According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), generalised anxiety disorder (GAD) is characterised by excessive anxiety and worry about a number of events or activities, occurring more days than not for at least six months. While occasionally feeling worried is a normal part of life, people with GAD tend to worry more frequently and find it difficult to switch off from worrying.
What Does Generalised Anxiety Disorder Feel Like?
GAD involves experiencing excessive and persistent worry in day-to-day life. It can significantly interfere with a person’s wellbeing and quality of life. Sometimes the person with GAD can perceive constant worrying as a normal, or even necessary, state of being. They may believe that ongoing worry is an essential part of everyday life because it helps them get things done, stay prepared or remain safe.
Why Can Worry Feel Like A Way To Stay In Control?
Sometimes, people feel that the only thing that would relieve their anxiety is gaining a sense of certainty, and that worrying will eventually lead to this outcome. However, if we stop and observe what actually happens, worry rarely leads to genuine certainty.
Even when it provides temporary reassurance, we are likely to find the next thing to worry about. In fact, experiencing periods of certainty or temporary relief can sometimes lead to worrying about not worrying, such as: “I’m not worrying, so I must be missing something. I need to worry so that I can remain alert and ready to deal with anything that might happen.”
Thus, the perceived function of anxiety can lead to a never-ending struggle for certainty and control in a world where neither is reliably available.
An important part of managing GAD is therefore learning not to try to eliminate uncertainty, but to demonstrate to oneself that uncertainty is normal and alright. This can be worked on in various ways. Here are three key tools you can practice in your own time which are based on treatment guidelines for GAD (NICE guidelines).
3 Ways To Help Manage GAD
1. Practise mindfulness
Mindfulness involves paying attention to the present moment without judging or attempting to change what is happening. When experiencing worry, it can be helpful to notice the thoughts as thoughts rather than treating them as facts or problems that must immediately be solved. For example, instead of becoming caught up in “What if something goes wrong?”, a person can acknowledge, “I am having a worrying thought about something that might happen”
Mindfulness can also involve bringing attention back to the present through the senses, breathing, or activities that are happening in the moment. The aim is not to stop anxious thoughts from coming, but to develop the ability to notice them without automatically engaging with them.
2. Set aside designated “worry time”
Another useful strategy is to establish a specific period of the day for worrying. When a worry arises outside this period, it can be acknowledged and written down rather than immediately acted upon. You can then remind yourself that you have allocated time to consider the worry later.
During the designated worry period, you can review the worries you have recorded and consider whether there is a practical action you can take. If there is, you can identify a specific next step. If there is not, you can practise accepting that the uncertainty cannot be completely resolved. Over time, this approach can help reduce the amount of time spent engaging with worry throughout the day.
3. Practise progressive muscle relaxation (sometimes referred to as applied muscle relaxation)
Progressive muscle relaxation (PMR) can help reduce physical tension associated with anxiety. It involves systematically tensing and then relaxing different muscle groups in the body, from head to toes or vice versa. Here is an example of a guided PMR available online: 7 Minute Progressive Muscle Relaxation Exercise: Feel the Tension Instantly Leave Your Body
Practising PMR regularly can help you become more aware of physical signs of anxiety and learn how to deliberately release some of the tension associated with them. It can be particularly useful when anxiety is accompanied by physical symptoms such as muscle tension or difficulty relaxing.
Conclusion
Living with GAD can involve becoming caught in a cycle of worry, uncertainty, and attempts to gain control over situations that cannot always be controlled. Although worry may initially feel useful or protective, it does not necessarily provide the certainty or reassurance that a person is seeking. An important part of managing GAD is therefore learning to respond differently to uncertainty rather than continually reacting to it.
