What is Generalised Anxiety Disorder?

Generalised anxiety disorder is excessive anxiety and worries about several events or activities most of the time at least for 6 months. The worry is difficult to control and is associated with symptoms like muscle tension, irritability, difficulty sleeping and restlessness. The worry usually involves simple daily activities, timeliness, finances or health. Though this is an ordinary worry for common people, for someone with generalised anxiety disorder, these worries reach a point where catastrophe seems possible.

Children with generalised anxiety disorder have significant distress in activities of daily life, often focused on the child’s fears of incompetence in many areas, including school performance and social settings. Also, children with generalised anxiety disorder may experience at least one of the following symptoms.

• Restlessness
• Being easily fatigued “mind going blank”
• Irritability
• Muscle tension
• Sleep disturbance

What causes this condition?

Like many other mental health conditions, the cause of GAD can be because of the complex interaction of biological and environmental factors. The severity of this condition may vary for each individual. The factors that trigger GAD in an individual are: 

Genetic Factors

If Generalised Anxiety Disorder runs in the family, the individual is at a higher risk of being diagnosed with GAD. Hereditary factors can be one of the contributors to the development of anxiety disorders. 

Environmental Factors

Any traumatic or stressful event in life, like abuse, neglect or the loss of a loved one, can trigger anxiety in an individual. It can increase the chances of GAD. 

Imbalance in Neurotransmitters

Any imbalance of hormones and neurotransmitters like serotonin, dopamine and gamma-aminobutyric acid will make it difficult for individuals to control their emotions. 

Cognitive Patterns and Personality Traits

Constantly thinking about negative things and overestimating the potential threats can trigger this condition in an individual. Moreover, the condition can worsen if the individual is highly sensitive or a perfectionist. 

Medical Condition

At times an individual can be affected by GAD if they suffer from medical conditions such as thyroid, heart disease or chronic pain. Apart from this, certain medications and substance abuse can also trigger this condition in an individual. 

What are the symptoms of GAD?

The symptoms of generalised anxiety disorder are similar to panic disorder, obsessive-compulsive disorder, anxiety and mood disorders. Studies have shown that this condition can physically or mentally affect adults and children. 

Physical Symptoms of GAD

The physical symptoms of GAD may include 

1. Fatigue - The individual may not feel hungry and take food on time or regularly. It can make them fatigued and weak. 
2. Insomnia/Trouble sleeping - This is one of the most common symptoms of GAD. When a person is affected by GAD, they may find it difficult to fall asleep because of the constant thoughts running through their mind. 
3. Muscle tension or muscle aches - The imbalance in food consumption and irregular sleep can give rise to other issues such as body and muscle pain. 
4. Trembling & Feeling Twitchy - People with GAD are more attuned to bodily sensations and heightened sensitivity. It can make their trembling and twitching more evident and noticeable. 
5. Nervous and Restless - This is a common factor in people suffering from GAD. They are unable to relax and are mostly edgy and fidgety. 
6. Sweaty - Excessive sweating in the palms and the underarms can also be a sign of GAD. It may be related to a body stress response or an increased sympathetic nervous system activity. 

Mental Symptoms of GAD

The condition of Generalised Anxiety Disorder can also affect an individual mentally, and its symptoms include:

1. Persistent worrying and anxiousness. It can immensely affect your everyday life, as you are worried about several things that are out of your control. 
2. Think about the worst possible outcome of any situation or plan. 
3. Perceive all situations as threatening when they aren’t. 
4. Indecisive and always having a fear of making a wrong choice. 
5. Unable to let go of the worry and concentrate on the work at hand. 
6. Unable to relax and constantly feeling restless.
7. Face difficulty in concentrating as the mind sometimes goes ‘blank’.

How is GAD treated?

Counselling for anxiety can be a treatment process for Generalised Anxiety Disorder. During counselling sessions, the counsellor or therapist adopts an ideal approach suited to the individual’s needs. 

Cognitive Behavioural Therapy (CBT)

CBT is widely used to treat GAD. It focuses on reducing the impact of negative thoughts and feelings contributing to anxiety. In this therapy session, the counsellor helps the individual develop coping strategies like relaxation techniques and problem-solving skills to help them face their fears. 

Acceptance and Commitment Therapy (ACT)

This therapy helps the individual to make their own decision and live life on their values and commitments. This therapy involves mindfulness exercises that can help them identify the anxiety symptoms and accept the anxious thoughts and feelings. 

Mindfulness-based Therapy

Mindfulness-based therapy can help with GAD as it helps to create a sense of present-moment awareness in the individual and helps to reduce anxiety-related thoughts and a non-judgmental attitude towards their thoughts and feelings. 

Psychodynamic Therapy

Psychodynamic therapy helps the individual to get an insight into what triggers anxiety in them by exploring past experiences, unconscious conflicts, and unresolved emotions. 

Supportive Counselling

Supportive Counselling provides a safe and empathetic environment for the individual to share their thoughts on their concerns and worries related to GAD, and the therapist or counsellor will help them by offering them emotional support and guidance and help them with coping strategies and problem-solving skills. 

Group Therapy

Group therapy for GAD involves counselling for anxiety sessions with others who are facing similar issues as the individual. Here, they share and discuss their concerns, receive support from others, and also learn how to manage their anxiety symptoms. 

Medications for GAD

Antidepressants: Healthcare providers commonly prescribe selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) antidepressants to treat depression, but they also can help treat the symptoms of GAD. They may take several weeks to start working.

Anti-anxiety medications:

Benzodiazepines, which are anti-anxiety sedative medications, can help manage severe forms of GAD. They can be very effective in rapidly decreasing anxiety, but some people build up a tolerance to them and need higher and higher doses to get the same effect. Because of this, your provider may prescribe them only for brief periods if you need them. Buspirone is another anti-anxiety medication that can help treat GAD. Buspirone takes three to four weeks to become fully effective.

Medically reviewed by Dr Sunitha MBBS, DPM (NIMHANS), DNB

Dr Sunitha serves as the Chief Psychiatrist at Agan Health Trichy. She specialises in Adult Psychiatry, and her fields of interest include consultation liaison psychiatry and women's mental health. With over 15 years of experience in the field of mental healthcare, Dr Sunitha has been instrumental in positively transforming the lives of many in Tamil Nadu. She is also a consulting psychiatrist at some of the reputed mental health institutions in Tamil Nadu.