Generalised Anxiety Disorder (GAD) Causes, Symptoms and Treatment
GAD Overview
Anxiety treatment essentially addresses the primary feature of a generalised anxiety disorder (GAD), which is constant, uncontrollable and excessive worry. This worry combines with symptoms of edgy arousal, including insomnia, irritability, muscle tension and hypervigilance.
The worry often surrounds one’s own well-being and the current and future welfare of loved ones. The content of worries in GAD is similar to everyday concerns that many people have, including money, family relationships and academic or job performance. However, the course of those worries is somewhat special. Worry as faced in GAD is problematic or impossible to control. Clients are incapable of altering their mindsets, and worrisome thoughts preoccupy them. In addition, trying to suppress troublesome thoughts makes things more severe. A generalised feeling of anxiety often occurs within other anxiety conditions as well. However, the specific uncontrollable worry (about contents other than the particular things of other anxiety conditions, e.g. phobias or panic attacks) distinguishes the diagnosis of GAD.
Historically, thinkers from Freud forward have attempted to explain the observation that some people become unreasonably anxious in response to fairly minor occurrences that would result in little, if any, anxiety in other people. This anxiety susceptibility was described as neuroticism by Eysenck in 1968. Furthermore, longitudinal research, in which scientists observe individuals over the years, has discovered links between neuroticism and the incidence of anxiety disorders.
Diagnostic Criteria for Generalised Anxiety Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for diagnosing GAD are the following:
A. Extreme worry (anxious expectation), occurring consistently for at least half a year (6 months);
B. The individual struggles with controlling the worry;
C. The worry and anxiety are related to three (or more) of the following symptoms:
- troubles falling or staying asleep,
- muscle tension,
- irritability,
- mind going blank,
- having trouble concentrating,
- fatigue,
- feeling agitated, or on edge
The GAD diagnosis is applied when symptoms do not occur due to the effects of medication or other substances or another illness (e.g. hyperthyroidism).
Treatment of Generalised Anxiety Disorder
Treatment is essential when symptoms of GAD markedly interfere with daily functioning of an individual in occupational, social or other areas. Furthermore, GAD therapeutic interventions are necessary when a person exhibits substantial distress or suffers from complications arising from the illness (e.g. secondary depression, binge eating, etc.).
Initially, an anxiety therapist provides patients “psychological education” about their symptoms, diagnosis, available therapeutic strategies and probable causes.
Anxiety and GAD treatment usually include psychological therapy for anxiety (e.g. online or in-person cognitive behaviour therapy (CBT)) and other interventions, including trauma therapy or medications, which psychotherapists or psychiatrists offer after carefully assessing and considering personal factors. These factors may include costs, local availability of therapeutic methods and symptom severity. Moreover, the consideration involves assessing comorbidities with other conditions, including personality disorders, depression, substance use disorder and the history of previous treatments.
Cognitive behaviour therapy (CBT) is a skill learning course that comprises cognitive and behavioural strategies.
The cognitive aspect entails recognising and analysing connections between thoughts, emotions and actions, along with reassessing interpretations of anxiety-triggering situations and questioning anxiety-provoking thoughts.
The behavioural component emphasises cognitive or in-vivo exposure to anxiety situations, broadened engagement in activities, improved social skills and fostering tolerance for uncertainty. These elements complement cognitive techniques. Notably, CBT has the strongest evidence base for treating anxiety and depression compared to other psychological therapies.
Bibliography:
- Anxiety Disorders in Adults. DOI: 10.1093/med:psych/9780195116250.001.0001
- Generalized Anxiety Disorder. DOI: 10.1093/med:psych/9780195116250.003.0008
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