Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is a common chronic anxiety disorder that affects twice as many women as men (Brawman-Mintzer, & Lydiard, 1997). As the name implies, it is characterized by worry that is excessive and unrealistic and lasts more than six months. Long-lasting anxiety is not focused solely on one specific object or situation, however in adults the anxiety may focus on issues such as health, money and career.
In addition to chronic worry, GAD symptoms can include trembling, muscle aches, abdominal upsets, dizziness, and irritability. Because of persistent muscle tension and physical anxiety reactions, they may develop headaches, heart palpitations, and insomnia. These physical complaints, combined with the intense, long-term anxiety, make it difficult to cope with normal daily activities.
People with this disorder often feel afraid of something but are unable to pinpoint the specific fear. They fret constantly and have a hard time controlling their worries. A person suffering from GAD generally exhibits a constant mood state of anxious apprehension, and worry that they can’t control (Butcher, Mineka & Hooley, 2005).
The uncontrollable nature of this worry leads to avoidance of events due to anticipated negative outcomes from such events. It leaves individuals who suffer from this disorder continually upset and discouraged. Sufferers typically spend over half of their average day worrying, with up to 90% realizing that their worries are excessive (Sanderson, & Barlow, 1990).
It appears that sufferers may intentionally use worry as a strategy for dealing with anticipated negative events, whereby they may superstitiously believe that by preparing for every possible outcome they can avoid disaster. A common feature of the GAD sufferer’s cognitions is a perceived vulnerability (something will go wrong) combined with a perceived lack of coping skills (I won’t be able to cope when things do go wrong).
DSM IV-TR Diagnostic criteria for Generalized Anxiety Disorder
(American Psychiatric Association, 2000)
A. Excessive anxiety and worry occurring more days than not for more than 6 months
B. Person finds it difficult to control the worry
C. Anxiety and worry associated with 3 or more of the following six signs:
- Restlessness or feeling keyed out or on edge
- Being easily fatigued
- Difficulty concentrating
- Muscle Tension
- Sleep Disturbance
D. Anxiety and worry not confined to features of Axis 1 disorder. The anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupational and other important areas of functioning.
E. The disturbance is not due to psychological effects of substance (e.g. alcohol abuse) or general medical condition.
Source: Anxiety Disorders CE Course