Generalized Anxiety Disorder

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Over the last several entries, we have been learning about some of the specific anxiety disorders that can disrupt your life. 

We began by considering that there is a place for normal fear and anxiety in your life; these feelings can alert you to something that is wrong or something important that needs your attention.  But these feelings can get out of hand in several ways. You may develop a panic disorder which includes panic attacks that seem to come out of nowhere.  You may develop a specific phobia disorder where the fear and worry focus on a specific object or situation.  With a social anxiety disorder the fear and worry focus on a variety of social situations that you end up trying to avoid.

“I’ve always been a worrier…I am always fretting over things I can’t control…Even the things I can control, I worry about how I am doing…I am constantly second guessing myself, wondering if could have done more or done better.” 

Do any of these statements sound familiar? 

Perhaps you know people who have said them, or you have thought them about yourself.  If you worry about lots of different situations and cannot seem to control that worry or it gets in the way of you living a fulfilling life, you may have Generalized Anxiety Disorder (GAD).  People with GAD say they are constantly worried about lots of things in their lives. They talk about being stressed or overwhelmed by the daily events of life.

Some of the symptoms that are part of GAD include:

·       Restlessness, feeling keyed up or on edge.

·       Being easily fatigued

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·       Difficulty concentrating

·       Irritability

·       Muscle tension

·       Sleep disturbance

·       The anxiety, worry or physical symptoms cause significant distress or impairment in important areas of functioning.

If you have at least three of these for more days than not over a period of six months, GAD may be present.  Also, GAD can develop slowly over time.  It can start when you are young and worsen as you age.  This is why you will often hear people who struggle with GAD say that “I’ve always been a worrier.” 

Again, all of us have anxiety and worry in our lives, but these feelings can disrupt our ability to function well at home, school, or work…or when they keep us from enjoying life.  For example, many people with GAD have trouble sleeping which certainly impacts your ability to do well in other areas of life.  This lack of sleep can result in loss of concentration and irritability.  A small ache in some part of your body becomes a worry that you have an illness.  Even when you aren’t busy, your mind finds something to worry about: a task at work, something happening to loved ones.

If you struggle with GAD, there may be this pervasive feeling that there is nothing you can do to predict or control the stressful situations in your life, so you worry about them.  We are learning that this worry is a way to avoid the many unpleasant symptoms listed above.  Sometimes, this can work; you think constantly about a situation, and the anxiety lessens.  But not for long.  It is easy to get caught in a feedback loop, where the anxiety returns more intensely, and you worry more to make it go away.  And still, you are unable to do all the tasks and activities that give your life meaning and pleasure.

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My work with people who struggle with GAD focuses on these efforts to control the anxiety and the worry. 

Avoiding these feelings is one of the main ways you try to control these feelings, but you can also analyze them and figure out why they are there; if you know their origin, the reasoning goes, you can make them go away.  None of these efforts really work; it is like the anxiety is a huge beach ball, and your job is to keep the ball underwater.  You may have some success, but it always finds its way to the top.  And it is not an enjoyable way to spend your time in the pool.

Instead, I help people to mindfully accept the anxiety and fear without getting caught up in it or trying to avoid it.  When you do this consistently, you get enough psychological distance and flexibility to choose actions that are consistent with your values, even if the anxiety and worry are still there.

This approach to dealing with GAD is called Acceptance and Commitment Therapy (ACT), and you can learn more about it on my anxiety treatment specialty page.