Generalised anxiety disorder (GAD)
GAD is just what it sounds like. You wake feeling tense. You stay that way most of the day. You go to bed feeling much the same way as you woke up. The big word that goes with GAD is:
WORRY
If you have GAD, you worry about a whole range of things. You worry about the same things that the rest of us worry about:
- your health
- the health of your loved ones
- money
- your job
- your social life
But you worry too much about them and can't stop even when you try hard to. You worry about things that you know you do not need to worry about, e.g.
Doug is good at his job but he worries, 'What if my boss feels I'm not up to this job? What if she gets rid of me? How would I get another job at my age?' My marriage is stressed just now; this could put it over the edge. 'How would I cope if she left me?'
This shows the dreaded 'What ifs' that are found all the time with GAD - you worry about something in the future and, even if your common sense knows it is not going to happen, you can't stop the worry. One worry leads to another. The 'What ifs' gets worse and worse. Your anxiety gets worse and worse. It is a vicious circle.
Jane's nine year old son has not returned from school. 'Sam should have been in ten minutes ago. What if something has happened to him? What if he has been run over? What if someone has taken him?'
Think how scared you would be if you believed this was true? You can see how this would feed the stress. What is wrong is that there are other and better reasons for Sam not being home - he is playing with his friends; he has gone to the shop; he is in a daydream walking home; he is often late home. But the GAD makes you jump for the worst outcome. If you had felt calm, you would be more able to think of the more obvious reasons.
These show how GAD can run riot with your thoughts. While the thoughts about Sam were caused by him not coming home on time, often the worry seems to come from nowhere. You can be sitting in front of the TV, feeling OK and, for no good reason, you start to worry about your work the next day. You can be making the dinner and you hear a siren. And you think 'Oh no, what if Alison has been in a crash and she is in that ambulance?'
Other signs to look out for
Poor concentration
A lot of people with GAD find they have this. You get to the end of a page in your book and go straight back to the top as you have not taken it in. You find that twenty minutes into a DVD, you have not picked up the plot. You talk to a friend and realise you have not heard what they have just said to you.
Tiredness
You might find you are tired more than you should be. You feel worn out by the worry. Simple tasks take their toll on you in a way they don't when you feel more on top of things
Temper
You might find you lose your temper over daft things - things you would not bother about most of the time. You might snap at work mates; scream at the kids; say nasty, cutting things to loved ones; fling cups at the wall in a rage. This often makes you feel guilt as you know you are going over the score.
Tension in your body
GAD tenses up your muscles. You might find you wake up full of aches and pains. The back of your neck gets tense. You get tension headaches. Your chest feels tight. You get that horrible feeling in the stomach when that big muscle tenses. You feel 'uptight' most if not all of the day.
Problems relaxing
You might find yourself always on the go. Doing this, doing that. You find it hard to sit still. You might annoy the family as you can't sit on your backside for more than ten minutes at a time. You might find it hard to sit back and let the world go by. There will often be something niggling away at you. You may lose your sense of humour. You can't take a joke as well as before. You become more serious than usual. You see yourself as a 'worrier'.
Poor sleep
It's no surprise that if you worry all day, you find you don't sleep well. You might find you worry less when you are busy at work or in the house. But when you get into bed, put the light out, you don't have anything to distract you any more. So your mind wakes up and worries flood in - 'what if…', 'what if…', 'what if…' And you are awake for ages. You might find you wake up in the night worrying and it takes a while to get over again. And if you don't get a good nights rest, you find it harder to fight stress the next day.
How common is it?
This is one of the most common signs of stress. But it is rarely found alone. As you will have seen in other parts of this website, GAD is just part of a range of other problems. Depression, social anxiety, and drinking too much go hand in hand with it. Some people may have irritable bowel syndrome (IBS) with GAD. The GAD makes the IBS worse and the IBS makes the GAD worse.
What causes it?
It is often hard to work this out [see the 'What causes stress' section for more information]. It often starts in teenage years but tends to creep up on you rather than being caused by one thing. Most people with GAD find it hard to say when it became a problem - it just slowly gets more and more of a grip on you.
What keeps it going?
The big thing with GAD is the way it affects your thoughts. Look at Doug's and Jane's worries. If you believed them, you would be stressed too. But they have made too much of them; they have not looked for better explanations. If they had done so they could have stopped the anxiety in its tracks. So learning ways to challenge the thoughts is a great way to get on top of the GAD. You can learn to do this in the treatment section with the 'Stand back; pull back the blinkers, wait a minute and challenge' skill.
