People with generalised-anxiety disorder are overly anxious and worried about everyday things. They worry about things that might happen to them, without any immediate cause. For example, their worries are about money, health, performing at work, or that something bad will happen to their loved ones.
What is a generalised anxiety disorder?
With a generalised anxiety disorder, a person is almost continuously anxious for more than six months without any obvious reason. The anxious feelings are accompanied by fretting and physical symptoms associated with anxiety.
Every person is anxious or tense from time to time. And that is just as well: fear is a reaction to imminent danger. Fear warns us of real danger. However, some people are also anxious when there is no danger. The fears then serve no purpose. If these fears are strong and present for a long time, they can become very annoying. Moreover, they are accompanied by (physical) symptoms of anxiety, such as dizziness, chills or nausea. In addition, people with anxiety symptoms mull over all kinds of problems that might happen to them in the future. Because these fears make them insecure and exhausted, they avoid all kinds of situations.
Symptoms of generalised anxiety disorder
Below are the main symptoms of generalised anxiety disorder.
- You worry excessively about everyday things (such as work and relationships) when there is no reason to do so. You have these anxieties for at least 6 months.
- You find it difficult to control your anxiety.
- Your anxiety is not triggered by a particular situation.
- You are not very afraid of one thing, as in other anxiety disorders like hypochondria (fear of serious illness) or going off in company (social phobia). Your anxiety divides into different things in your daily life.
- Worrying, anxiety and fear limit you in your daily life. For example, you can’t concentrate as much at work or your social relationships suffer.
The anxiety you feel does not stem from drug use or a physical condition. When you have a generalised anxiety disorder, you often suffer from physical tension symptoms in addition to your fears and anxiety. People with generalised anxiety disorder recognise themselves in the physical symptoms below:
- You are easily irritated
- You feel restless
- You are tired
- You have difficulty concentrating and remembering things
- You are irritable
- Your body feels tense
- You have trouble falling asleep or wake up often
Causes of generalised anxiety disorder
There is no single clear cause of generalised anxiety disorder; the disorder usually arises from a combination of biological, psychological and social factors. The following factors can play a role
- Heredity – if anxiety symptoms run in your family, you yourself are more likely to develop an anxiety disorder.
- Negative experiences – going through negative experiences, especially in childhood, can contribute to the development of a worry disorder. You might think of the loss of a loved one, a physical illness, bullying, or being criticised a lot.
- Overprotective parents – a peaking disorder is more common in people who grew up with overprotective parents. If you’ve had an overprotective role model, you’re more prone to brooding yourself.
- Character – certain character traits play a role in the development of generalised anxiety disorder. This is the case for reacting violently to emotions and stress, inhibiting yourself too much, and excessive avoidance of distress.
Impact of a generalised anxiety disorder
Having generalised anxiety disorder is often tough: the frequent brooding takes up time and energy, making it harder to complete tasks at home or at work. Physical symptoms such as restlessness and difficulty concentrating also make you function worse. Poor sleep leaves you exhausted. Sometimes you no longer manage to work and have to call in sick.
Generalised anxiety disorder also affects your relationships with others. For example, if you constantly seek reassurance from your partner due to a lot of worrying, this can lead to tension in the relationship. Children may feel controlled if you constantly call them. People with a brooding disorder appear to find it harder to give their children self-confidence. Loneliness can also be a consequence of the symptoms. This can happen if you avoid social situations because you think it worsens your worries. You may also find that others start to think you are a ‘nag’ because you discuss all your worries with them.
All the tension and worry can also cause you to develop physical symptoms. For example, nausea, sweating, diarrhoea or headaches. Stress-related physical conditions, such as irritable bowel syndrome (PDS), are also more common in people with a worry disorder.
Treatment of generalised anxiety disorder
Generalised anxiety disorder is well treatable. Depending on the symptoms and severity of the disorder, treatment consists of cognitive behavioural therapy, medication, or a combination of both. Treatment reduces anxiety, physical symptoms, worrying and fretting, and helps you sleep better. You will also suffer less from avoidance behaviour.
Cognitive behavioural therapy
With this therapy, you will learn how to deal with brooding behaviour and how to adjust your thoughts that you could not handle problem situations. You will also learn how to relax in everyday situations and how to stop avoiding them. The treatment consists of several components: learning to worry and worry less (cognitive therapy), learning to relax (relaxation training), practising in anxiety-provoking situations (exposure in vivo) and stopping avoidance behaviour (response prevention).
To be effective, you need to practice a lot. Cognitive behavioural therapy is thus a form of treatment that requires your active commitment. You also have to do homework assignments. Treatment usually lasts three to six months. It is useful that you keep repeating the exercises yourself, possibly with a refresher session.
- Cognitive therapy
Cognitive therapy focuses on the brooding thoughts you have. You will first learn to recognise these brooding thoughts and link them to anxiety-provoking situations (a husband coming home later than planned; being home alone with a child who gets sick). In the next step, you will learn that these brooding thoughts are often unrealistic. You will learn how to replace them with more realistic thoughts that don’t make you so anxious. - Relaxation training
Relaxation training teaches you relaxation exercises. You first practise them at home and later apply them in everyday life. You may also learn breathing exercises, because you are more relaxed if your breathing is calmer. - Exposure in vivo and response prevention
In “exposure in vivo”, you practice with situations you find scary. You put yourself in that situation without seeking reassurance in your usual behaviour. You start with the least difficult situations, and gradually become more difficult. You practise staying in that situation for as long as possible, so that you notice that the anxiety subsides and the situation is actually not frightening at all. In this way, the anxiety gradually dies out.
Medication
In the treatment of generalised anxiety disorder, so-called antidepressants are mainly used. These drugs were originally developed to treat depression, but they also appear to be effective in helping generalised anxiety disorder.
When you start medication, the doctor gradually builds up its dosage. It takes some time before you notice the positive effects, only after a few weeks. At first, your symptoms may actually get worse. This usually subsides over the course of a few days to weeks. If your anxiety becomes very much worse, you may consider, in consultation with your doctor, increasing the medication more gradually. Your doctor may prescribe an anxiety-reducing medicine in addition to the antidepressants. You will only be given such a drug for a few days to a maximum of three weeks because they have unpleasant side effects. They make you feel sick, make you think less clearly and there is a risk of becoming addicted to them.
The beneficial effect of antidepressants on anxiety occurs after six to eight weeks. Then you will feel less anxious and nervous, worry less and have fewer physical symptoms. If the medicine does not work or not enough, the doctor may first increase the dosage. If this also does not have the desired effect, the doctor may give you another medicine.
In general, it is recommended to continue taking antidepressants for at least a year. After that, you may want to taper off gradually over several months. In many people, the symptoms stay gone after that. Sometimes the symptoms come back+ then longer treatment is needed.
