Generalized Anxiety Disorder (GAD)

Anxiety is a part of life. You've learned that the fear/stress response is integral to the human condition and has many positive effects on your life. However, there are times when the temporary symptoms of anxiety stick around too long and a person's efforts to mitigate anxiety grow more repetitive and irrational.

Generalized Anxiety Disorder (GAD) is the first anxiety disorder we'll look at. It's a good place to start, especially to distinguish the fine line between healthy or understandable anxiety and the threshold where anxiety crosses into disorders. Many of the symptoms and techniques for managing GAD are shared by the other disorders we'll discuss. Understanding GAD is a gateway to understanding how other anxiety disorders both share and deviate from many of its qualities.

Definition/Exploration
Generalized Anxiety Disorder is diagnosed when a person experiences "persistent, excessive, or unrealistic worry about everyday things." A person may have GAD if they constantly fret and worry over the mundane, everyday details of their life. In the United States, 6.8 million adults—a little over 3% of the population—are diagnosed with the condition every year. Like most other anxiety conditions, women are twice as likely as men to experience GAD.

Symptoms
GAD's symptoms may sound familiar to most people. After all, everyone experiences anxiety, even months of anxiety, during certain parts of their life. The difference is one of degree and duration. According to the DSM, a person who experiences any of the following symptoms for 6 months or longer should schedule a doctor's appointment to rule out, or in favor of, a GAD diagnosis. Symptoms include:

• Headaches
• Insomnia
• Muscle tension/fatigue
• Shortness of breath/hyperventilation
• Irritability and/or a sense of edginess
• Trembling
• Sweating
• Lightheadedness
• Find it hard to concentrate
• Startle too easily
• Find relaxing difficult

As you can see, these symptoms are all classic signs of normal anxiety and fear responses. Sufferers of GAD, however, experience an excessive amount of these symptoms often when there is no discernable stress or life situation warranting them. Everyday tasks and chores can become painfully hard to perform under the weight of these sustained signs of anxiety.

Follow this link for a great side-by-side comparison of when normal signs of anxiety transition into the realm of anxiety disorders, including GAD and the others in this course.

Case Study
To help you visualize what a person living with GAD goes through, here is a case study excerpt of a 24-year-old man describing his thoughts and behaviors:

"He reported that he tends to overplan everything to prevent disaster, which results in tension and frequent headaches...He said he has always had trouble making decisions for fear of making mistakes and upsetting others, and now worries a lot about what his supervisor will think of him. However, he does not get anxious about engaging in social situations.

"For the past several weeks he has begun to experience bouts of fearfulness upon waking in the morning, and feels nervous, agitated, light-headed, and his heart pounds. He finds it difficult to concentrate on his study with his thoughts going "round and round like a record" - thoughts from which he has difficulty distracting himself. He has become frightened of going to university, worries about what misfortunes might befall him, or becomes anxious if he feels he has nothing planned for the day..."

Living with GAD
There are no direct causes of GAD. Like all other anxiety disorders, a combination of temperament, predispositions to low-anxiety thresholds, and life experiences work in concert to create Generalized Anxiety Disorder.

Researchers do know that GAD tends to develop over time. Unlike other anxious conditions (PTSD) which may have roots in very specific instances of trauma or abuse, GAD is a culmination of out-of-proportion stress and anxiety reactions to typical life events. Most people with GAD are also able to maintain job positions and hold relationships together. In this regard, GAD can seem more manageable than Social Anxiety Disorder, where people outright avoid interaction in an effort to "protect" themselves. Nevertheless, GAD's prevelance and interference with common, everyday tasks creates chronic tension and misery in the lives of people it affects.

People with GAD have many options when seeking treatment and symptom management. The protocol for following through and seeing if you have an anxiety disorder is the same for GAD as it is for the other conditions in this course. The basic outline looks like this:

• See your family doctor for initial check-up and/or diagnosis

• Seek a mental health professional whose methods (talked about here) and relationship you can trust

• Consider taking medication (discussed here) alongside your psychological treatment

• Practice anxiety-reducing lifestyle changes, including exercise, healthy diet, and mindfulness (more ideas discussed here and here)

• Be willing to be curious about your symptoms, to experiment and personalize your treatment, and to learn about the underlying mechanisms/cycles of anxiety and fear

GAD can be a debilitating but manageable anxiety disorder. Many of its symptoms overlap with "normal" periods of anxiety and worry, but hopefully you see their exaggerated, prolonged effect in contrast to normal periods of tension and worry. Keep these differences in degree and severity of anxious symptoms in mind as you learn about other anxiety disorders.