Generalized anxiety disorder
(The psychiatry bible)
Generalized anxiety disorder
At least six months of ‘excessive anxiety and worry’ about a variety of events and situations.
Generally, ‘excessive’ can be interpreted as more than would be expected for a particular situation or event.
There is significant difficulty in controlling the anxiety and worry.
Sensible Psychology Definition
Feeling tense, fearful and anxious much of the time
High levels of overwhelm and background stress manifest as continual worry, anxiety and fear relating to all and everything – or at least many things.
The length of time this is suffered is immaterial.
Reasons to be fearful
Feeling anxious about everything all the time is a horrible experience, but not necessarily an indication of an ‘imbalance in the brain’ that needs to be chemically corrected.
Anxiety is an essentially natural response.
For much of our evolution we naturally felt fearful a lot of the time, because, in truth, we were pretty far down the food chain. This was the case for eons, right up until we reached those crucial turning points in history when we figured out how to build shelters, make tools, wield weapons and generally began to have some real influence and control over our surroundings.
And there’s the rub: feeling out of control, a victim of circumstance rather than in charge of your own ship. Now we’re getting closer to a cause – and it isn’t unbalanced brain chemicals.
Whatever you do – don’t switch off!
In prehistoric times it could have been potentially fatal to sleep too deeply, with all those sharp-toothed predators prowling about, so it would have made sense to not sleep, or to keep waking up, if the brain registered a threat in the environment.
Relaxing, too, could have been fatal. If our cave person ‘switched off’ and let down their guard, they could rather soon have become an ex-cave person. You are here because your cave ancestors stayed alert.
So two common symptoms of generalized anxiety – inability to sleep properly and inability to relax, can actually be seen as adaptive. They are useful tools in the battle for survival . But any tool can become useless out of its proper context.
Fred Flintstone at large in a George Jetson world
Our nervous systems evolved to deal with a dangerous primitive world and they have not yet caught up with the huge changes that have taken place in how we live. Today’s ‘predators’ are more likely to be a bullying boss, an embittered ex-spouse or a troublesome teenager. But as far as your nerves are concerned, they are no different from a creature who’s about to have you for dinner.
Even though our ancient forebears might have felt hyper alert, worried or anxious a lot of the time because of the many genuine threats that surrounded them, they must also have been able to put aside their ‘generalized anxiety’ and enjoy some safety and security as well. The complex civilizations that surround us are the evidence for this. If you’re fighting for your life every other minute, you have no time or energy to put into anything else. Safety and security give you the opportunity to calm down and focus on other things – like commerce and creativity.
So anxiety and calm are both essential tools for us, and both have their place. Problems only arise when we are anxious when we should be calm, or too relaxed when we should be fearful.
When we are anxious about everything all the time, something is amiss because most of us are not in constant genuine danger.
Generalized anxiety can prevent sleep, put us off our food (or make us crave food) and interfere with every aspect of life. Fearing the worst, worrying about everyday things and constantly expecting disaster is exhausting.
Worrying about nothing
Stress feelings like anxiety act like water. Water will find a shape to fill, a channel to run down. Fear likes to have a form. If you feel stressed, but don’t know why, your imagination will construct something for the fear to fill. This is why people with GAD can find what to others may seem like absurd or far-fetched things to worry about.
Treatment for generalized anxiety
Generalized anxiety disorder is often treated with anti-anxiety drugs and/or antidepressants (see Drugs and medications). While these medications can help to calm symptoms, they do not help the sufferer learn how to manage their emotional response themselves. Psychotherapy, including Cognitive Behaviour Therapy (CBT), is more effective in this respect.
The sensible psychology approach
Effective treatment for generalized anxiety will combine solution focused psychotherapy with hypnosis and teach people how to
- calm the central nervous system through deep relaxation (so the imagination doesn’t feel compelled to give shape to stressful feelings by concocting worries)
- switch off worries by thinking differently or through practical problem solving.
- overcome any lingering effects of traumatic experiences in the past
People do sometimes need help to learn to reduce their over-arousal so that they can feel more relaxed more of the time. However, it should be recognized that anxiety, hyper-vigilance and worry were life-savers for all of us in the past, and are still life-savers when appropriately triggered.
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