All of us feel anxious at times. We may worry about things that might happen. We may have a restless night of sleep. But people with generalized anxiety disorder (or GAD) have physical symptoms that interfere with their normal lives. These problems may include restlessness, fatigue, problems with concentration, irritability, muscle tension, and/or insomnia. In addition, these individuals worry about a variety of events, such as health, financial problems, rejection and performance, and they find it difficult to control their worry. Many people with GAD feel that their worry is out of control “and that it will make them sick or make them go insane.
About 7% of the population will suffer from GAD. Women are twice as likely as men to have this problem. This is a chronic condition, with many people saying that they have been “worriers” all their lives. Most people with GAD have a variety of other problems, including phobias, depression, irritable bowel syndrome, and relationship problems. Many people who have this problem find that they avoid others because of fear of rejection, or that they become overly dependent on others because of their lack of confidence.
Only about 30% of the causes of GAD are inherited. There are certain traits that may make people more likely to develop this problem; these include general nervousness, depression, inability to tolerate frustration, and feeling inhibited. People with GAD also report more recent life stresses (such as conflicts with other people, changes in their work, and additional demands placed on them) than those without GAD do. People with GAD may not be as effective in solving problems in everyday life as they could be, or they may have personal conflicts in which they may not be as assertive or effective as they could be.
People with GAD seem to be worried that bad things are going to happen most of the time. They predict that “terrible” things will happen, even when there is a very low probability of bad things happening. They think that the fact that they feel anxious means that something bad is going to happen- that is, they use their emotions as evidence that there is danger out there somewhere. Many people who worry believe that their excessive worry may keep them from being surprised, or that worrying may prepare them for the worst possible outcome. If you are a chronic worrier, you probably notice yourself saying, yes, but what if…?”This “what-iffing” with a range of possible bad outcomes that you think you have to prepare yourself for. There seems to be no end to the things that you could worry about. In fact, even when things turn out to be OK, you may say to yourself, “well, that’s no guarantee that it couldn’t happen in the future!”
In addition to worrying about things that might happen “outside of yourself”, you may think that “worrying will make me crazy” or “worrying will make me sick”. If you have GAD, you may be locked in a conflict between the fear that worry is uncontrollable and the belief that worry protects you.
Because you may have been a worrier all your life, you may be pessimistic about the chances that anything will help you. It is true that you won’t get better overnight, so you will have to work on your worries and anxiety on a regular basis. Your therapist will want you to come to sessions on a weekly basis, to keep track of your worries, to practice relaxation or breathing exercises at home, and to work on managing your schedule so that you are not overburdened. In addition, your therapist will help you identify your worries and help you view things in a more realistic perspective. To do this, you will be asked to write down the things that you are worried about, and to use self-help homework techniques to challenge your negative thinking. You may also be asked to work on solving problems more effectively and on learning how to interact with people more productively.
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