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Are you suffering from GAD?

Do you worry about worrying? Are you unable to switch off and relax, even at weekends or on holiday? Do you have trouble sleeping or constantly check your phone and fret about messages you may have missed? You could be suffering from generalised anxiety disorder, warns Christine Fieldhouse

By Christine Fieldhouse
12 Sep 2014 | 12:00 am
  • Picture for illustrative purpose.

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  • Being constantly connected and permanently alert is perhaps the reason for the rise in GAD.

    Source:Getty Images Image 2 of 2

With our brains working on overdrive, we have a 1,001 things to do, read and deal with during our waking hours. Demands come from all directions – from our mobiles, laptops and computers as well as the old-fashioned type of interruption or request when a colleague drops by our desk or our family asks something of us.

Sometimes we’re so rushed off our feet we joke we’ll meet ourselves coming back, and for many people, multitasking is a way of life. Gone are the days when we went for a stroll to smell the roses. These days we would do a triathlon, then return and nurture the roses, prune them and make them into a stunning hand-tied bouquet, which we’d then drive 50km to deliver!

We have become a generation that lives on our nerves, day and night. Even when we’re eating or watching a movie, some of us can’t stop checking our phones for text messages while others sleep with a mobile phone or iPad by their beds so they can reply to messages throughout the night. On holiday, we make sure our hotel room has Wi-Fi so we can keep up to date with emails. It seems impossible – and socially unacceptable – to switch off properly. If we don’t reply to messages instantly, people ask if we’re OK.

But living in such a permanently alert state has had a knock-on effect on our mental health, and now increasing numbers of people suffer from GAD, or generalised anxiety disorder. While anxiety is a feeling of unease, such as worry or fear about medical tests or our children’s exams or a job interview, and passes once the event is over, GAD is a long-term condition that causes us to feel anxious about a range of situations and issues. When we suffer from GAD, we feel anxious most of the time and often we can’t remember the last time we felt relaxed.

Dr Yaseen Aslam, a consultant psychiatrist at the LightHouse Arabia in Dubai (www.lighthousearabia.com/psychiatry), says many of us have experienced worry at some stage of our lives, but GAD is persistent worry and apprehension. “Individuals experiencing GAD tend to worry about worrying and often the degree of worrying and apprehension is difficult to control,”
says Dr Aslam. “Although GAD has
many features in common with
other psychiatric conditions such
as phobic disorders and panic disorder, it is a different condition.”

Exactly how many people suffer from GAD is still unknown, largely because many don’t seek treatment. But a study in the UAE in 2000 found that of
254 patients at an outpatient walk-in clinic, 25.8 per cent of men and 47.1 per cent of women suffered from anxiety. In the UK GAD is thought to affect one in every 25 people, while the National Institute of Mental Health in the US says about 6.8 million people suffer from it.

It can begin at any point, although the years between childhood and middle age are the time of highest risk.

“Some studies indicate that more women are affected than men and the condition is becoming more common in the 35 to 55 age group,” says Dr Aslam.

UK-based Dr Marilyn Glenville, who specialises in women’s health, says GAD is now much more common than we think and women, especially, are feeling their lives are governed by stress and tension. “It affects women much more than men,” says Dr Glenville, author of The Nutritional Health Handbook for Women. “Women have always been the carers, and busy thinking about other people, so they have little or no time for themselves. With extra pressures and the feeling there isn’t enough time,
life is much faster now.”

But how can we tell if we or others are suffering from GAD?

According to Dr Aslam the most common symptoms are constant worrying, even over the smallest matters, feeling restless and irritable, having disturbed sleep and sweating, nausea and vomiting. Sufferers often have muscular tension and pain and they have poor concentration and memory. They also have a strong sense of foreboding, as if something negative is about to happen.

He adds, “I recently saw a 31-year-old senior executive who has long-standing problems with poor confidence and low self-esteem due to childhood trauma. He experienced marked GAD symptoms after a relationship broke down. This, coupled with the stress of managing a team in a high-pressure and competitive work environment, resulted in significant and persistent worrying.”

Like this executive, many GAD sufferers have undergone a stressful life event in earlier years, such as abuse or the death of a parent. But with GAD the symptoms persist once the trigger has gone, and sufferers may react to minor stresses like the car breaking down or the queue at the mall the way they reacted to the initial trauma.

Other causes are our genetic make-up and it’s thought anxious personalities can run in families.

Finnish scientist Iiris Hovatta, who supervised a study looking at the link between genetics and anxiety disorders, said environmental factors, such as stressful life events, may trigger an anxiety disorder more easily in people who have a genetic predisposition to the illness.

Dr Glenville, who is a nutritionist, believes our modern lifestyle also fuels GAD. She says our high intake of caffeine and sugar – which, ironically, we turn to when we’re feeling stressed – actually makes us more stressed because they cause ups and downs in our blood sugar levels. This leads to adrenaline and cortisol, our flight-or fight hormones, being released, leaving us in a constant state of anxiety. “Caffeine and sugar get people trapped in a vicious circle,” says Dr Glenville. “They may give a momentary relief and satisfaction, but they make us hyper vigilant. We think our lives are in danger and we stay in a state of high alert.”

When they suspect GAD, good psychiatrists will take a detailed history of the symptoms, and will pay particular attention to childhood and the patient’s personal history. Often tests will be undertaken to rule out physical conditions that cause GAD – gastroesophageal reflux disease, thyroid conditions and heart disorders are three examples. A psychiatrist will also assess the risk of self-harm, if appropriate.

GAD is a serious issue, but there is hope for sufferers. While experts say it can be
a lifelong condition, especially if it goes untreated, studies have shown that most patients improve significantly or recover once they have specialist treatment.

Dr Aslam confirms GAD is treatable, and once there has been a diagnosis, it’s important for the health practitioner and patient to work together on a programme of treatment. He adds that certain antidepressant drugs such as SSRI medications, which are licensed to treat anxiety disorders, are sometimes used. “Psychiatrists also use other prescription controlled medications such as buspirone,” says Dr Aslam. He adds that various talking psychotherapies such as counselling and cognitive behavioural therapy
have also proven to be effective.

Patients are also urged to follow a balanced diet and exercise regime, to get adequate sleep and to use relaxation techniques.

Dr Glenville says the first step we
can take is to give up caffeine and
sugar, but she acknowledges that,
in itself, it isn’t easy.

“Some people have the personality that means they can stop having caffeine and sugar in one go, but for others, it might be easier to get off them in small stages,” she suggests.

“Caffeine is a stimulant and it makes people much more agitated, so if they can cut down or give it up, they’ll start to see a difference quite quickly. If they could also cut down on their chocolate biscuits and cakes during their breaks at work, for example, they will start to feel better almost immediately.

“Feeling this good will encourage them to carry on. It could take a good two weeks for the body to realise
it isn’t actually under threat and
that it is safe.”

Dr Glenville, who works with clients from all over the world by telephone and Skype, also recommends supplements of B vitamins and magnesium, which is a calming
mineral for the body.

“Cutting out caffeine and sugar
from your diet takes some commitment at first, but I’ve seen people do it so many times and if they get it right,
their lives are transformed. They get a much better quality of life and once their bodies are calmer, their GAD eases,” she says.

By Christine Fieldhouse

By Christine Fieldhouse