Generalised anxiety disorder (GAD)

What is generalised anxiety disorder?

Generalised anxiety disorder (GAD) is characterised by an uncontrollable and unrealistic worry about everyday situations such as school, work, relationships or health. This worrying has to occur on the majority of days for at least six months for a diagnosis of GAD.

This worry is uncontrollable and can be accompanied by at least three additional symptoms which include feeling restless, getting tired easily, difficulty concentrating, feeling cranky, tense muscles and disturbed sleep.

GAD may affect parts of your life and you might find you're not able to enjoy the things you normally would. It is possible that you might also feel more likely to misuse alcohol and drugs as a way to escape or numb overwhelming feelings.

What are the symptoms of generalised anxiety disorder?

GAD can affect both your physical health and your mental health (behaviour and feelings). Symptoms can depend on a number of factors. They may pass quickly or may stay for a long period of time. If you, or a friend have some or many of these symptoms it may be worth talking to your doctor, a clinical psychologist or a counsellor about ways to treat GAD. 

Some common ways that GAD might affect your mental health (behaviour and feelings) include:

Mood symptoms

• feeling worried or scared
• being cranky or being in a constant bad mood
• feeling uneasy and on edge.

Thinking symptoms

• worried or a constant feeling that something bad is about to happen
• always wanting to be good, being very well-behaved, eg never get into trouble at school or with friends (though not necessarily at home)  
• being pessimistic and easily able to identify what may go wrong in any given situation.

Behaviour symptoms

• often asking many unnecessary questions and require constant reassurance 
• being a loner, or hanging out with a small group of group of people (who are often younger or older)
• being a perfectionist, taking a long time to complete homework because you try to get it absolutely correct 
• being argumentative (but not usually aggressive), especially if trying to avoid a feared situation 
• not answering questions and rarely volunteer comments or information at school or uni 
• getting upset when a mistake is made or if there is a change of routine eg sports day, substitute teacher, unexpected visitors or trip to an unfamiliar place.

Physical symptoms

• dry mouth and/or difficulty swallowing 
• nightmares 
• difficulty getting to and staying asleep
• difficulty concentrating 
• muscle tension and headaches 
• rapid heart rate and breathing 
• sweating 
• trembling 
• diarrhoea 
• flare-up of another health problem or illness (eg dermatitis, asthma) 
• sexual problems, such as not being having any sexual feelings or being interested in sex.

What causes GAD?

The causes of GAD are not fully known, however it is thought that GAD can be part your genetic and chemical make up, as well as part of your personality.

There are many things that might possibly trigger GAD such as your environment, stressful situations like school exams and/or problems within the family or a trauma.

Some of the causes of GAD might be:

• genetics, or a history of anxiety within your family  
• biochemical - an imbalance of the chemicals in the brain that regulate feelings and physical reactions can alter your thoughts, emotions or behaviour, and result in anxiety
• a stressful event or chain of events such as a family break-up, abuse, ongoing bullying at school, sexual abuse, a death, a relationship break up, family conflict 
• personality style - Certain personality types are more at risk of anxiety than others.

Getting help to manage GAD

There are a number of different treatments for GAD. A doctor, psychologist or other health professional can talk to you about your symptoms, and discuss alternative ways of treating and coping with them.

Check out the Who can help you section of the site to find more about what these people do and how they can help.

Have a look at the Anxiety Disorders Alliance (ADA) website for some more information on GAD.

Try to remember that managing GAD may take time and there may be good days and not so good ones. But - dealing with GAD is possible.

Psychological treatment

Psychological Treatment provides either an alternative to medication or works alongside medication and is usually provided by a mental health professional, such as a counsellor, psychiatrist or psychologist.

You may be able to find these health professionals through your GP, your local community health centre, or through colleges of psychiatry and psychology. Some GPs and other allied health staff also do counselling. Check out the Who can help you section for more info on what they do and on getting the best help.

There are a number of psychological treatments or therapies used for anxiety, including psychotherapy and counselling and cognitive behavioural therapy (CBT), which looks at your thoughts and behaviours and looks at ways of changing any negative thought patterns. You can find more information about CBT in the Different counselling techniques fact sheet.

Self-help groups are also available, and these can help to make you feel better, knowing and talking to others who are in the same situation. Also check out our online forum (forum and ROC links).

Psychological therapies can help to prevent a recurrence of anxiety. Medication can be effective for short term usage during a stressful time. There can be side effects with some of these medications, so talk to your doctor for more information.

Physical treatment

Medication may be helpful in managing an anxiety disorder. There are several different types of medication, which are prescribed by doctors or psychiatrists. Selective serotonin reuptake inhibitors (SSRI's) and anti-depressants increase the amount of serotonin in the brain and can only be used on a short term basis. These medications can be addictive.

Tranquilizers can also be used to alleviate some of the physiological symptoms of anxiety although it can make you feel sleepy and lacking in energy. They each work in different ways and have different applications. 

Like most medications there can be side-effects and some medications are better suited to adults than young people. It is best to ask your doctor about what options you have, how the medication will affect you and how to take the medication safely.

Medication can be an effective and immediate treatment for anxiety, as many of the symptoms are alleviated very quickly. It has been found to be helpful as a short term treatment for anxiety. Many of the medications have side effects so it would be good to ask your doctor for more information before taking these medications.

Self-help + alternative therapies

Along with seeking treatment to manage your anxiety disorder there are a number of things you can do that may help when you are feeling anxious. Alternative therapies can be good as a supplement to medication and/or therapy. Some of these include:

Eating well and being active - Even though you might not feel like it, exercising and eating well can help when you are feeling down. Biological factors, as well as social factors influence how you feel and how you react to, and think about, things and yourself.

Exercise helps stimulate hormones, such as endorphins, which help you feel better about yourself and your life. If you haven't done a lot of exercise before, it might be a good idea to start doing something small a couple of times each week. For example, a 15 minute walk or 2 or 3 laps of a pool.

Get out into nature - Evidence shows that when you have some sort of contact with nature, such as pets, plants, gardens or parks, your mood improves and you feel less stressed. Even just going for a walk in the park or at the beach may help. 

Write down your feelings - Writing down your feelings, or keeping a journal, can be a great way of understanding your feelings and a situation. It can also help you think about alternative solutions to problems.

Taking time out to relax - It is a good idea to try and take a bit of each day to do something you enjoy. When you are feeling down it may be hard to be social or motivate yourself to do things. It may help to make a list of all the things you enjoy doing and then plan to do something from this list each day. Check out our Relaxation fact sheet for ideas on good ways to relax and put things into perspective.

Breathing exercises - When you are anxious, your breathing can be quick and shallow, which reduces the amount of oxygen going to your organs. Learning how breathe efficiently can help reduce some of the physiological symptoms of anxiety. Have a look at the Breathing relaxation fact sheet for more information on breathing techniques.

Talking to someone - Although it may seem hard, sharing how you feel and hanging out with someone you trust can help you get through the hard times, see alternative ways of solving or thinking about a problem and help to take you to a happier, better place. This might be a trusted adult, your school counsellor, or a counsellor. For more information about seeing a counsellor for the first time, check out the First counsellor visit fact sheet.

If you are having difficulty speaking about what you're going through, you might start with sentences such as 'Right now, I'm feeling...', 'I think it started when...', 'I've been feeling this for...', 'My sleep has been...', 'Lately school/work/uni has been...'.

Support groups - As well as family and friends, support groups can be a place to share experiences and inspiration with others going through similar times. Contact your local community health centre for details of support groups in your area. Check out the Support groups fact sheet for more info.

Check out the Anxiety Disorders Alliance website for more details about local support groups.

Ring a crisis line - If you feel are having difficulty talking to people you know, it may be helpful to call a crisis line. Kids Helpline (1800 55 1800 - free call from a landline) or Lifeline (13 11 14 - cost of local call from a landline) are both anonymous and open 24/7.

Set small goals - Sometimes people set goals which are almost unachievable and then feel worse when they cannot reach them. Try to set goals that are achievable for you, even if it's on a day by day, or hour by hour, basis. And remember to reward yourself too. Check out the Setting goals fact sheet for more info.

Reducing stress - It may be a good idea to try and reduce the level of stress you are feeling. You may like to check out the Stress fact sheet for some ideas on how to manage stress.

Go easy on alcohol and drugs - try not to use alcohol and drugs in the hope of feeling better. The feeling is usually temporary and the after effects often make the problem worse. Check out the fact sheets on Low-risk drinking and Drugs for more info.

Give it time - changes in behaviour don't happen overnight and it might take some time before all GAD symptoms go away. It's a matter of taking baby steps, and getting the right support to get through this.

Acknowledgement:
Anxiety Disorder Alliance