Generalized Anxiety Disorder

What is Generalized Anxiety Disorder

Suffers of Generalized Anxiety Disorder, or GAD, experience excessive worry and distress about a wide range of life stressors. Generalized Anxiety Disorder Symptoms can sometimes lead others to describe GAD sufferers as “high strung”, “worry warts,” or “pessimists.” They often worry about issues that the average person worries about, such as health, finances, job security, and relationships, however their worry can become pervasive, distressing, and excessive beyond the norm.

According to the Anxiety Disorders Association of America, research shows that 3.1% of the US population, or 6.8 million adults, experience GAD. Furthermore, twice as many women than men will suffer from GAD.

Generalized Anxiety Disorder, GAD, Generalized Anxiety Disorder treatment.
Daily worry about work, relationships, health, and finances can all be part of Generalized Anxiety Disorder

Generalized Anxiety Disorder Symptoms can include:

  • Feeling irritable
  • Difficulty sleeping, such as difficulty falling asleep, staying asleep, or restless sleep.
  • Feeling tense or “uptight”
  • Racing thoughts
  • Constant exhaustion
  • Ruminating about past conversations or events
  • Excessively reviewing or revising plans
  • Repeatedly asking others the same questions
  • Excessive internet researching
  • Avoidance of work and social gatherings.

Generalized Anxiety Disorder vs. OCD

Generalized Anxiety Disorder occurs as an “If ____, then ____”, or “What if…” thought. GAD differs from Obsessive Compulsive Disorder (OCD) in its intensity and quality, but it generally follows the same anxiety cycle. Furthermore, GAD focuses on the general life stressors that all people experience, such as money, relationships, health, safety, and success. While OCD also exhibits these similar obsessions, GAD is experienced in a far less intense quality and intensity.

For example, someone with GAD may worry about their health by periodically reading a book on health and wellness, exercising semi-rigidly, and getting nervous around someone who sneezes. Someone with OCD may become fixated on their health by checking their pulse hourly, visiting numerous doctors for illness they are unlikely to have or develop, repeatedly checking their body for signs that they’ve been stuck with a needle without their knowledge, and washing their hands until their hands are cracked and bleeding.

GAD, like all other anxiety manifestations, can be considered a feeling problem, not just a thought problem. When push comes to shove, most people with anxiety rationally recognize their level of worry and rumination is excessive and unnecessary. However, they get caught up in the overwhelming feeling that comes from uncertainty.

Like OCD, people with GAD give into compulsive thinking, planning, and actions as a misguided attempt to control their future and their feelings. In part, these attempts are understandable since all of us want to avoid feeling pain or failure. However, these actions can slowly develop into an anxiety disorder if they are not identified and addressed.

Worrying Too Much and GAD

One way that many people start to recognize Generalized Anxiety Disorder symptoms is through their level of daily worry. Often, people with GAD may notice they are “worrying too much” or find they are constantly thinking about the “worst case scenario.” This can make them begin to think they have a dark outlook on life or are pessimistic. Even worse, some begin to think that their “negative” view of things will actually cause bad things to happen in their life! This last bit is not the case at all.

Thinking about the future is a common occurrence for all people. We naturally think about what will happen. This includes thinking about both the good and the bad. It just so happens we have a name for thinking a lot about things we don’t want to happen in the future; worry. The brain is simply trying to help us recognize what potential obstacles and pit-falls could be in our way as we move through life in order to help us avoid those unwanted events. The problem comes in when we begin worrying too much and it becomes an overwhelming burden.

Panic Attacks and General Anxiety Symptoms

Woman stressed in front of her computer. Generalized anxiety can often be about money, relationships, health, and one's job.
Paying bills can be monthly triggers to anxiety, stress, and panic.

While most people with Generalized Anxiety Disorder symptoms will not typically experience panic attacks, some may find their anxiety escalate to the point of panic. One study found 21% of those with Generalized Anxiety Disorder symptoms experienced panic attacks, and approximately 16% of those with GAD experienced situationally specific panic attacks, meaning panic attacks triggered during specific events or activities. It is important to also remember that individual panic attacks differ from Panic Disorder, which is its own condition.

The occurrence of panic related symptoms is typically addressed in the course of GAD treatment. First, learning that panic attacks will never kill or harm you can take a huge load off. Next, learning that the symptoms of panic attacks with GAD can be tolerated and experienced without medical attention or drastically changing one’s life can be a turning point in one’s Generalized Anxiety Disorder Treatment.

Building on this last point, when GAD includes panic symptoms, treatment will include exercises that help the sufferer face the feelings of a panic attack. This process, called Interoceptive Exposures, begins with identifying the various physical symptoms of a panic attack, including racing heartbeat, sweating, “stomach drops”, difficulty breathing, and dizziness. Once these panic symptoms have been identified, the therapist puts the client through various exercises to help progressively trigger the experience of those sensations in a controlled and safe environment. Over time, these sensations reduce in their intensity and the sufferer starts to see them as annoying and unpleasant, but not life altering or a genuine danger.

Treatment For Generalized Anxiety Disorder

The OCD Cycle.
Generalized Anxiety Disorder compulsions usually involve rumination, planning, inappropriate reassurance seeking, and avoidance.

GAD can be effectively treated using Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and Acceptance and Commitment Therapy (ACT). In concert, these two approaches help GAD sufferers develop a more balanced and reasonable perspective of their worries. Through treatment, clients will learn skills to help resist getting caught up in the anxiety whirlwind while learning that the presence of anxiety is nothing to fear. In short, clients develop a new relationship with the thoughts and feelings of anxiety.

Exposure and Response Prevention, while typically the go-to treatment for OCD, health anxiety, and specific phobias, is also used to great effect with GAD. As with these other disorders, GAD can be treated by facing the fear and habituating to the unwanted feelings. During treatment, the therapist and client collaboratively develop a list of triggering situations, places, items, or concepts that trigger the anxious response. Then, through a series of exercises, the client steadily and progressively approaches the triggers while resisting anything that would minimize or avoid anxiety. Over time, the client learns that:

  • They can indeed endure the anxiety (that they previously avoided at all costs), and
  • The situation they feared is highly unlikely to occur

To learn more about Generalized Anxiety Treatment at the Fullerton (Orange County) office, schedule a consultation, or set up an assessment, please contact me.

The California OCD and Anxiety Treatment Center offers specialized therapy for Generalized Anxiety Disorder in its Fullerton offices. In addition to serving North Orange County, Los Angeles, and the Inland Empire, CalOCD offers online therapy, group therapy, and Intensive Out-Patient treatment.

FearCast Podcast episodes related to Generalized Anxiety Disorder:

Episode 14- Making Decisions
Episode 10- Probability of Risk


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