Generalized Anxiety Disorder (GAD)
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If you are interested in counseling for Generalized Anxiety Disorder and Worry, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.
What is Generalized Anxiety Disorder?Generalized Anxiety Disorder (GAD), is defined as frequent excessive anxiety and worry across multiple life domains. In association with the worry, the individual may experience the following:
GAD is essentially a fear of bad things happening in the future. Individuals with GAD worry about a large variety of fears such as a loved one dying or being in a serious accident, something horrible happening to their children, money/financial security, getting a serious illness or dying, how they are performing in their jobs, losing their job, being evaluated by others, making mistakes, etc. Individuals with GAD find it very difficult to control their worry and describe the thoughts as repetitive. They also often describe worry as almost compulsive in nature. Long periods of time may go by before the individual realizes that they have been steeped in worry and chasing "worry rabbits down worry holes." |
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While worry can be a normal and even adaptive component of normal life, individuals with GAD tend to significantly overestimate the likelihood of bad things happening, overestimate the cost of those bad things happening, and underestimate their ability to handle those bad things. They also tend to have difficulty tolerating uncertainty and distress and get "stuck" in "what if" loops. They might also have beliefs that further perpetuate their worry such as believing that worry is a necessary safety measure or that worry is being responsible. These beliefs all maintain the disorder.
Importantly, worry itself is conceptualized as a cognitive avoidance strategy (even though it might feel like the opposite). This may sound confusing, since worrying feels like the opposite. However, worry is thought to be a verbal/linguistic process versus an "imaginistic" process, the former of which distracts and inhibits appropriate appraisals of threat (Borkovec, Sahdick, & Hopkins, 1991). In addition to worry, an individual may engage in other cognitive avoidance strategies such as planning and distraction. Individuals with GAD also frequently engage in overt safety behaviors to reduce their feared consequences from happening (e.g., texting their loved one repeatedly to reassure themselves that their loved one is safe, googling information about feared illnesses or conditions, procrastination, over-preparation, etc.). Unfortunately, all of these avoidance strategies only serve to perpetuate worry and fear and the individual ends up inadvertently maintaining their symptoms. Lastly, individuals with GAD report that, if the thing they were worried about recently has been resolved, they will start scanning for threat to make sure everything is safe, and will inevitably find something else to worry about.
Importantly, worry itself is conceptualized as a cognitive avoidance strategy (even though it might feel like the opposite). This may sound confusing, since worrying feels like the opposite. However, worry is thought to be a verbal/linguistic process versus an "imaginistic" process, the former of which distracts and inhibits appropriate appraisals of threat (Borkovec, Sahdick, & Hopkins, 1991). In addition to worry, an individual may engage in other cognitive avoidance strategies such as planning and distraction. Individuals with GAD also frequently engage in overt safety behaviors to reduce their feared consequences from happening (e.g., texting their loved one repeatedly to reassure themselves that their loved one is safe, googling information about feared illnesses or conditions, procrastination, over-preparation, etc.). Unfortunately, all of these avoidance strategies only serve to perpetuate worry and fear and the individual ends up inadvertently maintaining their symptoms. Lastly, individuals with GAD report that, if the thing they were worried about recently has been resolved, they will start scanning for threat to make sure everything is safe, and will inevitably find something else to worry about.
What is the Treatment for Generalized Anxiety Disorder?
Cognitive-Behavioral Therapy (CBT): Cognitive-Behavioral Therapy (CBT) is the treatment of choice for GAD and is considered to be evidence-based. CBT includes many components and is based on the principle that thoughts/beliefs (Cognitions), emotions, physical symptoms, and behaviors are all intricately related. Helping someone feel better in CBT will typically involve changing unhelpful thoughts/beliefs (Cognitions), emotions, and behaviors via a variety of tools such as cognitive restructuring, emotion regulation and distress tolerance skills, mindfulness, behavioral activation, coping skill development, interpersonal effectiveness skill refinement, trauma processing, etc.
The goals of CBT for GAD are to:
- Provide psychoeducation regarding the maintaining factors in GAD and how worry works and the relationship between situations, thoughts, emotions, and behavior.
- Evaluate and alter assumptions about the likelihood and cost of feared consequences via cognitive restructuring and behavioral experiments.
- Evaluate and alter assumptions about the client's own self-efficacy (their belief in their ability to handle challenges, bad things happening, and their own anxiety).
- Identify and alter other related beliefs that perpetuate and maintain the client's worry (e.g., beliefs about the function of worry, beliefs about responsibility, beliefs about perfectionism, beliefs about the controllability of worry).
- Help the individual distinguish between "helpful" and "productive" worry versus "unhelpful," maladaptive, unproductive worry.
- Alter both cognitive and behavioral avoidance strategies and help the individual face their fears to allow for habituation and healthy evaluations of their feared consequences (likelihood and cost estimates).
- Increase emotional engagement and uncertainty tolerance and decrease cognitive avoidance.
- Teach the client attention focus retraining from internal and external threat focus to task-focused attention
- Learn problem-solving skills to apply when appropriate
- Learn worry postponement strategies
- Learn mindfulness skills
- Help the client increase their acceptance of uncertainty
- Teach our client's to live consistently with ones values
OakHeart Generalized Anxiety Disorder Counselors, Psychologists, and Social Workers
Generalized Anxiety Disorder Related Blogs:
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Essentially, Generalized Anxiety Disorder (GAD) is chronic worry (American Psychiatric Association, 2013). I often describe it as the tendency to get on the hamster wheel of worry. Worries spin around and around, continuing to fuel anxiety. If you are diagnosed with this, you will also be experiencing the physical impact of this anxiety, such as sleep difficulties or muscle tension....(to read more, click on the link above).
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Chronic, persistent worry, exhibited in individuals with generalized anxiety disorder tends to fall into two categories (American Psychiatric Association, 2013): Worries about solvable problems and worries about unsolvable problems. Often my patients with Generalized Anxiety Disorder (GAD) are incredibly good at managing solvable problems. If you are reading this and you have been diagnosed with GAD, I bet you have been called an effective problem solver by people who know you well. Worrying about unsolvable problems similarly is often an attempt to solve a problem that has not yet occurred...(to read more, click on the link above).
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