What is Generalised Anxiety Disorder?
Generalised Anxiety Disorder (GAD) is one of a range of anxiety disorders which include panic, agoraphobia, post-traumatic stress disorder, Obsessive Compulsive Disorder, social anxiety, specific phobias and stress.
GAD may exist alone but most commonly it coexists with other anxiety disorders, depression and physical health problems.
The key feature of GAD is worry and apprehension which is out of proportion to the circumstances. Typically the subject matter is widespread and the focus of the individual's concern shifts from subject to subject. The person involved tends to find GAD difficult to control which has consequences for their ability to work and function socially.
Other psychological and physical symptoms that may be present include:
- poor concentration
- increased sensitivity to noise
- sleep disturbance (typically finding it difficult to fall asleep)
- dry mouth
- urinary frequency
- frequent bowel movements
- shortness of breath
- inability to relax
- aching pains (particularly in the shoulders and back)
How many people suffer from GAD?
Globally estimates of the number of people who are likely to suffer from GAD during their lifetime vary from country to country from less than 1% to about 6.5%. In England the Adult Psychiatric Morbidity in England survey in 2009 estimated 4.4% of individuals were likely to suffer from GAD and as with depression prevalence rates are up to 2.5 times higher amongst females than males.
Why adopt a CBT approach to treat anxiety?
The NICE guideline in 2009 considered a wide evidence base of research and recommended CBT as the psychological treatment of choice for Generalised Anxiety Disorder.
CBT approaches have tended to reflect the changes in the way that GAD is diagnosed. Consequently, early CBT approaches for anxiety involved teaching an individual to challenge the specific content of their thoughts so that they became more rational. Other approaches have evolved that focus upon the repetitive process of worry and for instance target and individual's intolerance of uncertainty. These are often combined with applied relaxation techniques which focus upon the physical manifestations of anxiety.
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