Do you have generalized anxiety?
Generalized Anxiety Disorder (GAD) is the single most
common anxiety disorder. Its symptoms are what most people mean
when they describe themselves as 'always being anxious'.
Generalized anxiety disorder is more than just worrying about something.
It's worrying about many things and worrying most of the time. No
doubt, you know someone who could be described this way.
Despite this, many people with generalized anxiety deny that they have a
real problem that really should be treated. Some have had
it for most of their adult lives. They're resigned to it, describing
themselves as 'worriers', as if it were an unchangeable characteristic of
their personalities. Treatment seems futile.
However, generalized anxiety is usually treatable, even when
it has been a lifelong problem.
Other people with GAD see no point to treatment, pointing to the very real
sources for their worries: business problems, family problems, health
problems, national politics, the economy, global warming, etc. And in
reality, there is a lot for people to be worried about in the world.
In other cases, people develop generalized anxiety while coping with an
extremely stressful situation, or multiple stressful situations, for a
prolonged period of time. But generalized anxiety can be diagnosed and
treated even when someone's nervous tension and
worrying is prompted by significant personal stress.
I diagnose patients with generalized anxiety disorder when their tension,
nervousness, or
worrying has itself become a problem in their lives.
The exact diagnosis of generalized anxiety disorder depends on someone
feeling anxious or
worried most of the time for at least six months, despite trying to control
their worrying. In addition, they must have three or more of the following
symptoms at least part of the time:
- feeling tense, restless or on edge
- being easily fatigued
- difficulty concentrating or mind going blank
- irritability
- muscle tension
- sleep problems (insomnia, difficulty staying asleep, or
having restless, unsatisfying sleep)
If you feel that you have been anxious, tense, or 'a worrier'
your entire life, you probably have generalized anxiety disorder.
If you have notable periods of severe anxiety, anxiety attacks, or
panic attacks, you might also want to look at my page on
Panic Disorder & Agoraphobia. In addition,
many patients with generalized anxiety disorder also suffer from
Major Depression and Dysthymia.
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Therapy for generalized anxiety
Generalized anxiety disorder tends to be one of the
more chronic problems that people experience. It often begins
in childhood or the early teenage years. People come in for
treatment when it has become significantly worse as a result
of the demands of adult life.
Short-term therapy for generalized anxiety disorder usually involves
three major components. The first component is made up of relaxation
techniques that give the person a feeling of well being. Relaxation
techniques involve daily use of imagery or meditative breathing.
Once these have been mastered, the person learns to monitor their
tension in order to relax whenever they feel especially anxious.
The second part of the process involves retraining the thinking
process, so that irrational, exaggerated, or unrealistic worries are
recognized and addressed. We identify key worries and develop
realistic, rational responses to them. These are used to answer
the worries whenever they occur. Through repetition, patients
learn to regard their worries as brief annoyances rather than
realistic problems.
Finally, we look at systematic biases in the way people look at the
world. We all filter our daily experiences to determine what is
important and what isn't. People with anxiety problems usually
regard negative experiences as much more important than all the
positive things that more commonly happen. We use a variety
of thinking exercises to alter this unbalanced outlook.
When patients are interested in a long-term approach to change
a 'worrier' personality, we look at their core beliefs about
themselves and others. We examine how these were learned,
and whether what was learned was realistic and in proportion to
adult life. Once these are identified, exercises are developed to
help substitute more realistic core beliefs.
Schemas are a combination of core beliefs, memories,
feelings, and outlook on the world. Schema therapy helps patients
identify and change the schemas that are at the root of their anxiety.
Schema work is usually begun after the most significant symptoms
of generalized anxiety disorder have been reduced or eliminated.
It is a longer form of therapy. However, it is both more efficient and
effective than older methods of therapy used to treat generalized
anxiety disorder.
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