Is it normal to worry?
Updated: Dec 12, 2019
Feeling anxious is a normal human emotion, sometimes referred to as a feeling of unease, worry or fear. Think about how you felt the last time you sat an exam. However, if these feelings start to affect someone's daily life, they may have an anxiety disorder such as Generalised Anxiety Disorder (GAD).
GAD is a long-term condition that is thought to affect up to 5% of the UK population. It affects similar numbers of men and women and is most common in people aged 35-59, although it can affect people of any age.
Other anxiety disorders include panic disorders, phobias, post traumatic stress disorder (PTSD), obsessive compulsive disorder, phobias and acute stress disorder. GAD often occurs alongside these other anxiety disorders.
What Causes GAD?
It's not known exactly what causes GAD, but the current evidence suggests that the following factors may play a role.
A past traumatic experience
A long term health condition
Overactivity in specific areas of the brain linked with emotion and behaviour
Imbalance of serotonin and noradrenaline, chemicals involved in mood regulation
As with many mental health conditions, there are people who develop GAD with no obvious cause.
What are the symptoms of GAD?
People who have GAD feel anxious on most days, may not remember the last time they felt relaxed and may have a tendency to always think the worst. The anxiety may significantly affect their daily life and be extremely stressful, upsetting or uncontrollable. GAD can be diagnosed if the person has had symptoms for at least 6 months.
GAD can cause both physical and psychological symptoms.
Feeling restless, worried or 'on edge'
Having trouble concentrating
Having trouble sleeping
Trembling or shaking
Stomach ache, nausea and/or vomiting
Pins and needles
Some people may experience more symptoms than others and they may withdraw from social contact and take time off work. Interestingly, these actions can make the problem worse by negatively affecting their self-esteem.
How is GAD Diagnosed?
If someone is experiencing any symptoms of GAD, they should be encouraged to see their GP.
The GP will talk to the person to try and establish what is going on. They may want to rule out other causes which may have similar symptoms (particularly Panic Disorder), and they may want to treat any other contributory problems before treating GAD.
In order to diagnose GAD, the following points need to be met:
2 major symptoms and 3 minor symptoms from the official classification system
Symptoms present for at least 6 months
The problem is causing significant distress or is impairment of social life or work
How is GAD Treated?
As with most mental health conditions, GAD can be well managed using a combination of self-help and therapeutic options. The aim of treatment is complete relief of symptoms (remission).
A stepped-care model is used to organise the provision of care to people with GAD.
Step 1 - Education about GAD and treatment options
Step 2 - Individual self-help and psycho-educational groups
Step 3 - Cognitive Behavioural Therapy (CBT)/ Applied Relaxation or drug treatment
Step 4 - Complex psychological and drug treatments, often with multi-agency input
A GP can organise referral to the psychological therapies in Step 3 but the individual may also self-refer through their local Community Mental Health Team or directly to their local service.
Self-help strategies may be 'non-facilitated', or may be 'guided' activities. These include the common mental health self-help activities, including:
Good sleep hygiene (regular bedtimes and about 8 hours sleep)
Having regular social contact with family and friends
Getting regular exercise
Eating a healthy, balanced diet
Minimising consumption of alcohol and caffeine
Joining online or face-to-face support groups
Using clinically validated self-help books, online courses and apps, such as those in the NHS Apps Library
In summary, anxiety is a normal human emotion, but if it's affecting a person's daily life, they may have an anxiety disorder.
Encouraging them to undertake self-help activities and seeing their GP or local Community Mental Health Team should start them on the road to controlling their symptoms.
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