Generalised Anxiety Disorder (GAD)

What is it?   Generalised Anxiety Disorder, also known as ‘GAD’, is characterised by excessive anxiety and worry about a variety of daily stressors for a period of 6 months or more (Rowa & Antony, 2008). Anxiety disorders are the most common mental disorders in Australia and women are more likely to suffer from GAD than men (Australian Bureau of Statistics, 2012). GAD usually begins during childhood or adolescence and is rated as a ‘disorder’ because the associated worries are so frequent and intense that they may become debilitating.

Why Does It happen?   Genetics and environment can play a role in the development of GAD. Although GAD can run in families it is not considered to be an inherited disease (Hoge, Ivkovic, & Fricchione, 2012). In terms of biology, GAD may be caused by a lack of neurotransmitters such as serotonin. Traumatic experiences and multiple stressors in life such as challenging family and relationship situations may also lead to GAD.

What are the symptoms?   You may have GAD if, for 6 months or more, on more days than not, you have:
1) Felt very worried,
2) Found it hard to stop worrying, and
3) Found that anxiety made it difficult for you to carry out everyday activities (e.g., work, study, self-care).

In addition to uncontrollable and persistent worry, if you also experience three or more of the following:
1) Feeling restless or on edge,
2) Having difficulty concentrating,
3) Feeling irritable,
4) Muscle pain (e.g., sore jaw or back),
5) Feeling tired easily, and
6) Have trouble sleeping (e.g., difficulty falling or staying asleep).

What can I do about it?
Cognitive Behavioural Therapy (CBT) focuses on changing beliefs about worries and may help guide you away from unhelpful attempts to control the worry (Hoge, Ivkovic, A, Fricchione, 2012). Anxious thought patterns can be reduced by evaluating your thoughts and impressions more objectively. CBT can teach you how to see problems in a different way and how to use techniques such as imagery and relaxation to alleviate anxiety.

Relaxation response training in the form of progressive muscle relaxation or diaphragmatic breathing can help, and is sometimes used with CBT. This can help reduce muscle tension.

Mindfulness training can teach you to increase awareness of present moment experiences, such as thoughts and emotions, without judgment. This therapy focuses on accepting problems rather than striving for immediate change, and can help foster a compassionate and non-judgmental awareness of your experiences (which can help with clearer decision making).  It can help you to focus on present moment experiences instead of worries.

Sleep hygiene. Given the high frequency of sleep disturbance in this disorder, education on sleep hygiene can be useful. It is sometimes used with CBT to ensure the best possible sleep efficiency and quality.

Other treatment options may include physical exercise, healthy eating, reducing use of caffeine, alcohol and other drugs.

Medication. Pharmacological approaches include antidepressants, for example selective serotonin reuptake inhibitors (SSRIs) – benzodiazepines, the anticonvulsant pregabalin, and serotonin-norepinephrine (noradrenaline) reuptake inhibitors (SNRIs). Medication aims to change the balance of neurotransmitters in the brain, which may help to reduce some symptoms of anxiety (Goncalves & Byrne, 2012).

Gina Huisy (13th November 2013).

References

Australian Bureau of Statistics. (2012).  4125.0 – General indicators, Australia, Jan 2012  Mental Health. Retrieved 10 March 2013, from Australian Bureau of Statistics http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4125.0~Jan%202012~Main%20Features~Mental%20health~3150

Goncalves, D. C., & Byrne, G. J. (2012). Interventions for generalized anxiety disorder in older adults: Systematic review and meta-analysis. Journal of Anxiety Disorders, 26, 1-11. doi: 10.1016/j.janxdis.2011.08.010

Hoge, E. A., Ivkovic, A., & Fricchione, G. L. (2012). Generalized anxiety disorder: Diagnosis and treatment. BMJ. doi: 10.1136/bmj.e7500

Rowa, K., & Antony, M. M. (2008). Generalized Anxiety Disorders. In W. E. Craighead, D. J. Miklowitz & L. W. Craighead (Eds.), Psychopathology: History, diagnosis, and empirical foundations (1 ed., pp. 78-114). Hoboken, New Jersey: John Wiley & Sons, Inc.

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