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Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by excessive worry, physical symptoms of anxiety and difficulties with tolerating any situations that might produce uncertainty.  

Excessive worry is a tendency to get chronically entangled in “what if” questions. Someone who worries excessively might ask themselves questions that range from “What if I will be late?” to “What if I get sick?” to “What if I make wrong decision?” The subject of worry varies from situations or problems that the person encounters in daily life to situation or problems that are not present in daily life but the affected person imagines might eventually occur. Worrying might create an illusion of action and a lot of people confuse worrying with planning or with caring even though these are very different thinking processes. Worry is circular and does not produce satisfying answers. Planning is structured and a planner has the ability to let go of the problem until the time when the action plan can be implemented. Caring is yet different. When we care, we have emotional connection to the person we care about and we do what is needed to help them. When we worry, we might be so lost in the worry process that we are unable to offer the assistance that the person we care about might require.  

Physical symptoms associated with GAD might include tension, headaches, a sense of restlessness, tiredness and abdominal discomfort. These symptoms are the result of the worrier’s chronic state of readiness – a sense of bracing for impact and trying to prevent bad events from happing by questioning all possible outcomes (worrying). This chronic alertness culminates in tiredness and an exaggerated stress reaction. 

Not surprisingly, many chronic worriers end up by feeling hopeless and depressed as most put a lot of mental effort to address their problems but see no positive results. The culprit here is intolerance of uncertainty. Worriers postpone actions until they are certain that they have chosen the correct path of action, which often leads to procrastination about important life decisions.  

Cognitive behaviour therapy helps persons who have difficulties with chronic worries to recognize the difference between the desired and actual impact of worrying, teaches worry containment techniques, helps adjust biased thinking, teaches relaxation techniques and generally helps with developing of a flexible reaction style that promotes action over over-thinking.  

Useful self-help books include: Dutiful Worrier: How to Stop Compulsive Worry without Feeling Guilty (2011) by Elliot Cohen, The Worry Cure: Seven Steps to Stop Worry from Stopping You (2006) by Robert Leahy, and The Anxiety and Worry Workbook: A Cognitive Behavioural Solution (2011) by David Clark and Aaron T. Beck.