Generalized Anxiety Disorder: What it is, how it works, and what treatments are available
My mother is the only person who always understands how I’m feeling, and she knows just what to say to ease my suffering. As a kid it seemed like I was just a little more sensitive and cautious than the other kids, but either way I still would tend to feel like I didn’t belong some days. When I was fourteen I visited a psychiatrist who diagnosed me with Generalized Anxiety Disorder (GAD); at the time I had no idea what the words she was saying to me even meant. That was the day that my mother revealed to me that she also suffers from GAD. It is difficult for people without anxiety disorders to understand how constant the anxious feelings really are and that they can escalate to become much more severe than any normal anxiety. I’ve been knowingly living with GAD for four years now and I have many questions about it that have yet to be answered. Considering my mother and I both suffer from this disorder, I want to know if it could possibly be genetic or if I was simple conditioned to it from observing her. I also am curious about what happens in the brain of someone who suffers from generalized anxiety disorder and how it causes the symptoms. Most importantly I want to find information on possible treatments that would not only allow me to deal with my anxiety in a way that will better my life, but also I need to know how I can help my mother because seeing her deal with this disorder and being able to relate to her pain inspires me to make some changes that will hopefully benefit both of us. I was surprised to discover how many different types of anxiety a person can experience; Dr. Roxanne Dryden-Edwards, an assistant professor of psychiatry at John Hopkins Hospital in Maryland, explains that anxiety can even be beneficial in cases such as that of performance anxiety which can actually heighten a person’s performance. Anxiety disorders such as GAD tend to be detrimental, inhibiting a person’s performance in everyday life. Generalized anxiety disorder causes irrational fears and worries that make it difficult for a person to sleep, think, and function in everyday scenarios. Anxiety puts the body in a state of panic as if it were in danger, so the symptoms that accompany the disorder tend to be mostly emotional and behavioral including thoughts and reactions that spawn from the feelings of panic (Dryden-Edwards). Robin Henig is a freelance science writer for The New York Times Magazine who received the Guggenheim Fellowship award for Natural Sciences. Henig says that although everyone will experience some kind of anxiety in their lives, others who suffer from anxiety disorders are forced to deal with anxious thoughts and feelings almost constantly throughout their lives. Daniel Smith is a writer who began his career at The Atlantic Monthly where he was an editor. He recently wrote a book titled Monkey Mind: A Memoir of Anxiety in which he explores not only the emotions that come with anxiety but also the clinical condition itself. Most anxiety sufferers know that their thoughts and fears are irrational and they know that they can get help, but the anxiety makes them reluctant to do anything at all. People often do not see their anxiety for what it is, “a habit of mind”; since they do not view it as a habit that they can overcome they usually take no actions at all to fixing their problem because they believe it is something that they cannot change. (Smith). I never considered my anxiety to be a habit, and so I believed that it was something that I would have to deal with for the rest of my life. I was prescribed medication for it and that made it seem like it was something I could not control or lessen by my own means. Dr. Elizabeth Hoge, psychiatrist at the Massachusetts General Hospital’s Center for Anxiety and Traumatic Stress Disorder says “People with anxiety have a problem dealing with distracting thoughts that have too much power. They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit.” (qtd. in Corliss). To the average person it may seem that Hoge’s point of view is in conflict with Smith’s, as he believes that anxiety sufferers are aware that many of their worries are not beneficial to them; however, I perceive these two ideas to be referring to different situations. There are times when I am frustrated because I know that my worries are unrealistic but they still continue to pain me, while other times I feel so confused that I cannot discern what is and is not worth my worrying. It is as if every day is different because I never know when I’m going to be fine or almost completely nonfunctional due to my anxiety. It seems like it would be very difficult to have common cases of GAD because the feelings that are accompanied with it are so sporadic and unpredictable that no case of this disorder can be classified as ordinary. It, ironically, cannot be generalized.
Don and Sandra Hockenbury are a husband and wife duo of Psychologists, and together they have written a popular series of Psychology textbooks. “Generalized anxiety disorder is like the dull ache of a sore tooth—a constant ongoing sense of uneasiness, distress, and apprehension.” (Hockenbury and Hockenbury 568). This is a perfect analogy for generalized anxiety disorder; the feelings are always there lingering even when it seems like there is nothing to worry about. GAD is sometimes referred to as “free-floating anxiety” because the anxiety can occur due to anything, or sometimes nothing at all (Hockenbury and Hockenbury 567). It is disheartening feeling anxious almost all of the time, especially when there is nothing in particular triggering it. It seems like it is impossible to make the feelings go away when the cause of them cannot be pinpointed. Normal anxiety fades shortly after the triggering situation is over, but with generalized anxiety disorder when one worry is resolved it is almost instantly replaced with another (Hockenbury and Hockenbury 567). This gave me a realization; I always assume that my worries will be dissipated once the cause of them is no longer present, but this has never been the case. No matter how many of my worries are resolved there will always be more that will leave me feeling dissatisfied and anxious. “Individuals with a family history of anxiety and depression are more at risk for having generalized anxiety disorder.” (Dryden-Edwards). I am curious to find out if this finding is due to a genetic disposition to the disorder or a result of the child being nurtured into developing the disorder by someone else who has it, or possibly a combination of both. This plays into the idea of the nature versus nurture debate; I could be anxious because I inherited it from my mom, because she nurtured me into it, or most likely a mixture of both factors. William Meek has had experience working with mental health patients including those dealing with generalized anxiety disorder. He earned a B.S. in psychology and received his Ph.D. in counseling psychology. Meek said “The gene or set of genes responsible may remain dormant for a person’s entire life if the other factors are never experienced, or the genes may be expressed from a very early age.” The environment in which a child grows up can be a factor in whether or not they develop GAD. If a child has a parent with the disorder they may be predisposed and the anxiety of the parent could trigger similar anxiety in the child. GAD has genetic vulnerability meaning a person might be biologically predisposed to the disorder and it will develop when the necessary factors are present (Meek;Vanin and Helsley). John Vanin is a doctor of psychiatry with over thirty-three years of experience, and is currently working in West Virginia. Dr. James Helsley specializes in geriatric medicine and has been certified by the boards of Family Practice and Geriatric Medicine. Due to an experiment by professional Harvard psychologist Jerome Kagan, it has been concluded that some people are born with anxiety disorders and environmental factors can only worsen the symptoms. Kagan studied nineteen babies; the first eighteen acted normally but the nineteenth baby showed signs of temperament and anxiety. When baby nineteen grew up Kagan reevaluated her and she still showed the symptoms of an anxiety disorder (Henig). When reading the testimony of baby nineteen, her worries sounded similar to mine in average situations. This made me realize the connection between all sufferers of GAD, because the worries do not necessarily have to be the same but the way they describe it and the feelings and emotions that weigh in the writing are highly relatable. The results of this experiment help distinguish between normal anxiety and anxiety disorders. Since generalized anxiety disorder has been shown to have contributions from both environmental and biological factors I have concluded that a mixture of both is not only what contributes to GAD but what causes each case of it to seem so different from any other. Stephanie Pappas has a bachelor’s degree in psychology and a science writing graduate certificate from the University of California, Santa Cruz; she interned at both Stanford Medical School and Science Now Magazine as a science journalist. Researchers know that the amygdala in the brain helps process emotion, memory and fear and that this plays a crucial role in anxiety disorders. Stanford Medical researchers discovered that, in patients with generalized anxiety disorder, the two sub-regions of the amygdala were still sending the correct signals to their designated places, but the lines of communication were distorted. The researchers also found that both regions had less connectivity to the region of the brain that is responsible for determining stimuli (Pappas). This may suggest that people with GAD may have difficulty determining which situations are worth worrying about and which should be dismissed. In the brains of patients with GAD, researchers found that the amygdala was more connected to a network of cortical executive-control that is known to have cognitive control over emotion (Pappas). This could be a possible explanation for the obsessive worrying that comes with generalized anxiety disorder. Sufferers become overwhelmed with emotion and in an attempt to keep themselves from completely breaking down emotionally, they worry and let their feelings out slowly over longer periods of time. This is a defense mechanism that often backfires because it is likely that the sufferer could have handled the situation better than he/she thought, and the worrying is excessive and unnecessary. Reading about the advances that are being made in the research of generalized anxiety disorder is exciting to me because it gives me hope for the future of living with anxiety.
Complete recovery from generalized anxiety disorder does not occur often, thus the goal of treating anxiety is to lessen it to a point that allows the patient to have more functionality in situations that were once more difficult for them to handle (Tonks). Alison Tonks is a freelance medical writer who makes a living writing articles for the British Medical Journal. Tonks also does work in the department of Medicine and Health Sciences at the University of Auckland in Auckland, New Zealand.
There are numerous treatments these days for generalized anxiety disorder, but many of the people who suffer from it are so anxious that they are reluctant to take any action toward helping themselves. Jack Gorman, former Chief Scientific Officer and Senior Vice-President at Comprehensive Neuroscience Inc. and Care Management Technologies, said “patients with generalized anxiety disorder tend to have cognitive abnormalities that hinder their ability to effectively deal with symptoms associated with generalized anxiety disorder and other aspects of their environment”; this shows just how important it is for people with GAD to get treatment. The disorder not only hinders a person’s performance in everyday life, but it also makes the idea of the anxiety increasingly difficult to deal with.
Treatments for generalized anxiety disorder are emerging and changing just as rapidly as new discoveries are being made about the disorder, so it is necessary to pay attention to credibility to separate fact from pseudoscience. I am hoping to find some natural treatments for GAD because I have always felt uncomfortable about taking medication because of the possible tolls it could take on my body and its health. Medications may be helpful in increasing the ability to function in the short-term, but they create a whole new dependency. It is reassuring to me to know that the most recently developed medications have been proven to be both safer and more tolerable than those that have been used to treat anxiety previously (Gorman). The underlying cause of generalized anxiety disorder has been proven to be a collaboration of many factors and so it seems as if effective treatments for GAD will require several elements to target each aspect. Successful treatments for GAD incorporate psychiatric, emotional, medical, financial, cultural, and social problems as each of these factors influence the disorder in different ways (Vanin and Helsley 183). I had never considered that treatments for anxiety disorders should be just as complex as the factors causing the symptoms. This explains why it would take more than a medication to treat generalized anxiety disorder. Evidence has shown that both psychotherapeutic and medical treatments can have a positive effect on a person’s ability to function and therefore reduce feelings of anxiety (Martis). Brain Martis is an assistant psychiatry professor with the University of Michigan Health System. Psychotherapy is a treatment for generalized anxiety disorder that helps patients develop the necessary cognitive and behavioral strategies that will allow them to deal with both the internal and external factors that contribute to their anxiety and prevents them from functioning normally (Gorman). Psychotherapy uses the multifactorial approach to treating anxiety which has been proven to be more effective than treatments that single out one factor. Early psychotherapy techniques targeted only the bodily causes of anxiety through various relaxation techniques, but it was not until they used the techniques in addition with cognitive therapy that increased results were seen and there was a much lower need for medication (Gorman). Cognitive therapy is a form of psychotherapy which focuses on the current problems that the patient is dealing with rather than past issues. It has been found to be the most effective short-term treatment for generalized anxiety disorder (Tonks). Elaine Pomfrey has written a few articles for the Transcendental Meditation website, but it seems as though that is the only organization she is affiliated with; because of this, some of the information in her article is likely to be biased. A study published by the American Journal of Psychiatry looked at the relationship between diet and levels of depression and anxiety. The study concluded that diets consisting of processed foods, desserts, and fast food caused higher levels of depression and anxiety than diets of whole grains, vegetables, fruits, fish, and meats. Alcohol and caffeine can increase feelings of anxiety and other symptoms of GAD which includes having negative effects on a person’s sleep patterns. Foods containing tryptophan such as peanut butter, cheese, nuts, milk, and poultry are proven to improve mood, as tryptophan aids the brain in producing serotonin which is a neurotransmitter that gives general feelings of calmness and wellbeing (Pomfrey). It makes sense that foods known to contribute to good health would also be beneficial toward a person’s mental health, therefore I am not surprised that these types of foods would reduce anxiety. Changing my diet may be difficult and will certainly take time, but it seems like it will be a change that is highly worthwhile and so I am going to try to convince my mother to make these healthy changes with me in hopes of reducing anxiety in both of us. Anxiety can be lessened through meditation and behavioral therapy as they teach that thoughts are not always reflective of the truth and what is rational (Smith; Corliss). Julie Corliss is the executive editor of the Harvard Heart Letter. Corliss earned her B.A. in biology and her master’s certificate in science communication. Meditation can be effective in eliminating feelings of stress and anxiety because it puts the body in the necessary relaxed state to decrease anxiousness and refresh the mind (Pomfrey). I have tried meditation before and I have noticed that when I get into a meditative state I am able to focus more on physically feeling my environment opposed to thinking and feeling my emotions, and this allows me to relax my mind and set aside my anxious thoughts and feelings. Hoge says that meditation can give anxiety sufferers the mindfulness that they need to distinguish what is and is not worth worrying about (Corliss). Based on Hoge’s ideas, meditation will not only relax a person enough to dissipate worries temporarily, but it can also change how that person thinks and deals with future worries. Human bodies are supposed to eliminate the day’s stress during sleep. Today, stress is often carried over from the previous day because people are getting less sleep and suffering from more anxiety and stress (Pomfrey). People seem to be constantly on their feet these days and they do not get as much rest as their minds and bodies require. Transcendental Meditation seems like a quick way to take a break from a busy life to relax and refresh. “The Transcendental Meditation technique has been scientifically proven to produce a deep state of relaxation in the body as well as brain coherence. During the twenty minutes of meditation, a unique state of restful alertness is experienced which reduces stress and fatigue.” (Pomfrey). A study done at American University showed that students who practiced Transcendental Meditation saw a significant reduction in blood pressure which can be associated with a fifty-two percent lower risk for anxiety (“At-Risk”). This article was taken from Medical News Today which is run by one of the top health care publishers on the internet. I have been living with generalized anxiety disorder for eighteen years and my mother has lived with it for more than three times that length. It is not an easy thing to deal with and it makes our lives a great deal more difficult. It seemed like it was about time one of us took an advance toward learning more about our condition and how we can live with it more easily. The research that I have done on this subject has already transformed my mindset and put me on the right track to dealing with my anxiety more effectively and hopefully someday eliminating it almost completely. Now I know what I can do for myself; I am going to change my diet to incorporate more healthy foods as well as taking at least twenty minutes each day to relax and meditate. I am going to enlighten my mother and teach her the changes she can make to her state of mind and the physical things she can do that will make her life easier to function in.

Works Cited
"At-Risk College Students Reduce HBP, Anxiety, Depression Through Transcendental Meditation." Medical News Today. N.p., 18 Nov. 2009. Web. 20 Apr. 2014.

Corliss, Julie. "Mindfulness meditation may ease anxiety, mental stress." Harvard Health Publications. N.p., 8 Jan. 2014. Web. 20 Apr. 2014.

Dryden-Edwards, Roxanne. "Generalized Anxiety Disorder (GAD)." Medicine Net. Ed. Melissa Conrad Stöppler. N.p., 12 Apr. 2012. Web. 16 Mar. 2014.

Gorman, Jack M. "Anxiety disorders: a pocket guide for primary care." Physicians Postgraduate Press Inc 2003 [Memphis, TN] . Web. 12 Apr. 2014.

Henig, Robin M. "Understanding the Anxious Mind." The New York Times Magazine Sept. 2009. SC4 Library. Web. 15 Mar. 2014.

Hockenbury, Don H., and Sandra E. Hockenbury. Psychology. Ed. Jessica Bayne. 6th ed. New York: Worth Publishers, 2013. 567-68. Print.

Martis, Brian. "Anxiety Disorder." Encyclopedia Britannica. 2013. N. pag. Web. 15 Mar. 2014.

Meek, William. "Genetic Vulnerability and Generalized Anxiety Disorder." About.com. Ed. Neil Vogel. N.p., 8 Jan. 2007. Web. 30 Mar. 2014.

Pappas, Stephanie. "Brain scans show distinctive patterns in people with generalized anxiety disorder in Stanford study." Stanford Medicine. Ed. Jessica Bayne. Stanford School of Medicine, 7 Dec. 2009. Web. 30 Mar. 2014.

Pomfrey, Elaine. "Eat, Meditate, Exercise - Treating Anxiety Naturally." Transcendental Meditation. Maharishi Foundation USA,, n.d. Web. 20 Apr. 2014.

Smith, Daniel B. "The Idiocy Of Anxiety." The New York Times 12 Aug. 2012: 8. SC4 Library. Web. 15 Mar. 2014.

Tonks, Alison. "Treating generalised anxiety disorder." Clinical Review 326.7931 (2003). Web. 12 Apr. 2014. Vanin, John R., and James D. Helsley. Anxiety disorders: a pocket guide for primary care. Totowa, New Jersey: Humana Press, 2008. Print.