Contents:

1. What is Generalised Anxiety Disorder (GAD)?
2. About anxiety disorders
3. Symptoms of GAD
4. What causes GAD?
5. Diagnosing GAD
6. Might I have GAD
7. Page 2: GAD Self Help

What is Generalised Anxiety Disorder (GAD)?

Generalised anxiety (GAD) is the most common anxiety disorder, about 4% of the population feel anxious, worried or fearful most of the time. People with GAD worry so much it interferes with their life. They find it hard to relax, hard to sleep and often feel mentally and physically exhausted from worrying so much.

About anxiety disorders

Feeling nervous when confronted by an aggressive person is enough to make most of us feel a little scared. Anxiety is different - we feel anxious when there's no real danger or threat. The feelings in the body are very similar, but feelings of anxiety are prolonged or out of proportion to the threat we face.

For example, I might not be able to sleep, fearing I haven't locked all the doors. I might get up to check them several times, even though I remember locking them.

Sometimes we can become so anxious that we start avoiding things. Some people develop a phobia, or have to perform certain rituals such as counting or cleaning which can stop them getting on with day-to-day life.

When fear is very intense, when it goes on for too long or when it stops us getting on with life, we may have an anxiety disorder.

There are a number of different anxiety disorders. They include:

• Panic disorder
• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Generalised Anxiety Disorder
• Social anxiety
• Phobias

In this information sheet we will be looking at generalised anxiety disorder, or GAD.

Symptoms of GAD

The main symptom of GAD is excessive worry. Worry can preoccupy the person, interfering with daily life. The worry can be very hard to control. People with GAD are often overly concerned about everyday things such as:

• health
• money
• work
• accidents or injuries
• family and relationship problems

People with GAD often anticipate disaster, becoming preoccupied with the very worst thing that might happen, even when it's very unlikely (catastrophising). If a partner is late, a person with GAD may jump to the conclusion that they have been in an accident, rather than the more likely explanation that they have been held up in traffic. Sometimes people feel very anxious but can't identify anything specific they're anxious about.

When GAD goes on for a long time we can become exhausted. We might find everyday activities like going to work or to the shops too much to bear, so we stay in and avoid people. Some people might smoke or drink too much, or experiment with illegal drugs to find relief.

A lowering of sex-drive with GAD is to be expected. GAD can also lower our immune system, making us more susceptible to coughs, colds and other illnesses.

What causes GAD?

We don't know for sure, but it's likely to be a combination of things. Our genes, our experiences and our outlook on life all play a part.

It seems that GAD is linked to the functioning of a part of the brain called the amygdala, which has an important role to play in the processing of fear and anxiety.

Sometimes GAD is triggered by things that happen to us, which might be stress or a trauma of some kind. Some people seem to be more prone to GAD than others, with women being twice as likely as men to seek help for GAD.

Long term drug or alcohol use has been associated with the development of GAD, as has smoking and excessive consumption of caffeinated or high-sugar beverages such as tea, coffee and stimulant drinks.

Diagnosing GAD

We all worry, more so when we're under stress. Diagnosis is often a matter of degree - recognising when worry becomes such a problem that it will respond to treatment. GAD can only be diagnosed after symptoms have been present for more than half the time and for more than six months.

Some medical problems can cause similar symptoms to GAD, as can illegal drug use and other anxiety problems such as panic disorder, phobias or health anxiety. Other possible causes must be ruled out before GAD can be diagnosed.

The International Classification of Diseases (ICD-10), a guide to diagnosis, says that a period of 'at least six months with prominent tension, worry and feelings of apprehension about everyday events and problems' must have passed before diagnosis, and that at least four symptoms from the following list must be present, of which at least one must come from items numbered '1' to '4'.

Autonomic arousal symptoms
01	Palpitations, fast or pounding heart
02	Sweating
03	Shaking or trembling
04	Dry mouth (not because of dehydration or medication side effects)
Chest and abdomen
05	Difficulty breathing
06	Choking feelings
07	Chest pain or discomfort
08	Nausea or abdominal distress (e.g. 'churning' stomach)
Brain and mind
09	Feeling dizzy, unsteady, faint or light-headed
10	Feelings that objects aren't real (derealisation), or feeling distant or somehow 'not really here'(depersonalisation)
11	Fear of losing control, going crazy or losing consciousness
12	Fear of dying
General symptoms
13	Hot flushes or cold chills
14	Numbness or tingling sensations
Tension
15	Muscle tension or aches and pains
16	Restlessness and inability to relax
17	Feeling 'keyed up', 'on edge' or of mental tension
18	A sensation of a lump in the throat, or difficulty swallowing
Other symptoms
19	Exaggerated response to minor surprises or being startled
20	Difficulty concentrating, mind going blank due to worry or anxiety
21	Persistent irritability
22	Difficulty getting to sleep due to worry

You can download a PDF of the above table here: Diagnosing GAD

Might I have GAD?

As a quick check if you might have GAD, have a look at these two questions. They are from a questionnaire called the GAD-2.

Over the last two weeks, how often have you been bothered by any of the following problems?

	Not at all	Several days	More than half the days	Nearly every day
Feeling nervous, anxious or on edge?	0	1	2	3
Not being able to stop or control worrying?	0	1	2	3

Add up your scores for the two questions. Your score will be between zero and six. If your score is three or more, you might have generalised anxiety and you should seek medical advice.

If you score less than three on the GAD-2 scale but still think you may have a problem with anxiety, ask yourself:

'Do I find myself avoiding things and does this cause me problems?'

If you answer 'yes' to this question you should take the issue further with a health professional.

These questions won't give you a diagnosis - that's something only a qualified health professional can do - but it will give you a better idea about your symptoms. Don't worry about the privacy of your results, we don't store them anywhere so they are confidential to you.