GENERALIZED ANXIETY DISORDER

Generalized anxiety disorder is a diagnosis that is given to individuals who present with persistent, excessive and uncontrollable worry for at least six months about multiple concerns. The worry is also associated with other somatic symptoms such as restlessness, being easily fatigued, irritability, concentration problems or having one's "mind going blank", irritability, muscle tension and sleep disturbance. People with GAD are often perfectionistic and indecisive. GAD often goes undiagnosed because people (including many medical professionals) see worry as normal. This may be true, but excessive and uncontrollable worry is not and so people suffering with GAD often only tend to present at a mental health professional once the anxiety spins out of control (into panic attacks) or once people become depressed. Even at this point people with GAD may receive a diagnosis of panic disorder or depression, where the underlying problem is excessive worry.

GAD was previously thought of as the "waste paper basket" of the anxiety disorders because any cluster of symptoms, which did not clearly fit in with any of the other anxiety disorders, would often receive a GAD diagnosis. This should not be the case and it is important that persistent and recurrent worry must be present in order for a GAD diagnosis to be made.

Cognitive therapy with a number of behavioural interventions form the central component to treatment for GAD. There are two levels to treating worry and GAD. The one is aimed at the content of worry. The irrational and dysfunctional nature of the thoughts associated with worry are identified and corrected and individuals are assisted in drawing more evidence-based conclusions that tend to be less catastrophic. The second level of intervention is aimed at worry itself. Worry is a mental activity (like a mental behaviour) that is believed to be associated with a number of inaccurate beliefs about the usefulness of worry. Meta-cognitive approaches (Wells 2007) help individuals understand their irrational beliefs about the usefulness (or dangerousness) of worry that keeps worry alive and drives the mental behaviour.