WHAT IS GENERALIZED ANXIETY DISORDER (GAD)?
Virtually everyone can describe personal examples of times they have
felt anxious and worried. It’s a natural part of being a member of
the human race. However, generalized anxiety disorder (GAD) is a condition
where anxiety and worry are present in a person’s life almost all the
time and interfere with their success and contentment with life. GAD
is an anxiety disorder characterized by almost constant worry that
is difficult to control. The worry is accompanied by anxiety and physical
symptoms that can include feeling restless, fatigued, and irritable
as well as experiencing problems concentrating, muscle tension, and
poor sleep.
HOW COMMON IS GENERALIZED ANXIETY DISORDER?
Approximately 6% of the population will suffer from diagnosable
GAD in their lifetime; in a 12-month period, rates of GAD are approximately
3%. Women are two times more likely than men to suffer from GAD.
Typically,
GAD does not go away without treatment.
WHAT ARE THE CONSEQUENCES OF GENERALIZED ANXIETY DISORDER?
The consequences of GAD on a personal note can be quite devastating.
People with GAD commonly experience difficulties with work, school,
and their interpersonal lives; they express much less satisfaction
with their
lives as compared to individuals without GAD. People with GAD
are at much higher risk to go on to suffer from other emotional
disorders
such as depression, drug & alcohol abuse, etc. The consequences of GAD can also be felt on a societal level.
For example, individuals with GAD (compared to individuals without
GAD) disproportionately utilize the health care system and generate
more health
care costs
HOW DOES WORRY RELATE TO GENERALIZED ANXIETY DISORDER?
Fear is an emotion we experience when we sense there is an immediate
threat or imminent danger in our lives. When our bodies sense
danger, a protective system, sometimes referred to as a “fight-or-flight”
response, springs to action to help us take immediate action.
Ordinarily,
we
calm down once a sense of safety has returned. Anxiety is a
similar but separate
emotion where we sense a threat or danger in the future or
just on the horizon of our lives. Like fear, anxiety is a natural
and usually
healthy
response to future threat or stressful situation–for if we
take
certain action, we may successfully prevent the circumstance
from occurring.
Worry is an activity related to anxiety. It’s a verbal/thinking
activity often focused on the future especially with respect
to negative outcomes
we fear. For people with GAD, they constantly believe that
bad things are going to happen even when the available facts indicate it’s unlikely
to come to pass. People with GAD often indicate that worry
is their way of mentally preparing for the worst or mentally
problem-solving
so that they find a response to actually prevent these feared
future
circumstances. Some
people with GAD say that by worrying, it actually reduces the
likelihood of something bad happening. Research has shown that
the reason
why worry becomes uncontrollable may be in that it keeps us
from feeling
the full
impact of distressing situations, but they also do not get
over those situations either. In essence, by worrying, we reduce
how
worked up
we get, but those events stay with us that much longer. We
are never able
to “put them to bed.” Instead, they return more intensely than
before causing us to worry even more, and we find ourselves
in a viscous circle.
WHY ARE FEAR AND ANXIETY IMPORTANT?
Fear is the emotion that arises when we sense immediate threat
or danger for ourselves or loved ones. When fear arises and we
feel
“scared,” programming
at the core of who we are as humans is activated to help us get
in position to take the action needed to protect ourselves. It’s
our
brain’s way
of getting the body ready. This response is often called “fight
or flight.” When the danger has passed, our brain sends the “all
clear”
message and
we begin to let down our guard and begin to relax once again.
Anxiety is an emotion closely related to fear, and is associated
with a future sense of danger, misfortune, and dread. Like fear,
anxiety has
survival value by helping us prepare for this future we dread perhaps
as a way to make it not come true or to make it’s impact is minimal
as possible. After the anticipated danger passes, the brain once
again signals
the all clear, and our body’s respond by relaxing and getting on
with life.
All emotions, even the ones we do not really wish upon ourselves,
have their place in helping us survive and even thrive within society.
Emotions
send us signals about our needs and whether we want to spend time
securing what we have in our lives or whether we want to add on
to what we have
and enhance our lives. Emotions tell us in different ways which
direction to go in. If we allow them to run their course, they
are over and
done with rather quickly. Emotions are meant to be short acting
messengers and motivators, and when their work is done, to subside
and get out
of
the way
WHY DO WE WORRY?
Worry is a common experience for all humans, but it is not the
same thing as anxiety. Worry is one of the ways we respond to our
anxiety,
by influencing
the choices we make to respond in an uncertain future. Many people
who worry say that it helps them by spurring them to problem-solve,
or as
a way to magically ward off what we fear or prevent it from happening
or for the sense of control and predictability it provides. While
we are worrying, we may feel as though we are actively doing something
to address our problems. However, the primary reason that people
worry
is
actually, quite subtle. When we worry as a response to anxiety
and fear, we gain some relief from our anxiety, at least for a
short
while, because
worry acts almost like a tranquilizer in our bodies. It’s nature’s
way of taking the edge off of our powerful emotions. Scientific
studies, including ones that include brain scans, show that while
we are worrying,
thinking regions of our brain are very active, while the emotion
regions are less active. So, worry appears to be an activity that
all of us
do as a tonic for our nerves, but HOW it’s working for us is not
what it appears to be doing.
The sneaky thing about worry is that every time we successfully
dull or quiet our fear and anxiety, the more likely we are to utilize
worry the next time. And before we know it, we’re hooked …worry
becomes
a
habit or a way of life.
SO, WHY NOT WORRY?
If worry truly is a way of dulling the intensity of our emotions,
what’s so bad about that? Why NOT worry?
First, ALL emotions, including fear and anxiety, are vital to our
survival and to offering us color and meaning to our lives. When
we worry in response
to anxiety, we begin to approach the world with thought but without
emotion. We get up in our heads and spend time thinking about a
variety of possible
futures or dwelling on things that might have happened to us and
wondering what those things will mean for our future, and guess,
what? … we fail
to see what’s happening around us in the here and now … in the
present moment. Worry closes us off from the emotional side of
ourselves.
Second, research convincingly shows that suppressing our emotions
and not experience them, makes them come back more powerfully.
That is, every
time we exert effort NOT to have an emotion, it does subside for
a while, but it keeps coming back, and often does so with greater
intensity on
every return trip. In this sense, worry serves to suppress our
emotions or at least take the intensity or edge off of them, but
we need to
constantly go back to worry, and before we know it, we are devoting
lots of time
to worry.
Third, the more we worry, the more likely we are to make worry
into a life style choice. We get a short-run benefit from worry
in terms
of
sparing us from experiencing powerful emotions, but it has the
potential to change the focus of our lives towards constantly looking
out for
our security instead of broadening and building our lives. Instead
of fulfilling
our aspirations, finding our prince charming or girl of our dreams,
celebrating the lives of children, or whatever, we become a slave
to our need for
security.
WHAT IS A HEALTHIER APPROACH TO EMOTION REGULATION?
Emotions can feel intense and painful, especially when they escalate.
Ideally, we need ways to respond to our emotions besides worry
and avoidance. The ability to reflect upon our emotions, understand
what
needs they
are informing us about, utilize this emotional information if its
indeed helpful, and improve our ability to know the best way to
respond to our
emotions may inevitably be the best ways we have to responding
to times when we feel our intense and painful emotions.