A Beginner's Guide to Generalized Anxiety Disorder

 At first, it can be hard to even recognize what forward movement even looks like.

At first, it can be hard to even recognize what forward movement even looks like.

When I was first diagnosed with Generalized Anxiety Disorder, I went searching high and low for a guide that would help me understand what I needed to know about what that meant and what I should do. It was a very confusing time. I googled like crazy, but found nearly nothing online that informed me in a real, useful way. This was way back in 2015, and at the time there was much less than there even is now. Many "guides" used the word worry repeatedly. Worry wasn’t what I did or how I identified. Overthinking, yes. Worry, no.

Then I read a quote from the tennis player Mardy Fish that captured my experience of anxiety in vivid detail. He says: “I wish I had been able to tell myself that I was doing great. But my frame of mind back then couldn't process great. All I could focus on was doing better.”

This short guide is meant to help people who, like me at the time, are just beginning their journey with GAD. If you find yourself googling like crazy and not being able to find answers to your questions: Welcome, kindred soul.

Q. What is Generalized Anxiety Disorder, exactly?

A. If you've already been researching this, you know that GAD is often described as a psychological disorder characterized by excess “worry” particularly about work, finances, and relationships. That's now how it felt to me. I've noticed that often people with GAD don't realize they have it for a long time in part because they don't think of themselves as worriers.

You might hear that GAD means you worry about worry. If you don’t even consider what you're experiencing as worry, that bit of information doesn’t help. And if you are so habituated to pushing away the worry as a coping mechanism, then descriptions like that will lead to a vicious avoidance cycle.

For me, having GAD means that I tended to overthink nearly everything, meticulously trying to figure it all out. When problem arose, I’d write them down and begin my crazed attack in every direction. More noticeably, it also meant crippling shoulder and neck pain and nausea, especially on buses. I used to get dizzy  at times, almost to the point of fainting. The physical symptoms are important: this is what can help you get diagnosed faster. Don't ignore them! 

Q. Can a person have GAD and not know it?

A. It's more common than not that people who have GAD see many doctors before they get properly diagnosed. Gastroenterologists, chiropractors, neurologists, acupuncturists, and gynecologists are some of the people Gaddies might visit on the path to diagnosis.

Q. Is GAD hereditary?

A. Yes, there is a genetic component, but as is often the case, that’s only one part of the equation. Genetic roots and predisposition to anxiety disorders can be triggered by environmental factors. The death of a loved one, divorce, the sudden loss of a job or your house, or a big change in circumstance can bring on episodic fare-up of GAD.

Q: If GAD flares up, does that mean it’s dormant at other times?

A: Even if you're predisposed to GAD, with proper treatment, you can bring your symptoms into check. Since you are predisposed to this condition, when things happen to you, you will be more likely to have bigger anxiety responses than other people. 

Q. How messed up is someone with GAD, exactly? Please be specific.

A. It depends on the person. My GAD makes me aware and worried about silly stuff like taking out the garbage. My family teases me about my absurd fear that if I miss taking out the garbage, our house will be overtaken with garbage. It makes me laugh, but the laughing doesn't stop my anxiety symptoms from coming around every Sunday.

Or this example from years ago, when a few ants were coming through our bathroom window. My response was immediate: "Let's replace the window." It didn't matter that we couldn't afford it. I just wanted the stress to go away. And why was there stress? It was because I didn't see the few ants on the floor. I saw an inevitable 100–200 ants that I imagined would invade and carry off our house.

It’s very hard to be in the here and now when catastrophizing. (Catastrophizing is a cognitive distortion. Learning to recognize cognitive distortions is one important element of cognitive behavioral therapy, the best method for treating GAD.)

A neighbor put it well when he said: “I realized that I did everything in a rush—even simple things like brushing my teeth or making coffee. Eighty percent of what I do on a typical day does not require hurrying and rushing. That rushing creates a lot of stress throughout the day.” I know exactly what he means. I sometimes have the feeling that if I don’t get a certain small household task done at any given moment, the world might end.

Gaddies are not known for their patience.

Q. If I have GAD, how do I make it go away? Does it last forever?

A. Learning to ride the wave is a great place to start. When stressful things happen, you can expect to feel your own particular gremlin poke his head out of the wave’s crest. Knowing what to do with him and that I’ve survived his visits before helps a lot. Here's some more information about whether generalized anxiety goes away.

My own personal trifecta of how to settle the wave is: Meditation. Medication. Communication. Of course, each person has different needs and a different approach. The way to figure out what works is to experiment.

Q. Can anyone develop GAD? What’s the line between having it and just being a regular stressed out American?

A. The difference between regular anxiety, stress, and GAD comes down to degree. Most people with everyday stress and anxiety aren’t fainting or getting up in the middle of the night. They don’t need neck rubs every day. And they aren’t negatively predicting the outcomes of regular social interactions in a way that adds extra stress to daily life.

A fellow Beautiful Voyager described it this way: “I tend to project into the future all the time. I’m often planning how to deal with some negative turn of events that might happen in the future. Most likely never will. So I’m worrying in the present about something that will never happen in the future.”

If his experience sounds familiar, you might want to keep reading about Generalized Anxiety Disorder.

Q. Is GAD what has been wrong with me?

A. If what you're reading here rings that inner bell of familiarity, you might want to pick up the book The Worry Cure. Don’t think about the title too much. Just investigate your physical symptoms through the lens of your thoughts paying attention to whether what this book has to say relates to you. If it doesn't, then it's likely not GAD that's been bothering you.

Q. Will I ever feel better if I have GAD?

A. I believe that you can feel better if you have GAD. Simply the fact that you're reading this now means that you're on the path.

Q. How do you know?

A. Times are changing. People are talking openly about depression, anxiety, and other forms of mental suffering in a way that they never did when I was younger. The more people speak openly about the spectrum of mental conditions, the more they can be helped earlier on.

Q: What should I do if I’m a friend or family member of a Gaddie?

A: I feel for you. It’s not easy to deal with an anxious person, especially at the high pitch levels that people with GAD specialize in. It’s hard to avoid the role of friend-therapist. You might find yourself talking your friend down and trying to give them a more realistic view of their surroundings. The goal is to help them build those muscles for themselves without exhausting yourself. Bottom line: put the oxygen mask on yourself first.

On the other hand, GAD often presents as perfectionism or invulnerability, so it can be confusing. How do you help someone who doesn’t seem to need help? By tuning in to your instincts. Is the person talking super fast? Are they in a lot of physical pain? If so, they may need to help to learn a new way of thinking about the world around them/

You can gently encourage them to stay grounded in the moment. Send them a link to this piece. Do it with love.