Often people with Generalized Anxiety Disorder (GAD) feel they are just a chronic worrier, feeling keyed up and anxious over just about everything in their lives. Since they often don’t remember a time they felt differently they don’t realize there is effective treatment to help rid them of what can at times seem like crippling anxiety.
GAD is an anxiety disorder characterized by almost constant worry over everything even when there is little or no real cause for worry. All of their smaller worries accumulate into the overriding worry they will not be able to make it through the day. They typically have negative expectations, anticipating everything in their life will go badly and they cannot change this. GAD can become so severe it interferes with individuals being able to function normally in their everyday life.
In a given year it has been estimated that 0.9% of adolescents and 2.9% of adults suffer from GAD in the U.S. Lifetime prevalence rates for adults have been estimated at 9%. Additional statistics suggest females are twice as likely to develop this disorder. However, it is believed this proportion may not be an accurate representation due to a reporting bias as men are less likely to report anxiety symptoms than women. Occurrences of this disorder generally peak in adulthood and middle age after which rates decline. The average age of onset is 30. While it appears there may be a resurgence of the disorder that occurs in the elderly, some have questioned whether this is valid given that older individuals frequently do have a number of real things about which to worry. The younger the person is when they develop the disorder the greater the likelihood they will experience co-occurring disorders and a greater level of impairment. GAD is more prevalent in individuals of European descent compared with those of non-European descent, in particular Asian, African, Native American, and Pacific Islander.
Generalized Anxiety Disorder rarely occurs by itself. Individuals who suffer from GAD usually have had or currently have other anxiety disorders and unipolar depression. Specific disorders found to co-occur with GAD include:
- Panic Disorder
- Social Anxiety Disorder/Social Phobia
- Simple Phobia
- Separation Anxiety (in children)
- Major Depressive Disorder
- Eating disorders (Anorexia, Bulimia)
- Substance Abuse
- Post-Traumatic Stress Disorder
- Bipolar Disorder
Brain Chemistry: GAD is linked to certain chemicals in the brain responsible for communication called neurotransmitters. When there are abnormal levels of these chemicals in the brain, messages about anxiety may not be properly communicated. The brain responds to non-threatening stimuli in the environment as if they were dangerous sending the body in a flight or fight response. The person interprets this heightened arousal level as anxiety although they don’t know what the cause is.
Brain Structures: There are certain structures in the brain that regulate fear, emotions and memory and regulate their relationships with physiological responses to stress. Individuals with GAD may be highly sensitive to novelty and unpredictability, experiencing these factors as stressors which trigger a fear response.
Genetic: People with GAD often have a first degree relative with an anxiety disorder, although it may not be specifically GAD. This suggests a common heritable pathway for anxiety disorders.
Environment: Those who have experienced numerous stressful or traumatic events in their life like the loss of a job, break up of important relationships, abuse, abandonment, multiple moves, divorce, the loss of a child etc. are more at risk for developing GAD than peers without this history.
Signs and Symptoms
There are a number of signs and symptoms that are hallmarks of GAD. These include:
- Excessive and unrealistic worry occurring more days than not for most of the day
- Worry about numerous things in multiple areas of the person life (novel situations, school work, social settings, home-life)
- The worry is experienced as if it came out of nowhere, is not connected to anything specific, and may be referred to as free floating anxiety
- The worry is experienced as extremely difficult to control
- The person knows the worry is excessive
- Difficulty concentrating and attending to things
- Short term memory problems
- Feeling irritable, agitated and moody
- Mind going blank
- Feeling things will never improve
- Having an unrealistic view of problem situations
- The person begins to avoid an increasing number of places and events, never knowing what may trigger them
- Feeling unable to ever relax, enjoy quite time alone, or take pleasure in hobbies
- Procrastinating, even in relation to important things, due to feeling overwhelmed by anxiety
- Inability to function normally due to the anxiety becoming debilitating
- Avoidance of friends and family due to embarrassment over anxiety, fear of being triggered in their presence or concerns about what they think
- Feeling restless or agitated
- Muscle tension
- Body aches
- Rapid pulse, elevated heart rate, difficulty breathing Sweating
- The need to go to the bathroom frequently
- Exaggerated startle response
- Sleep problems
- Difficulty swallowing
Effects of GAD
The long term effects of GAD can be quite severe. When the body is kept in a constant state of anxiety the fight or flight response is continually turned on rapidly sapping the person’s strength. Effects of the disorder include:
- The development of substance abuse used in an effort to self-medicate or control the anxiety
- Problems at work or school including decreased productivity and multiple sick days
- Difficulty carrying out tasks quickly and correctly
- Heavy smoking
- Loss of important relationships due to others reactions to the individuals constant state of anxiety
- Trouble falling or staying asleep
- Depressed mood
- Teeth grinding especially when sleeping
- Heart disease
- Gastrointestinal problems
- Allergic reactions
- Respiratory problems
- Stomach aches
- Learned helplessness or no longer trying to improve things due to the belief nothing can make a difference
- Social withdrawal
- Inability to problem solve
- Dependency on others to make decisions
- Developing a fatalistic attitude or believing that instead of trying to make things happen, things will happen on their own
- Suicidal thoughts or behavior
- Poor nutrition
GAD can leave the person feeling helpless, hopeless and as if nothing will ever improve in the future. Lack of quality sleep, poor nutrition and the physiological reactions to the almost constant anxiety can have debilitating effects on the individual until they feel unable to function adequately in any part of their life. There is treatment for this disorder that can allow you to return to a happy healthy lifestyle. At Mount Regis we are here to help.