Are you worried about feeling anxious? Do you withdraw from meeting up and mixing with your family and friends? Do you avoid social situations in order to not have feelings of worry and dread? Do you find it difficult to go to work and do you take time off sick? These actions can make you worry even more about yourself and diminish your feelings of hurt.
Generalised Anxiety Disorder (GAD) is defined by the Statistical Manual of Mental Disorders (DSM 5) as an anxiety disorder. Psychiatrists have defined GAD as a condition where worry is seen as uncontrollable and often irrational. Worry is also so excessive that it involves extreme apprehension about future events or activities.
If you have GAD, it may not always be clear what you are feeling anxious about. One of the most debilitating aspects about anxiety is the manner in which it occurs without any apparent identifiable cause. Not knowing what triggers your anxiety can intensify it and you may start to worry that there is no solution to the way you are feeling.
The psychological symptoms of GAD (such as restlessness, feeling constantly ‘on edge’, a sense of dread, difficulties with concentration and irritability) can cause a change in your behaviour and the way you think and feel about things.
We all have worries as we encounter new challenges in the course of our everyday lives but if you have GAD you may take worrying to a different level, a more intense level. The difference between what might be termed ‘normal’ worrying and generalised anxiety disorder is that the worrying involved in GAD could be termed excessive, intrusive, persistent and debilitating.
What helps you manage your symptoms?
The Royal College of Psychiatrists states that for the most effective management of GAD:
Firstly, psychological therapy and Cognitive Behavioural Therapy (CBT) is suggested, as per NICE guidelines. CBT is an approach that seeks to help you gain charge of your thought processes by identifying automatic negative thoughts and to change them to help you to manage your situation. Your CBT sessions focus on helping you to acquire specific skills to empower you to reacquaint yourself with those activities which you may have avoided because of your anxiety (the behavioural aspect of the approach). You can listen to my interview with Professor Windy Dryden who explains the effectiveness of CBT. Secondly, medication is the next most effective such as a course of SSRI prescription. Thirdly, self-help such as reading books based on the principles of CBT and implementing the suggestions.
However, whether you seek professional help or not, it is still of critical importance to practice a self-help management regime in your daily life. Seeing a therapist will help but ultimately there is no magic wand. You will still need to manage your feelings and behaviour on a daily basis between sessions.
Self-help management regime for anxiety
- Practice mindfulness and relaxation techniques
Try to become more mindful, there are many practical toolkits available online. My interview with Fr Laurence Freeman explains the benefits of regular meditation. You can also download for free some useful relaxation techniques from Helpguide. Here is a useful breathing exercise to help you relax:
In – on the in breath draw up the magnetism of the Earth through your body, feet and the palms of your hands faced downwards. Think of the Earth and yourself as two magnets – one giant, and one tiny. If you like you can visualise the Earth’s energy spiralling upwards in an anti-clockwise direction from your feet to your head.
Out – on the out breath you are releasing the distortions of your bodies – physical at the cellular level, as well as energetic and emotional. In releasing distortions and toxins back down into the Earth we can remember that it is a giant transformer, willingly able to take these from us.
- Review your attitude to worrying
Everybody worries and from time to time we all let worry take greater prominence in our lives than it should. Scott Peck starts his book The Road Less Travelled with the line ‘Life is difficult’. That is perhaps the reality of modern living, that life can be tricky at times. However, if you’re focusing on “what if” scenarios all the time, your worrying has become unproductive.
- Do something different
When you feel anxious you may need to change the scenery and location of where you are. If you are indoors and working on a computer try to go for a long walk in a park and take in your surroundings. Leave your phone at home, if you can. You will have a more mindful experience if you are not focused on the receipt of phone messages.
- Avoid isolation
Try to join a group, however informally, as a way of containing your anxious feelings. Get in touch with friends and family who you feel comfortable speaking to. Isolating will only compound your anxious state. See my resources list at the bottom of the page for links to self-help groups. This is the behavioural aspect of CBT.
- Review how you are living
Evaluate your way of living and assess whether you could change your diet so that you are concentrating on eating nutritional meals. Try to avoid too many sugary products.
Try to observe a healthy sleep hygiene regime. Research has shown that sleep deprivation can lead to anticipatory anxiety. Try to avoid looking at your phone, computer and television two hours before going to bed.
Do you leave sufficient time to prepare for going out or going to work? Hurry and indecision can be detrimental to your sense of well-being. Try to leave plenty of time for the preparation of daily tasks and plan ahead. It can be useful to pack your bag for work the night before so that you don’t end up rushing. Planning ahead will also reduce the potential for anticipatory anxiety.
- Accept your existential crisis
For the existentialists, psychological dysfunction results from the individual’s refusal or inability to deal with the normal existential anxiety that comes from confronting life’s ‘givens’: inevitability of death, isolation, freedom and search for meaning. These are deep issues but break them down to practical parts. We often refuse to consider these questions when we get caught up in the engagement of material pursuit but there can be benefit to adjusting ourselves to the realities of life so that we can be more in the moment. Anxiety, for the existentialists, is derived from the realisation that our validation must come from within and not from others, or other things. Bring this mindful approach to your meditation and try to live in the moment.
From a transpersonal perspective, an existential crisis is witnessed as a loss of soul due to greater isolation we suffer in modern life from the advances of technology, pursuit of material possession and increased secularization. This all creates greater levels of anxiety as we search for more and more answers online when perhaps what we really need to do is to slow down and listen to our heartbeat in quiet periods of silent meditation.
If you think you are suffering from GAD it is important to speak to your GP, especially if you are experiencing physical symptoms. Your GP will know your personal history and should be well placed to help you.
Anxiety Alliance: A charity committed to the support of individuals suffering from the condition of anxiety disorder. Their telephone helpline number is 0845 2967877.
Anxiety Care UK: Runs mutual support groups.
Anxiety UK: A National charity founded by Harold Fisher, a sufferer of agoraphobia, for those affected by anxiety disorders. The charity provides resources to help reduce the impact of anxiety disorders. The Helpline number is 08444 775 774.
Anxiety in kids: how to turn it around
Helpguide.org: Treatment of GAD
NHS Choices: Treatment of GAD
NICE Guidelines on General Anxiety Disorder in Adults National Clinical Guideline 13
No Panic: A national organisation which provides support for those with phobias , anxiety and care. The Helpline number is 0800 138 8889.
Patient.co.uk: Information leaflet on GAD
Royal College of Psychiatrists: Information on anxieties, phobias and panic.