We all feel anxious from time to time, especially in reaction to stressful events, but when anxiety continues and interferes with daily activities, it can be a sign of a Generalized Anxiety Disorder (GAD). All people with anxiety disorders have the following traits:
1. Intolerance of Uncertainty
Understandably, we mostly worry about things where the outcome is uncertain. Worry is a natural reaction to uncertainty, and it can be seen as a way of trying to predict the future and manage the experience of uncertainty. People with a worry problem tend to be especially uncomfortable with uncertainty. Some would even prefer bad things to happen rather than live with the sense of not know what will happen next. Goal of treatment would be to remove the need to know the outcome of each moment, including:
Going to a film they know nothing about. Going to a different shop for their groceries. Ordering something they have never had before at a restaurant. Making opportunities to meet new people. Breaking routine.
2. Positive Beliefs about Worry
Compulsive worriers tend to believe that worry helps them in some way, though they may not be fully conscious of this. Some common beliefs they have are:
Worry finds solutions to problems. Worry motivates me to do things. Worry prevents possible dangers from happening. Worry shows I care.
They tend to believe these things with little evidence to support them.
3. Negative Problem Orientation
Worriers tend to use unhelpful strategies to try to solve problems, for example:
Seeking reassurance for decisions. Seeking out excessive information before making a decision. Making lists as a substitute for actions. Being overly busy. Throwing oneself into activity rather than problem solving (e.g. cleaning). Procrastination.
Then, they worry that they made the wrong decision.
4. Cognitive Avoidance
Because excessive worry is distressing, many GAD sufferers become worried about their worrying, so they go to the other extreme and push all upsetting ideas out of their mind. This is not a helpful strategy either, as real concerns and issues do need to be faced, and “fearing fear itself” does not improve the situation.
5. Underdeveloped Decision-making Skills
People with GAD are often unsure about how to make decisions and live with the results. This is a natural part of living and growing as a person. When this skill remains underdeveloped, a person fails to take risks, grow, and mature. They adhere more and more to anxiety-based rules and live less.
When worry is compulsive, hard to control, excessive, inappropriate (i.e. usually about minor things), circling around the same anxious predictions again and again, then we have a real mental health issue. This type of compulsive worry is Generalized Anxiety Disorder (GAD). 4-7% of the population will develop GAD at some point in their lives, women slightly more than men. In terms of remission, GAD symptoms rarely abate naturally over time.