Generalised Anxiety Disorder (GAD)

Overview

Generalised Anxiety Disorder (GAD) is a mental condition among individuals which leads to unnecessary tension and anxiety. This can hamper the daily activities of the person. There are many symptoms of this medical condition which can be physical or behavioural and need immediate identification. Often it is observed that this condition occurs in people because of genetic or neurological disorders. Immediate treatment includes therapy and suitable medication to reduce the anxiety levels. Also, proper sleep, diet, yoga and meditation can help overcome this condition.

What is GAD?

Generalised Anxiety Disorder (GAD) is a mental health disorder where a person worries excessively about everyday life events or activities such as work or school, relationships, health, or money. Unlike ordinary anxiety, GAD results in a constant and uncontrollable concern that may become out of proportion with the situation. The individual feels restlessness, fatigue, fogginess, irritability, muscle stiffness, and insomnia. These signs can persist for six months at least.

An individual suffering from GAD can experience a fall in quality of life, daily functioning, and interpersonal relationships. It is a genetically determined disorder that can also be explained in terms of stress and chemical imbalance. Therapies, medications, and patient behaviour modification are all part of the treatment process.

Types of GAD

A patient can experience different types of GAD which are as follows:

Somatic Symptom-Focused GAD

A high level of concern regarding physical well-being characterises this type of GAD. Patients can develop excessive and unnecessary thoughts, feelings and behaviour leading to life-threatening situations. This may result in more visits to doctors despite being reassured.

Socially Oriented GAD

In this form of GAD, the patient develops an obsession with how people in society will stigmatise them. This involves feeling humiliated and embarrassed in social settings without any reason. Furthermore, it results in not being able to interact properly in social gatherings and the fear of being looked down upon.

Performance-Related GAD

A phobia or fear of being unsuccessful or incapable of any life goals describes this type of GAD. This form of GAD is usually accompanied by a habit of being perfect and key concerns revolve around doing things perfectly and avoiding errors.

Family or Relationship-oriented GAD

Persons with this type of GAD are constantly worried about the welfare of family and friends. Low trust is a common feature, and there is a tendency to be jealous or to require frequent reassurance about the relationship’s stability.

Existential GAD

Existential GAD consists of constant concern with vague anxieties including the future, life and death, the meaning of life and so on. People can develop anxieties based on the unpredictability of life and the inability to predict and plan for the future.

Cognitive-Focused GAD

Rumination is the key concept in cognitive-focused GAD. The person continuously ponders about episodes, probable consequences, and ‘supposing’ situations. This causes constant stress and they fail to come up with a solution which will end the problem.

Symptoms of GAD

The symptoms of GAD prevent a person from functioning normally in their daily lives. GAD sufferers may worry excessively about many aspects of life, including career or money, family and friends, or health. Common physical symptoms include increased movement of the limbs, dry mouth, sweating, muscle stiffness, migraines, and insomnia. Cognitive symptoms may consist of concentrating difficulties, a feeling of being stressed or being interrupted by worrying thoughts.

Apart from physical and cognitive signs, a person may suffer from emotional signs of complaining about small things and getting annoyed easily. Moreover, they feel that terrible things will happen and cannot ease tension. Individuals with GAD may also have stomach problems, dizziness or rapid heartbeat. These symptoms are chronic, commonly lasting for six months or more and the experience is often out of proportion. Also, GAD is often comorbid with other mental disorders such as major depressive disorder, and social anxiety disorder and is known to interfere with a patient’s social and occupational functioning.

Causes of GAD

GAD can be caused because of genetic, environmental and psychogenic factors. One of the causes of anxiety is genetic where previous or immediate family members have anxiety disorders. Neurobiological factors include dysregulation of neurochemicals like serotonin and dopamine in the brain that influence mood and anxiety. Furthermore, biological and psychological traits, such as excessive rumination, overt interpretational style, or perceived threat levels, play an important part in GAD development.

Childhood experiences that might include trauma or abuse and chronic stress can instigate or magnify anxiety when people do not have the skills to deal with stress. Moreover, mental illnesses, which include being prone to perfectionism, and low self-esteem may also increase an individual's susceptibility towards GAD. In addition, normal life stressors such as major life transitions, physical ailment or financial crises can cause chronic anxiety.

GAD Diagnosis and Tests

Diagnosis of Generalised Anxiety Disorder commonly includes an assessment from a healthcare provider like a psychologist or psychiatrist. It starts with a clinical interview in which the person is questioned regarding the symptoms, previous illnesses and possible causes of anxiety. An important feature of the diagnostic criteria is the duration of symptoms occurring for
the last six months and interference with daily activities.

Screening tools include the Generalised Anxiety Disorder 7 (GAD-7) which consists of a self-report scale helping specialists evaluate anxiety levels. This provides specialists with an overall assessment of the severity and duration of anxiety and other related symptoms in a person. Special tests may be carried out to exclude other diseases with similar symptoms, including thyroid and cardiac diseases. Furthermore, DSM-5 may be used by mental healthcare providers to validate the diagnosis. Then the patient is given suitable therapies or medication to reduce their anxiety levels.

GAD Management and Treatment

Coping with and treating GAD requires a combination of psychotherapy, medication and alteration of lifestyle. Psychotherapy like Cognitive Behavioral Therapy (CBT) is one of the best practices of therapeutic disciplines that enable people to recognize and change negative attitudes, find better ways of solving daily problems, and practice less ruminative ideas. In addition, depending on the severity one may be prescribed antidepressants like the selective serotonin reuptake inhibitors (SSRIs) or prescribed benzodiazepines that can help with anxiety for a limited time.

Relaxation often comes up as an important and necessary component of a total treatment programme with a specific focus on stress relief. Moreover, the standard recommendations for modifying behaviour to reduce anxiety include exercise, proper nutrition, and sleep regimes. People might often feel like having a group of people who understand their situation and feelings.

Preventive Measures of GAD

Measures in preventing GAD consist of strategies to prevent stressful situations and ensure a proper healthy mental state. The strategies include proper ways of coping with stress, meditation, breathing exercises and muscle relaxation. These have positive effects on reducing the body’s impact of stress and keeping the mind stable and calm. Exercise is also important as it helps to improve mood due to endorphin production in physically active people.

To avoid letting anxiety increase, a person should focus on proper sleep and nutrition. Consuming foods that are nutritious supports brain function and can positively impact mood. Also, developing a good social support system, frequent communication between family members and friends, and therapy can help manage stress and anxiety disorders. Furthermore, learning helpful strategies which will enable a person to achieve realistic goals can help manage chronic anxiety and overcome GAD.

Myths and Facts Related to GAD

Some of the most common myths and facts about GAD include:

Myth 1: GAD Simply Means Undue Worry
Fact: GAD is greater than simply getting worried. It comprises motor tension, weariness, and problems with focus and includes distress and impairment.

Myth 2: GAD Patients Can Regulate Their Anxiety If They Want
Fact: GAD is a medical condition for which it is required for a person to seek immediate medical help rather than regulating the condition on their own. Most people have a belief that it is just a case of lack of self-control and anxiety. But it is more than this condition which requires proper help from trained specialists.

Myth 3: Medication is the Only Way to Manage GAD
Fact: Treatments for GAD include Cognitive Behavior Therapy (CBT), changes in one’s personal habits and stress reduction methods like yoga and meditation. Medication is a component of a treatment strategy.