|Publisher||Mental Health Foundation, NZ, 2013|
Also known as generalised anxiety disorder, fear, gad
If we see an item on TV that is disturbing, such as a terror attack, we feel horror, temporary distress and dismay, yet we continue with our activities and can put it out of our minds.
However, some people may see the same item on TV and suffer considerably more distress and worry. They may be up all night worrying about what to do if such an attack came to their town, and this worry can go on for days. This type of ongoing, all-over anxiety is called generalised anxiety disorder (GAD).
If you experience this level of anxiety, you feel worried about many things. You worry about your finances, your family, your car, your pets, literally anything can cause concern. Sometimes even thinking about how to get through your day makes you feel anxious. This is mentally and physically exhausting.
It’s common for people with GAD to have other conditions such as depression, or other anxiety disorders. These anxiety-related disorders can include:
GAD comes on gradually and can begin at any time in your life, though the risk is highest between childhood and middle age. Anxiety levels in most people with GAD fluctuate – when their anxiety level is mild, people with GAD can function socially and be gainfully employed. When their anxiety is severe, some people may have difficulty carrying out the simplest daily activities.
It is unknown exactly what causes GAD. What is known is that the wiring of some areas of the brain are affected in those with GAD and other anxiety disorders, and scientists continue to try to understand what that means and how it could lead to a better understanding of the condition and how to provide better treatment for those who experience it.
There is also a family, or genetic link. A person with a family history of anxiety disorder or obsessive compulsive disorder is more prone to develop this type of problem.
The symptoms of GAD can vary between individuals and, over time, within an individual. You may notice better and worse times of the day. And while stress doesn’t cause generalised anxiety disorder, it can make the symptoms worse.
People with GAD will usually:
If a child has GAD, their worries focus on their family, school and what could happen in the future, especially with their parents. Children and teens with GAD often don’t realize that their anxiety is out of proportion to the situation, so adults need to recognise their symptoms.
As well as many of the symptoms that appear in adults, children with GAD may have:
There is no test to diagnose GAD, and it can be somewhat hard to determine because it does not have some of the more noticeable symptoms of other anxiety disorders.
A diagnosis is made by your health professional, ie, doctor, psychiatrist or clinical psychologist, based on whether you (or your child) have some or all of the typical symptoms, and the length of time you have had them. Your health professional is likely to say you have GAD if you’ve felt anxious most days for over six months. For this reason it’s important that he or she spends time with you to get a full understanding of what has been going on.
Treatment of GAD can involve a number of aspects, each of which is tailored to your individual need. For most, a combination of medication and talking therapies, such as counselling, can be effective.
Your doctor may prescribe antidepressants. Finding the right medication can be a matter of trial and error – there is no way to predict which medication will be effective and tolerated (have fewer troublesome side effects) by any one person.
If you are prescribed medication you are entitled to know:
If you’re breastfeeding no medication is entirely safe. Before making any decisions about taking medication at this time you should talk with your doctor about the potential benefits and problems.
An assessment by a psychiatrist specializing in child and adolescent mental health problems should be undertaken before medication is prescribed for children and adolescents. Your doctor will help you find an appropriate psychiatrist.
Talk to your doctor if you are considering stopping treatment, and work with them to find some compromise that will ensure continuing wellness but address your concerns about the treatment. It is very important that any decision to stop medication is made with the input of your doctor.
Talking therapies are very useful for anxiety, especially with children and young people. Your doctor should be able to explain what is available locally and which type of talking treatment such as Cognitive Behaviour Therapy (CBT) is most suitable for you. CBT looks at two things: how your negative thoughts contribute to your anxiety and what might help you feel better.
Education about GAD can be extremely important to help you, your family/whānau and supporters. Your doctor should give you information about your condition, suggest different ways to handle it, and discuss any complications which could occur.
Also, talking things over with people you feel comfortable with can be useful and may help to define a problem and ways to begin to tackle it.
The term complementary therapy is generally used to indicate therapies and treatments that differ from conventional western medicine and that may be used to complement and support it.
Certain complementary therapies may enhance your life and help you to maintain wellbeing. In general, mindfulness, hypnotherapy, yoga, exercise, relaxation, massage, mirimiri and aromatherapy have all been shown to have some effect in alleviating mental distress.
It's also really important to look after your physical wellbeing. Make sure you get an annual check up with your doctor. Being in good physical health will also help your mental health.