Let’s Talk About…Generalised Anxiety Disorder

So what is Generalised Anxiety Disorder? (GAD)

GAD is form of anxiety disorder and is one of the most common mental health problems that people will experience in their lifetime. It involves having excessive and persistent anxiety or worry over a wide variety of things, that they feel unable to control or prevent. This overwhelming anxiety will cause significant distress and impacts on a person’s daily functioning. GAD will also involve someone having several different physical and psychological symptoms.

To be diagnosed with GAD a medical or psychological professional (e.g. doctor or psychologist) will look at the Diagnostic Statistical Manual for Mental Disorders or DSM-V criteria for GAD:

  • At least 6 months of excessive, difficult to control worry about everyday issues, that is disproportionate to any inherent risk, and causes distress, or impairment.
  • The worry is not confined to features of another mental disorder, or as a result of substance abuse, or a general medical condition.
  • The person experiences at least 3 of the following symptoms most of the time: restlessness/nervousness, being easily fatigued, poor concentration, irritability, muscle tension, or sleep disturbance.

The Chemical Imbalance

There are chemicals in our bodies that help to regulate our mood and emotional state. One of them is called Serotonin, which not only helps with our mood but also helps with our concentration, memory and cognitive functioning. Anxiety is a normal and natural human emotion, which results in decreased levels of serotonin. But when serotonin levels are reduced for a long period of time, this causes a chemical imbalance and may lead to someone to experience GAD.

The Symptoms

Restlessness: When someone is feeling anxious, stressed or worried they tend to be unable to relax or “switch off” from their overactive mind, therefore they are unlikely to be able to sit still for too long without feeling the need to fidget or move in some way to help them cope with the intensity of their anxiety. This may result in someone always needing to keep themselves busy/distracted by continually having an excessive list of things that they believe need to be done. Whilst sitting or standing when someone with GAD is feeling anxious they my start tapping their feet, shaking a leg or needing to have something in their hands that they can play with as a way of distracted or managing their anxiety in the moment.

Poor concentration: Due to the pre-occupation of anxiety provoking thoughts, someone with GAD is likely to struggle with concentrating on things that they would normally be able to. This can impact all areas of their life such as work, social interactions (remaining focused on a conversation), or leisure activities such as watching TV or reading a book. They may find that their mind can go “blank” due to their overwhelming sensation of anxiety.

Irritability: This may or may not be visible to those around them but those with GAD are likely to feel irritated due to their anxiety, as they feel tense about the uncertainty of the things they are stressed/worried about, and are heavily focused on the potential negative outcomes which can also be related to the negative views they have on themselves.

Sleep Disturbances: Those with GAD are likely to experience disrupted or poor quality of sleep, which can cause increased levels of irritability and will leave them more prone to fatigue. They anxiety can often become more heightened towards the end of the day, leading to them feeling unable to “switch off” and go to sleep. Even if a person with GAD is able to drift off, they may wake up several times in the night feeling alert and start to have continuous anxious thoughts.

Muscle Tension: We can hold our emotions with our bodies, which happens when someone is experiencing GAD. Two of the most common places that a person may have muscle tension is in the neck and shoulders, although it may also be other parts of the body such as the lower back.

Other symptoms
Although the below symptoms are within the diagnostic criteria, people who experience GAD may also have other associated symptoms such as irritable bowel issues, skin irritability, changes in appetite, heart palpitations, hot/cold flushes, nausea, and headaches/migraines.

Why do people experience GAD?

There are many different reasons why someone may experience or have a long-term problem with GAD but here are some of them:

  • Early traumatic life experiences e.g. bullying or childhood abuse
  • Environmental upbringing (e.g. pressure to always succeed or to be the best at everything)
  • Traumatic events; bullying, abuse, romantic relationship/social relationship issues
  • Family relationship difficulties
  • Financial difficulties
  • Work related pressure/stress
  • Low Self-confidence or self-esteem

The Vicious Anxiety Cycle

Support and Treatment for GAD

GAD is treatable from which many people are then able to better manage their anxiety, worry and stress to be able to overcome life’s difficulties. The best way to find out what NHS services and treatment options are available to you would be to have a discussion with your GP or search online for your local IAPT service provider (see my post on my job as a PWP – HERE )


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