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Anxiety

Anxiety is nothing more than a feeling of apprehension and uncertainty. Believe it or not some anxiety is normal and healthy. Chronic, and continuous worry, however, is not. Everyone experiences some anxiety even on a daily basis but people with Generalized Anxiety Disorder (GAD) experience constant anxiety which often has no apparent cause. GAD may be mild and manageable, but, for some people, it is debilitating. It can also cause and/or aggravate additional health problems, both physical and psychological.

People with GAD often worry about the same problems everyone worries about – money, health, families, jobs, etc. The problem is, people with GAD worry excessively and constantly. People without GAD have the ability to put normal worries on hold and focus on daily activity. People with GAD are often distracted by their worries and find it difficult to think about anything else.

Many people with GAD also feel constant anxiety with no apparent cause. They wake up feeling anxious and can never pinpoint a direct cause. The anxiety never seems to disappear throughout the day.

“Unfortunately, most people with GAD assume that they are just a ‘nervous person’ and that nothing can be done. They do not usually seek treatment unless their anxiety is complicated by depression, panic attacks or alcoholism. With appropriate treatment, however, GAD sufferers can feel less anxious and function better.” — Deborah Cowley, MD, in Psychopharmacology

The exact cause(s) of GAD has yet to be determined, and there is probably more than one possible cause. Research has suggested that it could be caused by over-activity in some parts of the brain that deal with emotions and behaviour. It could be an imbalance of the brain chemicals serotonin and  noradrenaline. GAD appears to run in families, so there is probably a genetic factor. A major traumatic or stressful event may sometimes trigger GAD. Another theory is that the person with GAD has internal conflicts which have yet to be resolved. GAD may begin in childhood or later in life. Most likely, GAD has both physiological and psychological components.

Generalized anxiety disorder is a relatively common anxiety problem, affecting up to 5% of the UK population alone, that turns daily life into a state of worry, anxiety, and fear. Excessive thinking and dwelling on the “what ifs” characterizes this anxiety disorder. As a result, the person feels there’s no way out of the vicious cycle of anxiety and worry, and then becomes depressed about life and the state of anxiety they find themselves in.

Generalized anxiety usually does not cause people to avoid situations, and there isn’t an element of a “panic attack” involved in the prognosis, either. It’s the thinking, thinking, thinking, dwelling, dwelling, ruminating, ruminating, and inability to shut the mind off that so incapacitates the person. At other times, thoughts seem almost non-existent because the anxious feelings are so dominant. Feelings of worry, dread, lack of energy, and a loss of interest in life are common. Many times there is no “trigger” or “cause” for these feelings and the person realizes these feelings are irrational. Nevertheless, the feelings are very real. At this point, there is no “energy” or “zest” in life and no desire to want to do much.

This emotional fear and worry can be quite strong. If a loved one is ten minutes late, the person with generalized anxiety fears the very worst — something’s dreadfully wrong (after all, they’re ten minutes late!), there’s been an accident, the paramedics are taking the person to the hospital and his injuries are just too critical to resuscitate him…..”Oh, my God!…..WHAT AM I GOING TO DO?” Feelings of fear and anxiety rush in from these thoughts, and the vicious cycle of anxiety and depression runs wild.

Some people with generalized anxiety have fluctuations in mood from hour to hour, whereas others have “good days” and “bad days”. Others do better in the morning, and others find it easier at the end of the day. These anxiety feelings and moods feed on themselves, leading the person to continue in the pattern of worry and anxiety — unless something powerful breaks it up.

Physical manifestations of generalized anxiety may include headaches, trembling, twitching, irritability, frustration, and inability to concentrate. Sleep disturbances may also occur. Elements of social phobia and/or panic may sometimes be present, such as high levels of self-consciousness in some situations, and fear of not being able to escape from enclosed spaces.

It is also common, but not universal, for people with generalized anxiety to experience other problems, such as a quickness to startle from it, a lack of ability to fully relax, and the propensity to be in a state of constant motion. It is difficult for some people with generalized anxiety to settle down enough to have a quiet, reflective time where they can calm down, relax, and feel some peace and tranquility. Strategies to peacefully calm down and relax are one part in overcoming this problem.

Normal life stresses aggravate generalized anxiety. The person who typically performs well at work and receives a sense of accomplishment from it, all of a sudden finds that work has become drudgery. If work is perceived as a negative environment, and the person no longer feels fulfilled, then considerable worry takes place over these situations. As a result, the anticipatory anxiety about going to work can become quite strong.

Symptoms

GAD may cause many unpleasant symptoms:

  • Headaches
  • Trembling, twitching
  • Lightheadedness
  • Difficulty concentrating
  • Nausea
  • Difficulty breathing
  • Sweating, hot flashes
  • Change in appetite
  • Frequent need to use bathroom
  • Startled easily
  • Lump in throat, difficulty swallowing
  • Sleeplessness
  • Restlessness
  • Muscle tension
  • Fatigue

Treatment

A person with excessive anxiety should seek treatment by first having a medical examination. An exam will rule out other possible causes of anxiety. Once good physical health is confirmed, the person should obtain a diagnosis from a psychiatrist or psychologist specializing in anxiety disorders. Chronic anxiety may be a symptoms of other anxiety disorders besides GAD, so these should be ruled out before treatment begins. There might also be other psychological problems present, such as depression, and the treating mental health professional should be aware of all problems.

Treatment generally includes medication, therapy or a combination. No one treatment method or medication works best for everyone, so patient and doctor (and/or therapist) should seek to find the best treatment for the individual. Cognitive-behavioral therapy (CBT) is an effective treatment for many people with anxiety disorders. With CBT, the person with GAD will learn relaxation and coping skills. Psychodynamic or “talk” therapy may also be effective in helping the person resolve and/or cope with various issues and conflicts. Effective medications include a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs) and sometimes a benzodiazepine. Self-help methods and support groups may also be helpful in addition to professional treatment.

Generalized anxiety has been shown to respond best to cognitive-behavioral therapy, an active therapy that involves more than just talking to a therapist. In CBT, the person gradually learns to see situations and problems in a different perspective and learns the methods and techniques to use to alleviate and reduce anxiety. Sometimes medication is a helpful adjunct to therapy, but for many people it is not necessary. Research indicates that generalized anxiety is fully treatable and can be successfully overcome over the course of about three to four months if the person is motivated and works toward recovery.

Generalized anxiety must be chipped away from all sides and that is what CBT is designed to do. No one has to live with generalized anxiety disorder – treatment for GAD has been shown to be both effective and successful.

Please seek a therapist who understands anxiety and the anxiety disorders. Remember, that just because a person has a degree behind their name, does not mean they understand and can treat an anxiety disorder. Feel free to ask questions of any professional and make sure your therapist understands and knows how to treat generalized anxiety. It is usually a good idea to see a specialist in this area (they don’t charge more), but they do have a practice that is geared toward the anxiety disorders.

Please take some time to read the following article that was kindly written by a Hypnotherapist. It is called “When the Gloves come off“.