: anxiety turns into depression when the person stops seeking support and going out with friends. Anxiety can be managed by talking things out with people who care and are supportive. And for those who are not comfortable with seeking help from familiar people, there are online platforms available where they can talk it out
Exercise: exercising is a great way to release bodily tensions. If hardcore exercise is too much, a person can get incredible benefits just from sticking to a daily brisk walk. It improves physical health as well as increases positive feelings
Psychological counselling is a standard treatment for anxiety. The techniques used in counselling can be cognitive behaviour therapy, psychotherapy or eclectic therapy which is a combination of other therapies.
Cognitive Behavior Therapy: CBT aims at changing the harmful negative thoughts upon recognizing them that maybe playing a role in sustaining the anxiety. It focuses on psychoeducation the client about cognitive distortions and with the help of relaxing techniques and systematic desensitization in some cases, manages the anxiety. CBT has been proven to recover the person from Anxiety altogether by exposing the person to fearful stimulus and making them confront the situations they tend to avoid because of anxiety.
Management by Medications
In milder to moderate cases, a person can get better by professional counselling alone. However, sometimes the symptoms become so distressing that he needs medication. There are different kinds of medications for anxiety management that control mental and physical symptoms. These include Benzodiazepines, beta-blockers, antidepressants, and tricyclics.
Benzodiazepines: They manage the anxiety symptoms quite quickly but they are highly addictive and have few side-effects. Valium or Diazepam are commonly prescribed Benzodiazepines
Antidepressants: they target depression but are prescribed for anxiety as well. These are serotonin reuptake inhibitors and they have side effects of nausea, sexual dysfunction, and jitters when the treatment begins. Prozac or Fluoxetine and Celexa or Citalopram are commonly used antidepressants
Sometimes the side effects can get severe, in such cases, seek medical advice immediately.
Anxiety is a natural response of a body in times of facing danger or a possible threat to survival. It is not a medical condition as long as it is not severe enough to affect daily life. When Anxiety exceeds its normal amount and distresses daily life for six months, it becomes an Anxiety Disorder.
There are different types of Anxiety disorders, among them, GAD is the most prevalent and common. Other types are specific phobia, social anxiety disorder, selective mutism, agoraphobia, and panic disorder.
Causes are complicated but any traumatic event in life can trigger anxiety. The treatment includes self-treatment at home, having psychological help and medications as well.
It has been suggested that having a good sleep routine, keeping check-lists and a balanced diet improves the anxiety symptoms and manages it for the short term.
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Frequently Asked Questions for GAD
What causes GAD?
The GAD is caused by genetic, personal, and environmental factors.
How long does GAD last?
The GAD can last longer, in GAD the period of worry is required to be six months.
Is GAD a mental illness?
Yes, GAD is a mental illness.
What are the 6 types of anxiety disorders?
The five types of anxiety disorders are:
Obsessive-Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
Social Phobia (or Social Anxiety Disorder)