Learn more about anxiety
Anxiety is a normal response that occurs when we are faced with stress. It has an adaptive function in that it lets us know when there is impending danger by creating a state of alertness and central nervous system arousal, which prepares our body to handle this threat by either fighting or fleeing. What different people regard as threatening can differ significantly. On a day to day basis we experience a general state of worry or fear when faced with something that we perceive to be challenging, such as a test, oral exam, performance, or presentation. While some people may find such events more anxiety provoking than others, we still recognize these emotions as normal and justifiable considering there are consequences associated with each event.
However, for some people even relatively low level challenges invoke a high or overwhelming level of anxiety. Anxiety is classified as a disorder when the person experiences certain symptoms such as the inability to sleep, irritability, muscle tension, and trouble concentrating, among others. For an individual with GAD, the symptoms seem excessive given the situation and are extreme enough to affect the person’s ability to function. Anxiety disorders can result in such a high degree of distress that they prevent the person from being able to lead a normal life. For most people, overcoming an anxiety disorder requires the help of a professional.
People suffering from Generalized Anxiety Disorder (GAD) report feeling anxious all the time. They often describe it as if it came out of nowhere and simply settled over them like a second skin. People with GAD have the tendency to constantly expect that a catastrophe is about to occur and can’t prevent themselves from worrying about health, finances, family, employment, or school.
Sometimes people with GAD will state that they can’t predict what may make them anxious, and with their inability to identify triggers for their symptoms, they begin to avoid any situation that may cause them anxiety. Since no one can fully predict every aspect of any given situation, this may generalize to avoiding most places or refusal to get together with people, even close friends and family.
Statistics of anxiety
Prevalence rates of GAD have been estimated to occur in approximately 2.9% of adults in the U.S. However lifetime risk for developing the disorder has been estimated at about 9%. The disorder is twice as prevalent in women as compared to men. However, it has been suggested that this estimate may not be entirely accurate, as women are more likely to report symptoms of anxiety than men. Rates of the disorder peak in adulthood and level off in middle age, after which the rates show a decline.
The average age of onset of GAD is 30; however, there appears to be a secondary age of onset that occurs in older populations. Prevalence rates for anxiety disorders among adults over the age of 54 have been estimated to range from 3.5% to 10.2%. When compared with the rates in young adults and middle aged adults, these rates are only slightly lower. The younger the person is when the disorder develops and the longer the course continues without treatment, the greater the likelihood of co-occurring disorders and more severe impairment.
GAD, as with other anxiety disorders, rarely occurs alone. The most frequent co-occurring disorders include:
- Other anxiety disorders (panic disorder, social anxiety disorder, social phobia, simple phobia, agoraphobia, and separation anxiety in children.)
- Depression (major depressive disorder, minor depression –dysthymia)
- Bipolar disorder (type I, type II)
- Eating disorders (anorexia, bulimia)
- Substance use disorders
- Posttraumatic stress disorder
Causes of anxiety
As with all mental disorders, no absolute cause of GAD has been identified. It is believed that a number of factors interact to lead to the development and maintenance of the disorder. Some of the factors which have been linked to the development of GAD include:
- Genetic: Research has indicated that genetic components contribute to the development of GAD. Those with a first-degree relative suffering from the disorder have a greater risk of developing the disorder than those with no such family history.
- Brain Structure: There are certain structures in the brain that control fear, emotional reactivity, and memory for anxiety related situations as well as regulate the effects of these factors on an individual’s physiological response when confronted with stress. When these areas of the brain are not functioning properly, this can lead to a heightened sense of both emotional and physiological anxiety
- Brain Chemistry: GAD has been linked to chemical messengers in the brain know as neurotransmitters. When levels of these substances are out of balance, messages about anxiety sent to the rest of the body may not be accurate. This leads to the brain communicating that non-threatening aspects of the environment are actually threatening, leading to increased physiological arousal. Sensing this state of over-arousal, the individual may develop what is judged to be a corresponding level of anxiety despite not knowing any cause for the anxiety to exist.
- Temperament: Individuals with GAD appear to be overly sensitive to novelty and the lack of predictability, and when experienced, these factors may lead to distress, triggering an anxiety response.
- History of Stress: Research suggests that individuals who have experienced numerous or chronic stressors such as trauma, the loss of loved ones, chronic illness, being exposed to danger, acute disease, divorce, or long term unemployment have been shown to be at increased risk for developing generalized anxiety.
Signs and Symptoms
Signs and symptoms of anxiety
There are physical and non-physical symptoms of Generalized Anxiety Disorder. These include:
- Trembling or shaking
- Stomach problems or pain
- Back pain
- Heart palpitations
- Numbness in the extremities
- Sweating/feeling overheated
- Feeling restless or being unable to sit still
- Difficulty concentrating, paying attention or focusing
- Deficits in problems solving and decision making
- Feeling irritable or short tempered
- Muscle tension
- Frequent urination
- Insomnia, or waking early and being unable to return to sleep
- Exaggerated startle response
- Excessive, ongoing worry and tension
- Viewing problems unrealistically
- Feeling “on edge” all of the time
Effects of anxiety
Due to the sense of constant worry and tension, GAD can impact every aspect of the individual’s life. Effects of GAD include:
- Substance abuse used to self-medicate the symptoms
- Difficulties at work or school, including decreased productivity
- Inability to carry out tasks efficiently and correctly
- Excessive smoking
- Social withdrawal and the loss of important relationships
- Teeth grinding during sleep
- Cardiovascular disease
- GI illness
- Excessive weight gain
- Development of new allergies
- Respiratory illness
- Stomach discomfort
- Feelings of helplessness or hopelessness
- Difficulty solving problems
- Becoming dependent on others to make decisions
- Suicidal ideation
- Nutritional deficiencies
- Changes in sleep patterns
- Social isolation
- Withdrawal from activities once enjoyed
- Decrease ability to interact normally with others in social, work, family or other situations
- Loss of self-esteem
- Lacking confidence in the parenting role
- Loss of motivation to change things even to make them better