Everyone feels anxious from time to time, but especially since the pandemic has pushed everyday worries into the stratosphere.Almost 1 in 4 people reported to be high Anxiety levels in 2022/23, according to the Office for National Statistics. And more than a third of young people aged 18 to 24 suffer from symptoms of depression or anxiety, the Resolution Foundation says.
While some anxiety is normal, too much anxiety can interfere with daily life and become a problem. So when does something more serious occur? And how can you tell if you’re suffering from a more complex mental health condition called generalized anxiety disorder (GAD)?
What is anxiety?
Anxiety is different from simply worrying about everyday life problems. “Anxiety is first and foremost a feeling of tension and anticipation,” explains Dr. Mike Capec, a former general practitioner and current hypnotherapist with more than 30 years of experience.
This is usually felt during times of big events, change, and uncertainty, but of course it can also include positive things, like nervousness before a big exam or a wedding, he explains. . “It’s a completely normal, natural feeling. But I think the general public tends to think of anxiety as something abnormal,” Chapek added.
Can anxiety become positive?
According to Dr. John van Niekerk, head of the general adult division of the Royal College of Psychiatrists, some anxiety can be a good thing. “In layman’s terms, we’re talking about stress. Stress and anxiety can be very helpful because they increase your alertness when you need it,” he says.
For example, anxiety can be a good motivator for exams or important work presentations. Similarly, anxiety during the pandemic made us more careful about things like washing our hands and wearing masks, which helped protect ourselves and others, he added.
When is anxiety a problem?
Van Niekerk says it becomes a problem when it starts to affect daily life.
Abnormal levels of anxiety can be a symptom of several different conditions, Chapek says. “It can be thought of as a disease or diagnosis in itself, such as generalized anxiety disorder or panic disorder. It can be a symptom of a physical illness, such as hyperthyroidism, for example. Or it can be a psychological condition. It could also be a symptom of another psychological condition, such as post-traumatic stress disorder,” he explains.
What is generalized anxiety disorder (GAD)?
Generalized anxiety disorder is a mental health condition. It’s usually diagnosed after all other reasonable causes have been ruled out, Chapek says.
symptoms
Signs of generalized anxiety disorder include:
- restlessness or irritability
- a feeling of impending doom or that something terrible is about to happen
- Tired easily and get tired quickly
- poor concentration
- irritated or furious
- muscle tension
- Sleep disorders – having trouble falling asleep or tossing and turning in bed frequently
How is it diagnosed?
“If someone has three of these characteristics, there is no better diagnosis. And if it is not due to drugs or medication, a diagnosis of generalized anxiety disorder may be appropriate. Yes,” Čapek explains.
To be diagnosed with GAD, these symptoms must last for six months or more and be present on most days, he added. “Six months is a fairly arbitrary line because it indicates that the anxiety has been present for some time and is not in response to a direct cause of distress,” Kapek says. .
“GAD is a state of excessive, persistent, and unwarranted anxiety. People diagnosed with GAD often struggle with a variety of worries at the same time, and these fears can be difficult to control.” Van Niekerk says. “It affects your daily life, including your ability to work.”
How is GAD anxiety different from other types of anxiety?
A characteristic of GAD is that the anxiety is not triggered by a specific situation, Van Niekerk added. Other types of anxiety include phobias that are usually related to specific objects (such as spiders) or experiences (such as flying). Or social anxiety. It is triggered in a social environment. Rather, people with GAD can worry about all sorts of different things in different situations. These concerns may also be out of proportion to their situation.
Although the symptoms of GAD are psychological in nature, they can also manifest in very physical ways, such as panic attacks and gastrointestinal symptoms. “Some people experience increased heart rate, rapid breathing, and even panic attacks. This can be so frightening and real that it may feel like you’re having a heart attack or stroke.” ‘ says Van Niekerk.
“Panic attacks can be associated with GAD, but they can also be a symptom of panic disorder. Sometimes the two can coexist, but we diagnose panic disorder before diagnosing GAD. This is to ensure that someone’s anxiety is not explained by panic disorder and to ensure that they receive the most appropriate treatment.”
He added that gastrointestinal symptoms may be related to changes in eating habits. For example, if you’re using food as a way to cope with anxiety.
How common is GAD?
Generalized anxiety disorder is a common condition, but its severity varies, says Professor Camilla Hawthorne, president of the Royal College of General Practitioners.
Typically, about a third of GP consultations include some psychological or mental health component, Chapek says. “At any given time, about 25 percent of the population will experience some form of persistent distress. GAD numbers vary between about 4 and 7 percent of the population,” he says.
Who is most affected by GAD?
Research suggests that GAD is most common between the ages of 35 and 55 and affects more women than men. However, Van Niekerk said this could be partly due to underdiagnosis in men. “There are some estimates that it is twice as common in women as in men, but there are concerns that men are underdiagnosed,” he explains.
“It may also have to do with differences in how they express themselves. Men may show more irritation and anger. They are more likely to experience physical symptoms such as back pain or muscle pain than anxiety. They may also self-soothe using alcohol or other unhelpful coping mechanisms.”
These coping mechanisms can also lead to further problems. “Trying to self-medicate anxiety through alcohol, excessive smoking, and sometimes drug abuse can naturally have an impact on your mental and physical health,” van Niekerk says.
Direct complications of GAD
Chronic unresolved anxiety itself can damage career prospects and interpersonal relationships, as well as put you at risk for developing certain health problems.
“People who are chronically stressed may be able to suppress their emotions and appear to be coping with it on the surface. However, they are more likely to develop cardiovascular disease, high blood pressure, and stroke. That’s for sure,” Chapek said.
Physiologically, anxiety can also lead to conditions such as irritable bowel syndrome and eczema, he says. On the other hand, chronic fatigue can lead to accidents and mistakes.
Externalizing anxiety through anger is especially common among men, van Niekerk added. This can be a problem both at work and at home, negatively impacting relationships with coworkers, lovers, children, and other loved ones.
What causes GAD?
Niekerk said it’s likely a combination of genetic and environmental factors. “If you have a family member with GAD, you are four to six times more likely to have GAD yourself, and there is some evidence that GAD tends to run in families,” he explains.
In Čapek’s experience, GAD is often caused by persistent stress that lasts for a long period of time, or by a series of stressors occurring one after the other. “Often it can be traced back to childhood, because most of our behavior patterns are built there,” he says.
“Some people get into a pattern of feeling stressed and feeling anxious about whatever it is, and then they learn that that anxiety is ‘normal’ for them. You will then find out that they may develop sleep problems or become hypervigilant because they are always expecting something to go wrong. ”
This may be a completely normal and understandable reaction to what they’ve been through, Chapek added. Therefore, he prefers to think of his GAD as a condition rather than a “disorder.” “Normalizing a person’s experience and understanding where their behavior is coming from is a good step toward recovery,” he says.
Treatment
Professor Camilla Hawthorne said people suffering from anxiety usually first consult their GP. “GPs are highly trained to have open and sensitive conversations with patients when they feel anxious or have concerns about their wider mental health,” she says.
“We take GAD’s presentation with great concern because ensuring patients feel heard and receive the best possible mental health care is a top priority for GPs. Where possible, GPs would offer longer consultation times for mental health patients, but they should be able to provide the complex care that patients require within the constraints of a standard 10-minute consultation. It’s becoming increasingly difficult to provide,” Hawthorne added.
Patients with GAD can present with a variety of symptoms, and there are various appropriate treatments depending on the individual situation. “These are determined by your GP in conversation with you, based on the severity of your symptoms, your medical history and any other medicines you are taking,” she explains.
Treatment options include anti-anxiety medications and/or talking therapies such as counseling and cognitive behavioral therapy (CBT).
