According to the study, 2 in 5 people admit to worrying at least once a day. However, for some people, worrying persists to the point where it significantly interferes with daily functioning, causing generalized anxiety syndrome. If this is the case for you, in the article you will learn what generalized anxiety is and how to deal with it ?
ICD-10 symptoms of generalized anxiety syndrome – diagnosis
Generalized anxiety is not always easy to diagnose, because some anxiety symptoms overlap with depression and other disorders, including long-term tension, chronic fatigue syndrome, neurosis, lack of energy. Therefore, it is important to see a specialist for a definitive diagnosis. The recommended therapeutic treatment for Generalized Anxiety Disorder (GAD) is cognitive-behavioral therapy.
Generalized Anxiety Disorder (a.k.a. free-floating anxiety) according to icd-10 also includes:
- Feelings of anxiety and tension, an experience of worry that has lasted for at least the past 6 months
- Worry is experienced as excessive and uncontrollable. Often occurs most days, and is clearly observed to increase. GAD hinders the ability to function on a daily basis and focus on everyday matters.
In addition, at least 3 of the following symptoms of generalized anxiety disorder must have been present for the past 6 months or longer:
- Feelings of anxiety, agitation, tension and inability to feel relaxed.
- Somatic symptoms: physical tension in the body, muscle tension, palpitations, dry mouth.
- Sleep disorders. Problems falling asleep, waking up or experiencing restless sleep.
- Difficulty concentrating.
- Feeling irritable.
- Chronic feelings of fatigue or exhaustion, difficulty experiencing a state of relaxation
Causes of generalized anxiety syndrome – epidemiology
The causes of generalized anxiety are not well understood. It is believed that an increased likelihood of generalized anxiety disorder may be associated with:
- Biological propensity to experience strong and intense reactions to emotional stimuli; high sensitivity and low immunity.
- Chronic stress, preceded by past difficult experiences. Greater risk of mental disorders.
- Direct or indirect messages from those around you – ” the world is dangerous” or “worry is helpful in overcoming problems”.
- A coping style that involves avoiding challenges or situations where negative emotions are likely to be experienced. The patient then perpetuates the symptoms without verifying his negative predictions.
Generalized anxiety disorder – what is worrying?
Worry is generally considered a form of mental problem-solving regarding potentially negative future events. Worry otherwise known as ruminations can be triggered by various external factors, events or thoughts that simply come to mind. Worry is characterized by a lot of “what if?” statements. For example: “what if I don’t pass the exam?”, “what if I won’t be able to provide for my family?”, “what if I get nervous during a job interview?”.
Normal worry is relatively short-lived and leads to positive behavior, related to solving the problem, through concrete action. Worry becomes unhelpful when it involves many issues, does not translate into action, is frequent enough to interfere with our daily affairs, and becomes increasingly difficult to control. Then it can be diagnosed – generalized anxiety disorder. Feeling anxiety in the long term is an extremely exhausting experience, taking away energy, even leading to health problems. More anxiety, less energy increases the spiral of worry, which can result in decreased realistic thinking and increased catastrophic thinking and worst-case future scenarios.
Anxiety disorder – black scenarios in my head. What triggers worrying?
Worry can be triggered by a variety of factors. Some stimuli may be more obvious, related, for example, to certain external events so-called situational anxiety, e.g. seeing a certain image on TV, hearing information, being in need of making a decision and facing uncertainty.
Some triggers for worry may be less obvious. One can mention thoughts or images that appear suddenly in one’s mind, such as an image of one’s illness, poverty or some difficult situation.
Often, the very question – “what if…” – can even be a trigger for worry, increasing anxiety levels. Imagine the thought in your head: ‘what if I left the iron on?’ If I think “surely, it won’t happen” or “it’s a waste of time for such thoughts” and decide not to worry about it, there is a high probability that I will forget about it and the thought will fly out of my head in a while.
However, when you start focusing on this thought, then you will add more scenarios, such as “the ironing board may catch fire and spread throughout the house.” Then you are very likely to move on to the worst-case scenario in your head and think “the house may burn down and I will lose everything!”. This example shows that the original and innocent question, “what if…” triggered an episode of worry.
What sustains the worry?
We define a patient who experiences generalized anxiety as a chronic worrier. Often such people are disturbed and even angry with their excessive worrying. They don’t understand why they can’t stop worrying, despite the perceived negative consequences. They often experience secondary thoughts such as: “why am I doing this?” or “why do I keep worrying?” or “I think I’m going crazy from these thoughts.”
There are two types of beliefs about worry itself that sustain worry and thus generalized anxiety disorder.
Negative beliefs about worrying
People with generalized anxiety disorder may worry about worrying. In this case, worryers often believe that worrying is “bad.” As a result, they may have the following thoughts:
- Worry is uncontrollable, will take over and lead to loss of control (e.g., “I won’t be able to control worry and it will never end”).
- Worrying is dangerous and will cause physical or psychological harm (e.g., “if I continue to worry like this, I will go crazy, break down, get sick”).
Positive beliefs about worrying
People who worry often have, false, positive beliefs that worrying is somehow beneficial to them. Positive beliefs may sound as follows:
- Worrying motivates me to take action.
- Worrying helps me find solutions to problems.
- Worrying prepares me for the worst.
- Worrying helps me avoid bad things.
- Worrying helps me anticipate bad events.
Positive and negative thoughts reinforce the spiral of thoughts, causing even more fear and anxiety. Therefore, a very important part of working with generalized anxiety is to work on modifying positive as well as negative beliefs about the worry itself. Unhelpful strategies that reinforce the problem of generalized anxiety are also: avoidance and thought control.
Avoidance
Avoidance can take the form of avoidance at the behavioral level (e.g., not going on vacation because there is bound to be a canceled flight; turning down a promotion to avoid worrying that one will not do one’s job well) or avoiding the worry itself (e.g., not watching or reading any news, or seeking support from loved ones and expecting their constant reassurances). The consequence of avoidance is a limited opportunity to experience reality and events that do not confirm our fears and beliefs about worry. In a sense, the lack of confrontation with fears perpetuates the problem of generalized anxiety.
Thought control
People who worry often try unsuccessfully to control their worrying thoughts in various ways. These may include attempts to suppress thoughts, distraction or strenuous attempts to think positively. Such attempts to control thoughts rarely work, as attempts to suppress thoughts usually have the opposite effect. The person is in a permanent state of constant alertness. Suppression causes the thoughts to occur more frequently, which in turn fuels the belief that worrying cannot be controlled.
Generalized anxiety disorder – how to cope?
Acceptance and mindfulness (Mindfulness)
Mindfulness training and meditation can be helpful in reducing worry and increasing concentration, on the present moment. Mindfulness helps you free yourself from automatic and unhelpful ways of thinking and reacting. By learning mindfulness, when we automatically drift off into negative thought, we learn to redirect our attention, back to the present moment.
Worry is always about the future or the past, so try to ground yourself more in the present tense. Try incorporating the three basic steps of mindfulness into your daily routine:
- Awareness of what you are currently thinking about and feeling in your body. Use the feeling of your breath to stay present. Concentrate on what is happening now, in your body, in your thoughts. Stop and stay in what is happening now.
- Free yourself from the need to solve the problem quickly, by saying something to help get rid of the feeling of uncertainty. Uncertainty is natural, we are not always sure what will happen next, it’s completely normal.
- Be non-judgmental. Try to observe yourself, get curious about your drifting thoughts, without judging them or trying to change them. Then return your attention to the “here and now” of your experience. Focus your attention fully on the sounds around you, the sensations in your body, your breath.
Deferring worry
Worry can arise anytime and anywhere, often for no particular reason. One of the basic coping strategies is to postpone worrying for a specific time. Learning to postpone worry will make it less severe on your day, and you will learn to manage your anxiety more. Dealing with difficulties takes time, people with generalized anxiety disorder should gradually and patiently change their patterns. Remember, be prepared to practice this method repeatedly, as it takes some patience to make the change. Below is a sample plan for deferring worry.
Create a worry period.
To begin, choose a specific time, place and length of time to worry. The time, place and duration should always be the same, every day (e.g., at 6pm every day, I will worry for 20 minutes). The time you choose to worry should not fall close to bedtime.
Location.
Find a specific place to worry, free from distractions e.g. TV, radio. It should not be a space where you spend a lot of time e.g. an armchair or bed. Rather, it should be a “special place” where you spend time, just for the moment of worry.
Put away your worries.
When, during the day, you realize that you are worried, postpone it to your worry time. Say to yourself, “I will worry about this in the time allotted for it. There is no need to worry about it now, there are more important or enjoyable things to take care of now than worrying.”
Present.
Try to focus on the present moment and the activities of the day, if you even drift off with your thoughts, then return to daily affairs.
Time to worry.
When, it’s time to worry, sit in a planned place and think for a while about the worries you had during the day. Remember to:
- Worry about topics you’ve brought to your attention only if you feel you need to.
- If, all or some of the worries have stopped bothering you, or no longer seem important, then no further action is required. If you must worry about some of them, don’t spend more time on them than the time specified in your schedule.
- During the time for worrying, it can also be helpful to write down your thoughts on paper, instead of worrying in your head. You can do this in any way that seems appropriate to you.
Accepting uncertainty
The inability to tolerate uncertainty is an attitude that many of us have. When we have this attitude, uncertainty and doubt are seen as bad and difficult. We behave in such a way as to avoid the experience at all costs, which often breeds feelings of helplessness and weakness. The most important thing is to protect yourself in a healthy way, an attitude of self compassion can help you be good to yourself, even in various difficult, uncertain situations.
If you don’t tolerate uncertainty, you may think that worrying is useful for you. You may think that worrying is a way to prepare for the worst. Worrying in the short term can reduce feelings of uncertainty. Therefore, it is very easy to get used to this kind of coping. However, has your worrying actually worked? Has anything become more certain or predictable? Unfortunately, life is still as uncertain and unpredictable as ever.
Try asking yourself the following questions
- Can I always have certainty in life ?
- What does my need for certainty give me, and what costs do I incur, as a result ?
- Do I tend to anticipate bad events just because they are uncertain ? What is the probability of positive or neutral outcomes ?
- What is the probability that the things I predict will happen? Is it possible to live and try different things despite the fact that there is a possibility that something negative will happen?
In fact, the only thing that worry gives is to suggest worst-case scenarios of events, which causes us not to try, not to take new actions. We stay in a zone of apparent comfort, not experiencing different aspects of life. So it’s worth asking ourselves, do we have time for worry and symptoms of generalized anxiety? Are we missing out on good moments from our present?
How much treatment does it take – generalized anxiety disorder (GAD)
In the treatment of generalized anxiety disorder (GAD)pharmacotherapy is widely used , which includes the use of drugs from the serotonin and norepinephrine group, i.e. selective reuptake inhibitors. Pregabalin is one of the leading drugs used in GAD. Pregabalin’s mechanism of action involves serotonin and norepinephrine reuptake, which can be helpful in treating anxiety.
The recommended therapeutic treatment for Generalized Anxiety Disorder (GAD) is cognitive-behavioral therapy. Treatment for Generalized Anxiety Disorder is subject to short-term therapy. Unless there are additional co-occurring disorders such as depression, CBT therapy usually lasts about 3 to 5 months. If you are experiencing long-term symptoms of generalized anxiety, make an appointment-psychotherapy online.