Generalized Anxiety Disorder

There are many anxiety disorders, they may range in severity in an individual, they may also not be constantly present. 

That is to say, you may go periods where anxiety is not an issue, then it may be.

So we like to name them, though some will overlap. So why name them?

Putting a label on an illness can help determine the treatment. Though labels are not beneficial, we do like to know what it is that torments us.

Anxiety disorders encompass Panic disorders/attacks, PTSD, OCD. Phobias.  Social anxiety and more.

I have posted before about this here, today’s post is about GAD. Generalized anxiety disorder.

Anxiety is a terrible thing, it is so powerful and so illogical. This fact will torment someone even more, knowing that there may be no logic to a worry. This doesn’t stop it though. Knowing this though, can be a step in helping you cope with it. Anxiety also torments the body in a psychical way.

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GAD

Generalized anxiety disorder. Don’t you hate that word, disorder?

it is but a title though, so lets not dwell on it.

GAD is anxiety that is more of an unrealistic nature. This does not help, that you know this.. or does it?

Actually it can, I will return to this.

Anxiety is a terrible thing to suffer with, knowing that there is no reason for it can be upsetting too. So we then worry about that as well. Worry circles. 

Symptoms. Before you read them, remember symptoms vary, overlap. Don’t use this to self diagnose.

Worrying, worrying about things that often leads to more worries, this is refereed to as “chaining”, worries begin to connect. They are often unrealistic. example: worrying about driving to work tomorrow, what if the car breaks down, then the worry changes to then you will be late or not make it in at all, so then you worry about being dismissed… this leads to worrying about not being able to pay bills, it goes on and on, though the car is running fine.

Muscle tension, aches. Constant worry causes us to tense our muscles, we may do so all day without realizing, by the days end, and following days, the muscles are sore from being used so much without release. 

Fatigue, possible insomnia. Waking during the night and worry keeps you from returning to sleep. often this may occur at two or three in the morning. (why this time? – this is when the bodies production of melatonin the hormone that puts you to sleep wears off)

IBS, loose bowels, anxiety will cause this.

Rashes… eczema, psoriasis are both related to anxiety.  

Rapid heartbeat, chest pains, shortness of breath.

On edge, irritable, easily startled, headaches. Nausea, concentration difficulties.

Ulcers, stomach pains. 

These symptoms though are but a few, and will vary. It is not a firm thing. GAD is more obvious with the no specific worry, this is why it is generalized.

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Causes This could be genetics. Stress, trauma. Environmental factors too. Your brain may be wired so that anxiety may be more likely. In simple forms neurotransmitters may not be passing along messages, this is chemical based. So the mind reacts differently to situations. Reasoning may not apply as easily. Female. Females are more at risk.

 Knowing the causes though, are not going to make you feel better, not going to make you say, ok go away anxiety. So we won’t dwell on these either.

Treatment and self help

Anxiety is a normal process, without anxiety we would be foolhardy, take risks, not know when to avoid dangerous situations. So we can not eliminate anxiety. We can control it though.

We can treat GAD with medications, two directions  are benzodiazepines or antidepressants. Benzodiazepines, often shortened to benzos, can be addicting over long term use. These are more of a tranquilizer base, used to calm yourself when anxiety is overpowering. Meds such as Xanax, Valium and Ativan can be used. Often as needed to calm one in a situation where anxiety is overpowering.

BuSpar  is often prescribed for GAD and offers fewer side effects and without withdrawal symptoms. It doesn’t leave you feeling  lethargic. 

Anti-depressants are used for Anxiety. Surprising? The use of SSRIs, TCA’s and SNRIs have been suitable for longer term usage. (don’t you love the letters?  kk SSRI – Selective serotonin reuptake inhibitors  TCA – Tricyclic antidepressants  SNRI – Selective serotonin–norepinephrine reuptake inhibitor)  sometimes letters are not as scary as big words…. 

Venlafaxine is a SNRI and is used to treat depression but also GAD. Again with less side effects than TCAs or SSRIs.

SSRIs prescribed can include Zoloft, Prozac, Paxil, Luvox, Celexa, Lexapro  and more. 

The goal with medication is that it at some point, if possible, it be discontinued. Therapy being the choice giving you the tools to solve, cope and deal with GAD.

 

Therapy though can help you deal with your anxieties, calm them, eliminate them. Forms of CBT are applied most often. Cognitive-behavioral therapy. More on this in a bit.

 

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Lets get into specifics now for self help. GAD is generalized worry, We need to narrow down our worries, to identify them, so we can eliminate the ones we can eliminate.

This is key also, We can not control everything. We need to realize this, the things that are out of our control will happen. We need to let go of these things we can not control.

Lets focus on the ones we can. We sort worries into things that may be and things that are. Real and hypothetical. Real worries are, how will I pay my phone bill this month I don’t have enough money. hypothetical would be, what if I am fired, then I won’t have enough money to pay my phone bill.

We have control of one, not the other.

One characteristic of GAD is living in the future. Worrying of things to come.

I am now going to give you some tools. Tools to manage your worries. Yay right? This can be done? YES 🙂

I am going to start backwards a bit, to make you feel better. Your muscle aches. They are tormenting you. Doing a very simple exercise can make this go away. As mentioned, stress/anxiety causes us to tense our muscles, neck back legs… The muscles ache from overuse. By doing this exercise a few times a day, we can stop this. We can take five to fifteen minutes to do this. This exercise will relax you and reduce tension. Easy Peasy, no gym, treadmill needed. We do it sitting down. It is a progressive exercise.

Progressive Muscle Relaxation teaches you how to relax your muscles through a two-step process. First, you systematically tense particular muscle groups in your body, such as your neck and shoulders. Next, you release the tension and notice how your muscles feel when you relax them. This exercise will help you to lower your overall tension and stress levels, and help you relax when you are feeling anxious. It can also help reduce physical problems such as stomachaches and headaches, as well as improve your sleep.

You are going to tense muscle groups. It is best to do this in the same way each time, Start with your feet. Scrunch your toes, hold it for five seconds. (never tense to the point the muscle hurts), release and move to your foot, tense what ever muscles in your foot you can, again hold for five seconds. Then your calf, thigh.. do the other leg.

The same process is used on your hands, arms, tense, hold release. 

There is an excellent article here on how to do this exercise.  How to do Progressive Muscle Relaxation

Practice this through the day often, you will find it not only eases your tense sore muscles, but relaxes you as well.

Breathing to calm. Deep cleansing breaths. I have posted on this often as well. Using the muscle relaxing techniques and the breathing exercises is one of your tools for learning to overcome anxiety. When you encounter situations where anxiety starts to overwhelm you, These tools can help you cope and dismiss the anxiety. Mindfulness too is useful. Eliminating all thoughts other than the task at hand forces the anxious thoughts out of your mind. The breathing exercise is actually a form of mindfulness. You focus all your thoughts on breathing only. A deep breath which you hold, then release very slowly, continuing to do this until you are once again calm. All your thoughts are on that breath, feeling it as it surges into your lungs, feeling it fill them as it is a very deep breath, and then feeling the wind as you slowly release it, feeling your heart slowing as you relax. It takes some practice, but not as much as you think.

Mindfulness, Breathing techniques and relaxation exercises too can be very helpful. 

Support groups. These can be arranged from your therapist, or administered by your therapist or you can find them on your own. Check online, there may be anxiety support groups that meet in your area. How can this help? First, knowing that you are not unique in having anxiety is calming, that others feel exactly the same way, meeting and discussing this can be very helpful. Then you discover, each person may offer tidbits of what has helped for them, sharing this too, is great. Meeting with people in groups that share the same things you do, doesn’t cause as much anxiety as there is more understanding. No judging. No stigma. 

Therapy from a therapist

There are many approaches to solving any problem. Therapy can be this way as well. Different techniques or combinations may be applied. After all, we are all different, so identifying how GAD is affecting you can determine the approach a therapist will take in helping you. 

CBT – Cognitive behavioral therapy  is applied most often as research has shown it to have the highest success rate.

Behavior contributes to anxiety. The well known fight or flight reflex is an example. We know an elevator feels trapping, so we avoid them, the fear of them becomes strong. This can apply to eating in a restaurant or checking our mail as bills show up there. The negative response reinforces the anxiety. Modifying this behaviour is a part of the therapy, using the relaxing tools. Exposure to these situations. When you discover, in these situations, that you are still safe, then you are better able to cope with them.

Cognitive therapy is more thought based, learning to cope with persistent worry. Scheduling “worry time” and “worry free zones”. Exposure to worry and techniques to cope with it. Learning that you can not predict the future. Positive imagery is used to replace negative thoughts. Learning problem solving, so situations that trigger anxiety can be dealt with. 

Establishing “worry time and worry free zones” gives you a time where you deal with worry, Worry free zones allow for relaxation. Expanding on the zones and decreasing the time over a gradual period is the goal. 

There is so much more to CBT, but I am approaching two thousand words now, I don’t want you to doze off. I will post more on this another time, this gives  you, perhaps an understanding on the subject. 

More importantly, don’t give up. There is help for GAD, perhaps you have not had it yet. Yes this can be eliminated. 

Like everything else, the more you put into it, the more you get out. With CBT you will be encouraged to do more and more on your own, after all you are being given tools and techniques to help you cope and eliminate your anxiety, you must practice them. 

It is like quitting smoking, it won’t happen until you want it to. Anxiety is crippling, it doesn’t have to be. 

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About sensuousamberville

I am a Practitioner, teacher and student. I think we should always be students, we should keep our minds open, to continue to learn. :-)

4 responses »

  1. What an informative post Amber. If I might offer a suggestion, some of the drugs you mentioned do not interact well with alcohol. For those of us that are a bit older, we all know a family member or friend that has been on Zoloft or Lexapro or Prozac or similar. And for those that also deal with IBS or UC, well, then you can toss Prednisone into the mix as well. I guess I am just encouraging those that are taking anti-depressants such as those listed above to please be careful with alcohol (and abstain if at all possible). 🙂

    Reply
    • Agrees, I can’t think of any medication that you should take whilst consuming alcohol. But Anti-depressants can really amplify the effects and are on the very strong no no list.

      Prednisone, blech, that is a terrible medication. too many side effects and again a strong no no with alcohol.
      🙂

      Reply
  2. Thank you for posting this. I didn’t realise how much “chaining” I do. Ugh, I hate GAD, I will ask my doctor about BuSpar, maybe I can go onto that instead of benzos.

    Reply
    • hmm, I still need a name for you 🙂 . Yes chaining is common, One worry leads to another and they build, fester and torment. If you can break the chain…

      BuSpar may be an alternative for you, it has less side effects than then benzos, but it can cause stomach pain as well. Perhaps it would work better for you though.

      so I didn’t get into antidepressants with you. Abilify is a good possibility.

      Reply

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