Generalised Anxiety Disorder

Thrive Psychology Clinic > Anxiety Disorders > Generalised Anxiety Disorder

May 6, 2022 / By thadmin2

Introduction

Generalised Anxiety Disorder (GAD) often begins in adolescence or early childhood, and subsequently persists through the rest of an individual’s lifespan. Left untreated, GAD may lead to a myriad of other secondary disorders such as Major Depressive Disorder (MDD), a higher risk of suicidal ideation and completion, as well as other anxiety disorders (Strawn et.al, 2018). It is characterised by a pervasive anxiousness that is related to multiple domains in an individual’s life, and causes a myriad of detriments to their mental and social wellness (Strawn et.al, 2018). 

GAD affects a large portion of the population, with 5% of children and 3 – 6% of adults struggling with it. Slightly more women are affected by GAD, with the condition being more common in people from the ages of 35 to 59 (“Overview – Generalised anxiety disorder in adults”, 2018).

 

Symptoms and Diagnosis(American Psychiatric Association, 2013)

According to the American Psychiatric Association, the diagnosis of GAD covers the following symptoms.

  1. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
  2. The person finds it difficult to control the worry.
  3. The anxiety and worry are associated with three or more of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months).
    • Restlessness or feeling keyed up or on edge
    • Being easily fatigued
    • Difficulty concentrating or mind going blank
    • Irritability
    • Muscle tension
    • Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
  4. The disturbance is not better explained by another mental disorder 
  5. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  6. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a mood disorder, a psychotic disorder, or a pervasive developmental disorder. 

 

How GAD can affect daily life

GAD may manifest in a variety of ways, e.g. one may find it difficult to concentrate or unrelentingly worry about school and work assignments. Daily tasks such as cleaning up after oneself may become harder to carry out as well. This is reflected through a poorer quality of life as compared to normative population (Rapaport et. al, 2005). As individuals with GAD tend to ruminate, these thoughts may subsequently lead to a higher risk of comorbidity with depression. Additionally, tension caused by GAD may manifest itself as soreness or fatigue of one’s muscles, as well as headaches that do not seem to go away. 

 

Causes and Risk Factors of GAD

Though the exact cause of GAD is not fully understood, it is likely that a combination of several factors play a role in the development of GAD (“Overview – Generalised anxiety disorder in adults”, 2018). These factors are:

  1. Overactivity in the areas of the brain that are involved with emotions and behaviour
  2. An imbalance of brain chemicals involved in the control and regulation of mood
  3. Genetics: An individual with a close relative who also has GAD is estimated to be 5 times more likely to develop GAD as well.
  4. History: Individuals who have experienced stressful or traumatic events such as domestic violence, child abuse or bullying
  5. Suffering from long-term painful health conditions such as arthritis 
  6. Having a history of drug or alcohol addiction or misuse.

Treatment of GAD

Though the list of factors that increase the risk of an individual developing GAD may seem extensive, it is important to note that GAD is treatable. It is important to seek help and apply positive lifestyle changes as soon as possible, so that the symptoms of GAD do not escalate. 

  • Psychological therapies
    • Cognitive Behavioural Therapy (CBT): As CBT is based on neuroscience, experimental and scientific psychology, it is a great tool in allowing us to understand how the human mind functions. Studies show that CBT leads to a lowered level of worry, and more effective results 6 months after treatment as compared to pharmaceutical means (Borza, 2017)
  • Medication
    • Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) have been shown to reduce the symptoms of GAD (Strawn et al., 2018)
  • Lifestyle changes
    • Exercising regularly: Exercise has long been known to increase the release of ‘happy hormones’ such as dopamine in our brain.
    • Stopping smoking
    • Cutting down on alcohol and caffeine intake
    • Adopting a healthier, balanced diet

It is important to remember that treatment of GAD has to be consistent, and that it may take a long time. However, keeping to the treatment plan will greatly reduce the chances of a relapse and increase one’s quality of life in the long run.

 

Conclusion

GAD can be a great source of stress for individuals who are struggling with it, and may often induce a sense of helplessness. It is important to identify the symptoms of GAD early, and seek help as soon as possible. For those with loved ones facing difficulties due to the symptoms of GAD, it is important to encourage them to seek treatment, as well as take note of particular triggers that may set off a bout of anxiety, in order to be able to assist them to the best of your abilities. Treatment options such as Cognitive Behavioural Therapy and positive lifestyle changes should be adopted, with the goal of reducing the symptoms of GAD as much as possible. 

At Thrive Psychology Clinic, we are committed to providing effective and efficient support for every child, adolescent and adult in their mental health. If you believe that your friends or loved ones around you may be struggling with behavioural/mental health issues, encourage them to seek professional help. Feel free to contact us via email: info@thrivepsychology.com.sg or call: 6962 9753 and we will be happy to assist you.

 

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)
  • Borza, L. (2017). Cognitive-behavioral therapy for generalized anxiety. Dialogues In Clinical Neuroscience, 19(2), 203-208. https://doi.org/10.31887/dcns.2017.19.2/lborza
  • Overview – Generalised anxiety disorder in adults. nhs.uk. (2018). Retrieved 31 March 2022, from https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/overview/.
  • Rapaport MH, Clary C, Fayyad R, Endicott J. Quality of life impairment in depressive and anxiety disorders. American Journal of Psychiatry. 2005;162:1171–1178
  • Strawn, J., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert Opinion On Pharmacotherapy, 19(10), 1057-1070. https://doi.org/10.1080/14656566.2018.1491966