What is Generalised Anxiety Disorder?

GAD is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue. GAD is a common condition, estimated to affect up to 5% of the UK population.

Slightly more women are affected than men, and the condition is more common in people from the ages of 35 to 59.

GAD can cause both psychological (mental) and physical symptoms. These vary from person to person, but can include:

• feeling restless or worried
• having trouble concentrating or sleeping
• dizziness or heart palpitations

Causes:

The exact cause of GAD isn’t fully understood, although it’s likely that a combination of several factors plays a role. Research has suggested that these may include:

• overactivity in areas of the brain involved in emotions and behaviour
• an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood
• the genes you inherit from your parents – you’re estimated to be 5 times more likely to develop GAD if you have a close relative with the condition
• having a history of stressful or traumatic experiences, such as domestic violence, child abuse or bullying
• having a painful long-term health condition, such as arthritis
• having a history of drug or alcohol misuse

Treatment:

Guided self help

Your GP or psychological therapies service may suggest trying a guided self-help course to see if it can help you learn to cope with your anxiety.

This involves working through a CBT-based workbook or computer course in your own time with the support of a therapist.

Or you may be offered a group course where you and other people with similar problems meet with a therapist every week to learn ways to tackle your anxiety.

If these initial treatments don’t help, you’ll usually be offered either a more intensive psychological therapy or medication.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is one of the most effective treatments for GAD. Studies of different treatments for GAD have found that the benefits of CBT may last longer than those of medication, but no single treatment works for everyone.

CBT helps you to question your negative or anxious thoughts, and do things you would usually avoid because they make you anxious.

CBT usually involves meeting with a specially trained and accredited therapist for a 1-hour session every week for 3 to 4 months.

Applied relaxation

Applied relaxation focuses on relaxing your muscles in a particular way during situations that usually cause anxiety. The technique needs to be taught by a trained therapist, but generally involves:

• learning how to relax your muscles
• learning how to relax your muscles quickly and in response to a trigger, such as the word “relax”
• practising relaxing your muscles in situations that make you anxious

As with CBT, applied relaxation therapy will usually mean meeting with a therapist for a 1-hour session every week for 3 to 4 months.

Medication

If the psychological treatments above haven’t helped or you would prefer not to try them, you’ll usually be offered medication. Your GP can prescribe a variety of different types of medication to treat GAD. Some medication is designed to be taken on a short-term basis, while other medicines are prescribed for longer periods. Depending on your symptoms, you may need medicine to treat your physical symptoms, as well as your psychological ones.

If you’re considering taking medication for GAD, your GP should discuss the different options with you in detail before you start a course of treatment, including:

• the different types of medication
• length of treatment
• side effects and possible interactions with other medicines

You should also have regular appointments with your doctor to assess your progress when you’re taking medication for GAD. These will usually take place every 2 to 4 weeks for the first 3 months, then every 3 months after that. Tell your GP if you think you may be experiencing side effects from your medication. They may be able to adjust your dose or prescribe an alternative medication.