CBT for Generalised Anxiety Disorder

Worry appears to have been around for as long as modern humans. The Roman poet Ovid (43BC – AD17), told us that “happy is the man who has broken the chains which hurt the mind, and has given up worrying once and for all”. Everyone knows what it’s like to worry, often about things like health, money or family, as occasional anxiety is a normal part of life and people experiencing Generalised Anxiety Disorder (GAD) tend to worry about the same things as people without GAD.  However, the worry experienced is persistent and excessive. Worrying about one thing leads quickly and easily to worrying about something quite different. As a result, worriers can get caught up in a whirlwind of thoughts about catastrophes that might happen, meaning GAD is characterised by a crushing sense that disaster is just over the horizon.

Once worriers are caught in this whirlwind, they often feel as if they can’t stop. The worries come at them thick and fast, and seem uncontrollable; sometimes circulating at the back of their minds, coming into sharper focus every now and then.

Seeing a qualified professional to determine an accurate diagnosis is key, here’s what professionals look for to help determine if someone’s worry and anxiety are related to GAD:

1. The presence of excessive anxiety and worry about a variety of topics, events, or activities. Excessive worry means worrying even when there is no specific threat present or in a manner that is disproportionate to the actual risk. Worry occurs more often than not for at least six months.
2. The worry is experienced as very challenging to control, and may easily shift from one topic to another.
3. The anxiety and worry are accompanied by at least three of the following physical or cognitive symptoms (in children, only one of these symptoms is necessary for a diagnosis):
   – Restlessness or feeling keyed up or on edge
   – Being easily fatigued
   – Difficulty concentrating or mind going blank
   – Irritability
   – Muscle tension
   – Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
4. The anxiety, worry, and other associated symptoms make it hard to carry out day-to-day activities and responsibilities. They may cause problems in relationships, at work or in other important areas of life.
5. In order to give a diagnosis of GAD, the symptoms also must be unrelated to any other medical condition, and cannot be explained by a different mental health issue or by the effect of a substance such as prescription medication, alcohol or drugs.

Of course, you may not have full-blown GAD, but you may still worry a lot. Although the formal diagnostic criteria are helpful, they are essentially a guide. Many people with disabling and distressing experiences of worry fall outside the diagnostic framework. When deciding to seek help, think honestly about how difficult it is to feel any sense of calm, comfort, and reassurance around your worry. Untreated, GAD often get worse with age as weighed down by the stresses of life over a long period, it takes less and less stress to trigger acute bouts of anxiety. Worriers may simply just get used to carrying the burden, but the impact on their lives is immense.