Generalized Anxiety Disorder

GAD is described as excessive anxiety and worry occurring for an extended period of time. An individual with GAD will constantly worry about several different things and will have persistent apprehension. The worry and anxiety cause emotional distress, difficulty with enjoying life, problems with relationships and school (or work) and will lead to  numerous physical symptoms for which there is no other explanation (such as headaches, lump in your throat, sighing, aches and pains, nausea, etc.).

It is perfectly acceptable to have an anxiety response to danger.  Indeed this is the well known  fight or flight response and is protective (i.e.. when a dog is chasing you, when you are moving away from home for the first time), but this is different from GAD.  A person with GAD constantly feels tense and on edge, even when there is no danger present.

 

November 2009, Michael Kimber was diagnosed with an anxiety disorder at the age of 25. He shares his story...

Video courtesy of: EggFilms

 

 

What Are Symptoms of GAD That Accompany Excessive Worrying and Anxiety?

• Difficulty swallowing
• Trembling, twitching
• Hot flashes
• Nausea
• Lightheadedness
• Going to bathroom frequently
• Air hunger - feeling as if you can not get enough air
• Difficulty concentrating
• Can’t relax
• Startle easily
• Trouble falling asleep (mind will not "shut off")
• Anticipate the worse outcome for any situation
• Excessive concerns and worries about usual daily activities

Who is at risk for GAD?

GAD often begins in childhood or adolescence. Once present, its severity can fluctuate and it will often get worse during stressful periods in a person's life. GAD has a genetic component.  Women are diagnosed  more often with GAD then men.

How Do You Know If Someone You Love Has GAD?

Someone with GAD will worry excessively about many different things, their worry is out of proportion to the concern/event, and is distinguishably greater than that experienced by most other people. 

Youth with GAD often do not experience panic attacks (as in panic disorder) but often have physical complaints such as headaches, fatigue, muscle aches and upset stomach.

These symptoms tend to be chronic and young people may miss school or activities because of these physical symptoms.

How Do You Differentiate GAD from Normal Worrying?


• Emotions are very sensitive (sometimes called "high strung"), such as feeling fearful, worried, tense or on guard
• Body responses can include: increased heart rate, sweating and shakiness, shortness of breath, muscle tension and upset stomach.
• Thoughts are related to real or potential sources of danger and the person may have difficulty concentrating on anything else (for example, the worry that they are not dressed appropriately, that their teacher will be annoyed with them, that their friends will go out and not include them, etc.)
• Behaviours will be altered to potentially eliminate the source of danger (for example, avoiding feared situations, people or places, and self-medicating with drugs or alcohol).

What are the Criteria for Diagnosis of GAD?

1. Excessive anxiety and worry occurring for at least 6 months about several things
2. Difficulty controlling the worry
3. The anxiety and worry are associated with three or more of the following:  (a) restlessness or feeling on edge, (b) fatigued, (c) difficulty concentrating, (d) muscle tension or  (e) sleep disturbance
4. Anxiety and worry are not due to substance abuse, a medical condition or a mental disorder.
5. The anxiety and physical symptoms cause marked distress and significant impairment in daily functioning.

When Does Anxiety Become a Disorder?

Physical, emotional and behavioural responses to perceived danger are normal reactions that people experience everyday. Anxiety responses are often automatic, and occur as a means of protecting ourselves from danger.

Anxiety is a problem when:
• It is greater intensity and/or duration then typically expected given the context
• It leads to impairment or disability at work, school or in social environments
• It leads to avoidance of daily activities in an attempt to lessen the anxiety

Someone In Your Life is Diagnosed with GAD, Now What?

Make sure that you learn about GAD and the treatment options.  Ensure that your concerns and questions are understood and answered by the health providers you are working with. • Some people with GAD will experience improvements in their anxiety and functioning with supportive cognitive-based counseling, others will require medication.


• If functional impairment is significant, help your loved one get medical attention or supportive counseling
• Some questions you can ask that will help you both identify if the anxiety is GAD include:
o Can you tell me about your worries?
o Do you or others see you as someone who worries more than they do?
o Do you have difficulty ‘letting go’ of your worries?
o Do you feel sick with worry sometimes? In what way?
o What things that you enjoy doing or would like to do are made less enjoyable or are avoided because of the worries?
o What, if anything, do you feel make worries better? Is this for a short or long time?
• Some people with GAD may develop clinical depression.
• Some may abuse substances such as alcohol to help control their anxiety. If this occurs, they may be at risk for substance use and dependency problems.

Remember that reassurance is not usually helpful and may encourage clinging behavior.  A parent who has a child that exhibits excessive anxiety in normal or usual situations should not always try to shield or protect their child from those situations.  Encouraging them to face their worries can help these worries be overcome.  Avoidance of situations associated with increased anxiety may over time become a behavior strategy that leads to isolation and withdrawal.

 

What Treatment Options Exist?

• Cognitive Behavioural Therapy
• Medication
Treatments with co-occurring conditions are treated depending on the conditions

Other Types of Mental Disorders That May Commonly Occur Alongside GAD Include:

Depression
Panic Disorder
Agoraphobia
Substance Abuse - especially alcohol

Resources for Teens and Families

My Brother/Sister has a Mental Illness: A Guide for Young People Ages 11 -16
My Brother/Sister has a Mental Illness: A Guide for Young People Ages 17-24
Guide to Panic Disorder
Transitions


Other Helpful Resources

National Institute For Mental Health 
Anxiety BC
Tools to Help Parents Talk to Their Kids About Anxiety
CBC Documentary: Age of Anxiety

 

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