Generalized Anxiety Disorder

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Author: Canadian Mental Health Association, BC Division

 

Worry is a normal reaction to a stressful or troubling event, and it usually goes away on its own. But what happens when the worry doesn’t go away? Some people worry all the time—even when everything is okay. They might feel like their worry is out of control or feel like they just can’t stop their worried thoughts. Others don’t notice their problem with constant worry until they feel physical signs of stress, like headaches, stomach aches, muscle tension and fatigue. We all worry sometimes. But if you seem to worry much more than other people and you worry so much that it affects the quality of your life, you may have something called generalized anxiety disorder.

What is it?

Generalized anxiety disorder, or GAD, is a mental illness. It belongs to a group of illnesses called anxiety disorders. People living with GAD worry much more than other people, and they worry more often than other people. They often worry about many different activities of daily life, such as their home, work, finances, family, health and the future. People living with GAD also find it hard to control or stop worrying once they start to worry. Worrying all the time can be hard on your body.  Most people living with GAD end up getting treatment for it only because the physical symptoms lead them to visit their doctors. GAD can leave you feeling tired, restless or irritable all the time. It can also make your muscles sore and make it hard for you to unwind, sleep or concentrate. GAD can also cause stomach problems, headaches and other physical health problems.

Day-to-day worries are a normal part of life. In fact, some worry is actually a good thing. Normal worry tells us when we might be in trouble or when something might be wrong. If we didn’t worry at all, we’d probably have a hard time getting out of bed and off to work.  It’s also perfectly normal to feel more worried than usual if you’re experiencing a stressful or difficult event like losing your job.

Worry becomes generalized anxiety disorder when it’s an extreme reaction to daily life, when it’s difficult to control, when it happen most days for several months and when the constant worry affects your body and your life. Many people with GAD say they can’t remember the last time they felt relaxed. The disorder can last for a long time, though symptoms may feel better or worse at times.

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Who does it affect?

Generalized anxiety disorder affects between 5% and 6% of people at some point in their life. GAD often starts sometime between late childhood and early adulthood, though it’s not uncommon for it to begin much later in life.  Children may also be diagnosed with GAD. In children, separation anxiety disorder, social anxiety disorder and obsessive-compulsive disorder can look like GAD, so a mental health professional will carefully look at where the child’s worry is coming from before they make a diagnosis.

There are some groups of people at higher risk of getting the disorder:

  • Women—Women are almost twice as likely as men to develop GAD.

  • Older adults—It’s not uncommon for people to develop GAD later in life.

  • People with another mental illnesses or substance use disorder—People living with GAD often have another mental illness. Mood illnesses like depression, other anxiety disorders and substance use disorders commonly occur with GAD.  People who start to experience GAD when they’re younger may be more likely to be diagnosed with more than one mental illness.

  • Family members—GAD seems to run in families, so you have a higher risk of developing the illness if a close family member also has GAD.

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Could I have generalized anxiety disorder?

  • I feel like I worry a lot more than most other people do

  • Once my worry starts, I have a hard time stopping it

  • I worry even when everything is okay—for example, I worry about getting sick even though my doctor says I’m healthy

  • My body shows signs of worry: my heart races, my palms get sweaty or my muscles feel tense

  • I feel restless or fidgety; I find it hard to sit still

  • I’m irritable and get upset easily

  • I have trouble sleeping; I feel tired all the time

  • It’s very hard for me to concentrate or make decisions—even minor decisions

  • I have a lot of fearful thoughts about the future

If you have some of these symptoms and they last for a long time, talk to a doctor or mental health professional.

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What can I do about it?

Generalized anxiety disorder is usually treated with a combination of counselling, medication and self-help.

  • Counselling—Many people living with generalized anxiety disorder benefit from a special form of counselling called cognitive-behavioural therapy or CBT. A mental health professional trained in CBT can help you work through the thoughts or beliefs and behaviours that lead to  or maintain worry. CBT also helps you manage your worry by teaching you skills to cope, relax, and solve problems. CBT is usually a short-term treatment. You can get the most out of treatment by regularly practicing the skills you learn in treatment.

    Mindfulness-based cognitive-behavioural therapy or M-CBT is a combination of something called “mindfulness” and CBT. Many people with GAD worry about the future. Mindfulness teaches you ways to focus on what’s happening around you in the present moment, while CBT teaches you about thoughts or beliefs and behaviours.

  • Medication—Two different kinds of medication may be used to treat GAD. Anti-anxiety medication, usually a group of medications called benzodiazepines, may make you feel relaxed. They’re usually only prescribed for a short time to help you cope with a period of intense anxiety. Antidepressants may help manage anxiety for longer periods of time.

  • Support groups—You are not alone. Anxiety disorder support groups are a great way to share your experiences and learn from the experiences of others.

  • Self-help—There are some things you can do on your own to help keep you feeling better. Regular exercise, eating well, getting enough sleep and keeping a consistent sleep schedule, managing stress, spending time with friends and family, spirituality and monitoring your use of alcohol and other drugs can help manage anxiety. You may also hear about herbal remedies and other alternative therapies to treat anxiety. There is less evidence available that they actually work. Remember that even herbal remedies can have side effects and may interfere with other medications, so it’s always important to tell your doctor what you’re taking and what you’re doing on your own.

Self-guided CBT may be helpful if you have mild to moderate GAD symptoms. Self-guided CBT means you work through CBT exercises by yourself. You can learn more about self-guided CBT from your family doctor or mental health practitioner.

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Where do I go from here?

In addition to talking to your family doctor, check out the resources below for more information about generalized anxiety disorder:

AnxietyBC
Visit www.anxietybc.com or call 604-525-7566 for information, tools, and community resources on anxiety.

BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca for the Anxiety Disorders Toolkit, more info sheets and personal stories about anxiety disorders. The Toolkit is full of information, tips and self-tests to help you understand generalized anxiety disorder.

Resources available in many languages:
*For each service below, if English is not your first language, say the name of your preferred language in English to be connected to an interpreter. More than 100 languages are available.

HealthLink BC
Call 811 or visit www.healthlinkbc.ca to access free, non-emergency health information for anyone in your family, including mental health information. Through 811, you can also speak to a registered nurse about symptoms you’re worried about, or talk with a pharmacist about medication questions.

 

Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call 310-6789 (do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.

 

 
About the author

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The Canadian Mental Health Association promotes the mental health of all and supports the resilience and recovery of people experiencing a mental illness through public education, community-based research, advocacy, and direct services. Visit www.cmha.bc.ca.

 
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