Nida Anwar

NOW-A-DAYS:

 Nowadays  anxiety is experienced at a spiritual and psychological level, it is scientifically measurable at the molecular level and the physiological level. It is produced by nature and it is produced by nurture.

GENERALIZED ANXIETY DISORDER:

• Generalized anxiety disorder (GAD) causes feelings of intense anxiety, worry, or nervousness about everyday life. People with GAD struggle to control these feelings, and the condition tends to interfere with daily activities and personal relationships.
• GAD, a type of anxiety disorder, is very common. It affects 3.1% of the population (or 6.8 million adults) in the United States in any given year. It is more common in women.
• Living with anxiety can be challenging. However, like other anxiety disorders, GAD is highly treatable. Some of the most effective treatments include psychotherapy, medication, and making lifestyle changes.

What is generalized anxiety disorder (GAD)?

 GAD is a common anxiety disorder that involves constant and chronic worrying, nervousness, and tension. Unlike a phobia, where your fear is connected to a specific thing or situation, the anxiety of GAD is diffused—a general feeling of dread or unease that colours your whole life. This anxiety is less intense than a panic attack, but much longer lasting, making normal life difficult and relaxation impossible. Generalized anxiety disorder is mentally and physically exhausting. It drains your energy, interferes with sleep, and wears your body out.

The difference between “normal” worry and GAD

Worries, doubts, and fears are a normal part of life. It’s natural to be anxious about an upcoming test or to worry about your finances after being hit by unexpected bills. The difference between “normal” worrying and generalized anxiety disorder is that the worrying involved in GAD is:

• Excessive.
• Intrusive.
• Persistent.
• Disruptive.

“Normal” Worry:

• Your worrying doesn’t get in the way of your daily activities and responsibilities.
• You’re able to control your worrying.
• Your worries, while unpleasant, don’t cause significant distress.
• Your worries are limited to a specific, small number of realistic concerns.
• Your bouts of worrying last for only a short time period.

Generalized Anxiety Disorder:

• Your worrying significantly disrupts your job, activities, or social life.
• Your worrying is uncontrollable.
• Your worries are extremely upsetting and stressful.
• You worry about all sorts of things, and tend to expect the worst.
• You’ve been worrying almost every day for at least six months.

Signs and symptoms of GAD:

Emotional Symptoms of GAD include:

• Constant worries running through your head
• Feeling like your anxiety is uncontrollable; there is nothing you can do to stop the worrying
• Intrusive thoughts about things that make you anxious; you try to avoid thinking about them, but you can’t
• An inability to tolerate uncertainty; you need to know what’s going to happen in the future
• A pervasive feeling of apprehension or dread.

Behavioural symptoms of GAD include:

• Inabilities to relax, enjoy quiet time, or are by you.
• Difficulty concentrating or focusing on things.
• Putting things off because you feel overwhelmed.
• Avoiding situations that make you anxious.

Physical symptoms of GAD include:

• Feeling tense; having muscle tightness or body aches
• Having trouble falling asleep or staying asleep because your mind won’t quit
• Feeling edgy, restless, or jumpy
• Stomach problems, nausea,  diarrhoea

Causes:

• Anxiety disorders are complex and result from a combination of genetic, behavioural, developmental, and other factors.
• Risk factors for GAD include a family history of anxiety and recent or extended periods of stress.

• The brain circuitry involved in fear and anxiety is known to contribute to the experience of GAD, though the mechanism by which GAD is activated is unknown.
•  Studies of twins and families suggest that genes play a role in the origin of anxiety disorders. Childhood adversity and parental overprotection have both been associated with the later development of GAD.
•  It is important to rule out medical causes of anxiety, such as thyroid disorders, before a diagnosis is made.

Generalized anxiety disorder self-help tip 1: Connect with others

Support from other people is vital to overcoming GAD. Social interaction with someone who cares about you is the most effective way to calm your nervous system and diffuse anxiety.

·      Build a strong support system:

• Human beings are social creatures. We’re not meant to live in isolation. But a strong support system doesn’t necessarily mean a vast network of friends. Don’t underestimate the benefit of a few people you can trust and count on to be there for you.

·      Talk it out when your worries start spiralling:

• If you start to feel overwhelmed with anxiety, meet with a trusted family member or friend. Just talking face to face about your worries can make them seem less threatening.

·      Know who to avoid when you’re feeling anxious:

• Your anxious take on life may be something you learned when you were growing up.

·      Be aware that having GAD can get in the way of your ability to connect with others:

• Anxiety and constant worrying can leave you feeling needy and insecure, causing problems in your relationships. Think about the ways you tend to act when you’re feeling anxious, especially anxious about a relationship.

Tip 2: Learn to calm down quickly:

While socially interacting with another person face-to-face is the quickest way to calm your nervous system, it’s not always realistic to have a friend close by to lean on.

Sight – Look at anything that relaxes you or makes you smile: a beautiful view, family photos, cat pictures on the Internet.

Sound – Listen to soothing music, sing a favourite tune, or play a musical instrument. Or enjoy the relaxing sounds of nature (either live or recorded): ocean waves, wind through the trees, birds singing.

Smell – Light scented candles. Smell the flowers in a garden. Breathe in the clean, fresh air. Spritz on your favourite perfume.

Taste – Slowly eat a favourite   treat, savouring   each bite. Sip a hot cup of coffee or herbal tea. Chew on a stick of gum. Enjoy a mint or your favourite hard candy.

Touch – Give yourself a hand or neck massage. Cuddle with a pet. Wrap yourself in a soft blanket. Sit outside in the cool breeze.

Movement – Go for a walk, jump up and down, or gently stretch. Dancing, drumming, and running can be especially effective.

Tip 3: Get moving

• Exercise is a natural and effective anti-anxiety treatment. It relieves tension, reduces stress hormones, boosts feel-good chemicals such as serotonin and endorphins, and physically changes the brain in ways that make it less anxiety-prone and more resilient.
• For maximum relief of GAD, try to get at least 30 minutes of physical activity on most days. Exercise that engages both your arms and legs—such as walking, running, swimming, or dancing—are particularly good choices.
• For even greater benefits, try adding mindfulness element to your workouts. Mindfulness is a powerful anxiety fighter—and an easy technique to incorporate into your exercise program. Rather than spacing out or focusing on your thoughts during a workout, focus on how your body feels as you move.
• Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing etc.

Tip 4: Look at your worries in new ways:

• The core symptom of GAD is chronic worrying. It’s important to understand what worrying is, since the beliefs you hold about worrying play a huge role in triggering and maintaining GAD.

• When you’re worrying, you’re talking to yourself about things you’re afraid of or negative events that might happen.

• All this worrying may give you the impression that you’re protecting yourself by preparing for the worst or avoiding bad situations.

Tip 5: Practice relaxation techniques for GAD:

• Anxiety is more than just a feeling. It’s the body’s physical “fight or flight” reaction to a perceived threat.
• Your heart pounds, you breathe faster, your muscles tense up, and you feel light-headed.
• Your heart rate slows down, you breathe slower and more deeply, your muscles relax, and your blood pressure stabilizes.
•  Since it’s impossible to be anxious and relaxed at the same time, strengthening your body’s relaxation response is a powerful anxiety-relieving tactic

Deep breathing:

• When you’re anxious, you breathe faster. This hyperventilation causes symptoms such as dizziness, breathlessness, light headedness, and tingly hands and feet. These physical symptoms are frightening, leading to further anxiety and panic.

Progressive muscle relaxation:

• Can help you release muscle tension and take a “time out” from your worries. The technique involves systematically tensing and then releasing different muscle groups in your body. As your body relaxes, your mind will follow.

Meditation:

•  With regular practice, meditation boosts activity on the left side of the prefrontal cortex, the area of the brain responsible for feelings of serenity and joy.

Tip 6: Adopt anxiety-busting habits:

• Get enough sleep. Anxiety and worry can cause insomnia, as anyone whose racing thoughts have kept them up at night can attest.
•  But lack of sleep can also contribute to anxiety. When you’re sleep deprived, your ability to handle stress is compromised.
•   Improve your sleep at night by changing any daytime habits or bedtime routines that can contribute to sleeplessness.

Limit caffeine:

• Stop drinking or at least cut back on caffeinated beverages, including soda, coffee, and tea.
• Caffeine is a stimulant that can trigger all kinds of jittery physiological effects that look and feel a lot like anxiety—from pounding heart and trembling hands to agitation and restlessness.
• Caffeine can also make GAD symptoms worse, cause insomnia, and even trigger panic attacks.

Avoid alcohol and nicotine:

 Having a few drinks may temporarily help you feel less anxious, but alcohol actually makes anxiety symptoms worse as it wears off. While it may seem like cigarettes are calming, nicotine is actually a powerful stimulant that leads to higher, not lower, levels of anxiety.

Eat right:

• Food doesn’t cause anxiety, but a healthy diet can help keep you on an even keel. Going too long without eating leads to low blood sugar—which can make you feel anxious and irritable—so start the day right with breakfast and continue with regular meals.
• Eat plenty of fruits, and vegetables, which stabilize blood sugar and boost serotonin, a neurotransmitter with calming effects.
•  Reduce the amount of refined carbs and sugar you eat, too. Sugary snacks and desserts cause blood sugar to spike and then crash, leaving you feeling emotionally and physically drained.

Treatment for generalized anxiety disorder:

• In order to control your GAD symptoms, you’ll still want to make lifestyle changes and look at the ways you think about worrying.
• Cognitive-behavioural therapy (CBT) is one type of therapy that is particularly helpful in the treatment of GAD.

The five components of CBT for anxiety are:

Education:

 CBT involves learning about generalized anxiety disorder. It also teaches you how to distinguish between helpful and unhelpful worry.

Monitoring: You learn to monitor your anxiety, including what triggers it, the specific things you worry about, and the severity and length of a particular episode. This helps you get perspective, as well as track your progress.

Physical control strategies:

CBT for GAD trains you in relaxation techniques to help decrease the physical over-arousal of the “fight or flight” response.

Cognitive control strategies:

 Teach you to realistically evaluate and alter the thinking patterns that contribute to generalized anxiety disorder. As you challenge these negative thoughts, your fears will begin to subside.

Behavioural strategies:

 Instead of avoiding situations you fear, CBT teaches you to tackle them head on. You may start by imagining the thing you’re most afraid of. By focusing on your fears without trying to avoid or escape them, you will feel more in control and less anxious.

Medication for anxiety:

There are three types of medication prescribed for generalized anxiety disorder:

Buspirone:

 This anti-anxiety drug, known by the brand name Buspar, is generally considered to be the safest drug for generalized anxiety disorder. Although Buspirone will take the edge off, it will not entirely eliminate anxiety.

Benzodiazepines:

These anti-anxiety drugs act very quickly (usually within 30 minutes to an hour), but physical and psychological dependence are common after more than a few weeks of use. They are generally recommended only for severe, paralyzing episodes of anxiety.

Antidepressants:

 The relief antidepressants provide for anxiety is not immediate, and the full effect isn’t felt for up to six weeks. Some antidepressants can also exacerbate sleep problems and cause nausea or other side effects.

References:

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

National Institute of Mental Health    

National Institute of Mental Health (Genetics Workgroup) – Genetics and Mental Disorders