Much ado about nothing

PHOTO: Much ado about nothing

THERE are people who get extremely worried about everything in life. Sometimes, there is little or even no reason to worry. There are others that even worry about getting through the day. They tend to worry about the little things in life that are usually trivial by other people's standards.

These people are more inclined to think that things will go bad and are always seen as pessimistic in nature. If you too have these feelings, than it is possible that you have a condition called generalised anxiety disorder (GAD).

What's GAD?

This condition is characterised by feelings of excessive anxiety and worry. These feelings last for most days, or even daily, and would usually involve most activities of the person's life. This means that the person feels and acts in this way most of the time, whether he is at home or at work.

Most of us have our own set of problems or worries, but people living with GAD find it difficult to control their worries. Most often, they are worried about multiple problems that are usually trivial in nature.

Most patients with GAD have trouble getting through the day as they are so worried that things will go wrong. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks.

GAD is something that takes time to develop and most people with GAD are anxious even from a young age. As children, they may have been extremely anxious about meeting friends or exams. Sometimes, these children may have even refused to go to school, especially on the first few days of every school year. Often, one of the parents may have needed to sit in the classroom or stay in the school to make the child feel safe.

The anxiety may be seen before and during exams, or when the child has to perform in public, for instance, during debates or public speaking, dances or drama.

Eventually, most of these children are able to be on their own in school, but they remain chronically anxious in later life.


What causes GAD?

GAD sometimes runs in families, but it is unclear why some family members have it while other don't. What is known is that GAD affects parts of the brain that are involved in fear and anxiety.

What are the common signs and symptoms of GAD? A person with GAD may experience the following problems:

  • Worry excessively about everyday things
  • Have trouble controlling their worries
  • Know that they worry much more than they should
  • Not able to relax
  • Have a hard time concentrating
  • Be easily startled
  • Have trouble falling asleep or staying asleep
  • Feel tired all the time
  • Have headaches, muscle aches, stomach aches, or unexplained pains
  • Have a hard time swallowing
  • Are irritable, sweat a lot, and feel light-headed or out of breath
  • Have to go to the bathroom a lot
  • They might experience low mood or feel sad
  • Some may also experience frequent gastric complaints


How is GAD treated?

Firstly, the person needs to talk to a doctor about the symptoms. Most people would discuss their problems with their general practioner. Usually, the doctor would make sure that the problems are not related to any physical ailments.

Sometimes, conditions like an overactive thyroid or heart ailment can mimic the symptoms of GAD. Once the doctor is certain that there is no physical problem, then he may refer the patient to a psychologist or psychiatrist for further management.

GAD is generally treated with psychotherapy, medication, or a combination of both.


Psychotherapy is a form of talk therapy between the therapist and the patient. A type of psychotherapy called cognitive behavior therapy (CBT) is especially useful for treating GAD. It teaches a person different ways of thinking, behaving, and reacting to situations, and that can help the person feel less anxious and worried.

Often, CBT is continued even after medications are discontinued. CBT is thought of as long term therapy as it helps to change the person's way of thinking. The person may still be anxious, but it helps him cope better.


Most people do not like medications, but if the symptoms are severe and CBT has not helped much, then oral medications are required to help control symptoms.

Generally, there are two types of medications commonly used to treat GAD - anti-anxiety medications and antidepressants. There are many different types of anti-anxiety medications. Most of these work fast, but they generally should not be taken for long periods. Sometimes, the doctor might use these medications for a short period, and then wean the person off it gradually.

Antidepressants are traditionally used to treat depression, but they also are helpful for GAD. However, they may take several weeks to start working.

The common side effects of these medications include headaches, or stomach discomfort, or even dry mouth. These side effects are usually mild and tend to occur during commencement of treatment.

To avoid such problems, your doctor would start off by prescribing low doses of the medication, and then increase it slowly over time.

You must ask your doctor about the side effects of any medications. Most of these medications are not recommended for children, and are rarely prescribed to teenagers. CBT is usually the first option for teenagers as they often do not respond well to antidepressants.

Some people do better with CBT, while others do better with medication. Some do best with a combination of the two. It is best to speak with your doctor about the best treatment for you.

How to make treatment more effective

Ways to make treatment more effective

It must be remembered that medications are only part of overall therapy. Simple changes in lifestyle can also be of great benefit.

Many people with anxiety disorders benefit from joining self-help or support groups, and sharing their problems and achievements with others.

Internet chat rooms can also be useful, but any advice received over the Internet should be viewed with caution. Talking with a trusted friend or family provides support, but it is not a substitute for care from a mental health professional.

Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy.

Other options include aerobic exercise, or even qi gong, which may have a calming effect.

Since caffeine, illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided. Check with your physician or pharmacist before taking any additional medications.

The family play a very important role in the recovery process of a person with an anxiety disorder. Ideally, the family should be supportive and understand the person's condition.

Family members should not trivialise the disorder or demand improvement without treatment. This is often the case with mental health issues as the symptoms are invisible and not physical. Most people respond and empathise better when symptoms are physical.

If your family is doing either of these things, you may want to bring them along to see your therapist. Your therapist can explain to them what's going on, and help them help you get better.