Compassionate Treatment Plans for Generalized Anxiety Disorder

Generalized anxiety disorder is not the same as “being a worrier.” It is a clinically defined condition where worry becomes so relentless and overwhelming that people cannot turn their minds off. 

The constant worrying associated with generalized anxiety disorder is also accompanied by physical symptoms like fatigue, muscle tension, disrupted sleep patterns, and a chronic sense of feeling that something is always going to go terribly wrong. Most individuals who have been diagnosed with GAD will report having trouble turning their mind off, even when in a safe and non-threatening environment.

If all of this sounds familiar to you, you are not alone, and you are not stuck. Generalized anxiety disorder is treatable. Using the right clinical resources and developing an individualized treatment plan based on your personal experience, you too can find long-term relief.

Generalized anxiety disorder (GAD) is a chronic type of anxiety disorder defined by excessive, irrational worry about a variety of everyday concerns such as work, health, financial issues, and relationships.[1] These worries are usually disproportionate to the actual likelihood or impact of feared outcomes and are extremely difficult to manage or stop. Unlike worry that is in response to a specific situation, those with GAD experience general anxiety across all aspects of their life, with their anxiety shifting to new areas and whatever presents itself next.

Generalized anxiety disorder affects millions of adults during their lifetime and affects women at higher rates than men.[2] Many people diagnosed with GAD have other anxiety-related disorders, depressive disorders, and substance abuse disorders as well, which is why it is very important that the treating professional has accurately assessed the client in order to develop an appropriately comprehensive treatment plan.

People with generalized anxiety disorder commonly present with combinations of psychological and physical symptoms that severely interfere with their functioning and quality of life.

Below are the most common:

Psychological symptoms

• Excessive, difficult-to-control worry occurring more days than not for at least six months
• Worry occurs across numerous concerns — not focused on one area
• Difficulty concentrating, mind goes blank or feels disorganized
• Increased irritability and emotional responsiveness
• Persistent sense of dread or anxiety about something going wrong
• Mental catastrophizing — jumping to the worst possible outcome

Physical symptoms

• Chronic muscle tension, especially in the neck, back, shoulders, and jaw
• Low energy levels, even after adequate rest or sleep
• Disrupted sleep, difficulty falling asleep, staying asleep, or waking unrefreshed
• Feeling restless or on edge
• Headaches
• Abdominal and gastrointestinal symptoms like nausea or stomach discomfort

The most debilitating aspect of generalized anxiety disorder is often its physical symptoms; however, these are frequently mistaken for unrelated health problems. This often leads to delayed diagnosis of the true underlying cause and access to proper treatment.

The development of generalized anxiety disorder results from the interplay of genetic factors, biological and neurological factors, psychological factors, and environmental factors.

• Genetic factors —  GAD runs in families, and studies have shown a substantial heritable component of this condition; however, genetics alone do not determine whether or not someone will develop it.[3]
• Neurobiological factors — Differences in how the brain processes fear and threat detection, including dysregulation of neurotransmitter systems involving serotonergic, norepinephrine, and GABA systems.[4]
• Psychological factors — Cognitive patterns that involve an intolerance of ambiguity, a distorted perception of risk, and the belief that worrying is helpful or necessary to prevent adverse outcomes.[5]
• Environmental factors — Chronic stress, major life transitions, traumatic events, and prolonged exposure to unpredictable or uncontrollable environments.[6]
• Comorbid conditions — GAD frequently co-occurs with panic disorder, social phobia, OCD, PTSD, depression, and substance use disorder, and each comorbid condition can worsen the total burden of anxiety.[7]

GAD is often under-treated because many people with it consider their constant fear as a part of who they are instead of recognizing it as a clinical condition that could be treated. 

You should look into seeking professional help when:

• You find yourself worried almost every day and have difficulty managing those worries
• Your concerns are affecting your job, your social life, sleep, or health
• You find that coping methods such as relaxing and exercise are not enough to keep your fears from growing
• You find yourself using alcohol, drugs, or other avoidance behaviors to help calm your fears
• Co-occurring depression, panic attacks, or other mental illness has developed
• A healthcare professional has evaluated your symptoms as moderate to severe

Seeking treatment earlier in the course of GAD produces better outcomes. If your anxiety continues untreated for long periods of time, avoidance habits and distorted thinking patterns become more deeply entrenched and harder to change.

The first step in treating GAD at Agape is a full clinical evaluation of the client’s symptoms, including determining the degree of each symptom, previous treatments, other conditions, and individual goals. Once we understand where you are, we will develop a plan specifically tailored to you instead of applying a one-size-fits-all protocol. 

Important aspects of GAD treatment at Agape include:

• Cognitive-Behavioral Therapy (CBT) — The gold-standard evidence-based treatment for GAD.[8] CBT focuses on cognitive restructuring to help the client change the “what if” ideas that support worry, helps identify distorted thinking by completing thought records, and teaches skills to avoid anxiety-provoking situations and tolerate uncertainty.
• Mindfulness and Mindfulness Meditation — Structured mindfulness meditation practices increase awareness of the current moment and reduce anticipation. Clients practice mindfulness both during sessions and outside of them.
• Relaxation Techniques  — Focused on developing relaxation skills that directly address the physical aspects of GAD. Examples include progressive muscle relaxation, deep breathing exercises, and guided imagery.