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What is Generalised Anxiety Disorder (GAD)?

You are unlikely to be surprised that ‘Anxiety’ and ‘Worry’ are both very common but manageable for many people.

GAD on the other hand is characterised by excessive, uncontrollable and often irrational worry accompanied with high levels of apprehension about events or activities and constantly anticipating ‘something bad is going to happen’. This excessive worry often interferes with one’s daily functioning. People experiencing GAD are overly concerned about everyday matters such as health issues, money, death, family problems, friendship problems, interpersonal relationship problems, or work difficulties.

Excessive worry results in many symptoms of anxiety which affects our body and can lead to many unpleasant physical symptoms such as palpitations, shallow or fast breathing, feeling nauseous, headaches, sweating or shaking. Most of us would have experienced some of these symptoms at some point. However, for people who experience GAD, these symptoms can be almost constant with little respite and therefore understandably very distressing.

Anxiety also affects our mind that tends to produce many anxious thoughts. People who have GAD often refer to ‘rushing thoughts’, unable to rationalise and feeling ‘overwhelmed’.

It I’s important to emphasise that anxiety is a normal reaction to danger and an important survival mechanism. For example, feeling nervous before a job interview can have its advantages as ‘speeding up’ means that we are ready for action and can think on our feet and perform better. Of course, when we are in real danger such as crossing a road whilst a car is approaching too fast, these physical symptoms need to alert us to act, in this instance, walk much faster.

Anxiety can become a problem when there is no danger, but our mind imagines danger’. For example, if you have the tendency to have hypothetical worries such as ‘What if get burgled or What if I get involved in a road traffic accident’, it is understandable that your body will produce ‘fight or flight’ response to prepare you for danger even though it is not real. Think about it like a test fire alarm, the sound is the same but there is no real danger of fire.

For many of us anxiety may begin when we are going through a stressful time or we can also feel anxious when we perceive that we are not able to deal with all the demands of life and work or have sufficient resources to manage stress. Your personality will play a role. Some people are better at managing stress and multiple demands but unfortunately others may find stress more difficult to handle, tend to react to stress differently, often experiencing thoughts such as ‘I cannot cope’, they may benefit from learning how to manage stress and anxiety better.

Most people I see who present with GAD experience unhelpful thoughts about their physical symptoms as their symptoms may be frightening. For example, it is common that people think that there is something physically wrong with them, they are feeling ‘out of control’ or believe that they are going mad.

There are several strategies for controlling anxiety. Relaxation techniques can help with physical symptoms, for example controlled breathing or progressive muscle relaxation (learning how to tense and release different muscle groups) and using imagery and creating a safe place.

You can also learn how to recognise your anxious thoughts and look for the evidence for what you think, identifying any alternative views, asking yourself what is the worst that could happen, what is the best that can happen and what is the most realistic scenario. For example, using my previous example of a job interview, the worst that can happen is that your mind would freeze, and you would be silent during the interview or be physically sick, the best scenario you would sail through it with no anxiety and the most realistic scenario is that anxiety would mobilise you and improve your performance.

GAD can become disabling for many people as they start avoiding and their life becomes very restrictive.

If you think you have GAD which is negatively impacting on your life, you may benefit from the evidence-based therapy such as Cognitive Behavioural Therapy. If you live with someone with appears to have GAD, encourage them to get help.

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