Generalized Anxiety Disorder

Stress, Sleep, Anxiety and Depression are very close friends.

Stress and Anxiety knew each other first, then Anxiety was introduced to Depression.

Anxiety then met Poor Sleep.

Anxiety went to introduce Stress and Depression to Poor Sleep, but they already knew each other...


Anxiety can be like a relationship with a toxic friend that you keep around because you don’t have the tools to set them free. Learning to gently dissolve this relationship and have an amicable parting is important.


Anxiety disorders are common. It isn’t unusual for your neighbour, teacher, friend or family member to have received a diagnosis, particularly if they are female and between the ages of 18 and 29. After a diagnosis, management of symptoms can continue over the next 20 to 30 years, but the length and severity depends on many factors which we will discuss.


Understand the disease spiral

General Anxiety Disorder is categorized as excessive worrying, usually triggered and maintained by the stress response. This is often coupled with a poor sleep cycle, fatigue, poor concentration, memory impairment and sometimes migraines. If general physical health is poor, these physical symptoms will be more prominent or severe. This is one of the most important factors to remember if you experience anxiety or any mood disorder.


Co-morbidity is common. Meaning that other conditions and health issues come along with anxiety.


Managing the Unmanageable

It is estimated that only about 50% of people get treatment for GAD, choosing to self-manage or settling for a poorer quality of life. Avoiding treatment is common because of poor perceived self-efficacy. This means a person has little or no belief that they are capable of addressing and improving their condition. Of course for anxiety and mood disorders, this is far from the truth.


Improving Self-Efficacy

After a diagnosis of any mood disorder, half the battle is knowing that things can be helped and actions can be taken to improve your life. The best place to start is to find the right person to help you. While your peer network (friends, family etc.) are great, they are unlikely to have the tools to provide the you with exactly what you need. Get a recommendation from your doctor or people you know so you can start talking to someone ASAP.

Changing your view about self-efficacy leads to positive changes


Learn more about you.. and your Brain!

It is documented that people with GAD manage their condition more effectively when they understand the ins and outs of what their body is doing and why.


Getting to know anxiety-related brain activity is very useful to piece together associated symptoms. During a state of worry, neural pathways act differently in a person with GAD compared to someone without. The brain has the capability to act like an exercised muscle where well-used parts build up and underused parts can shrink!


In turn, brain areas that have changed in size can have their specific functions affected. This can explain some of the symptoms that accompany an anxious state. The positive thing is that new neural pathways can be formed in order to alleviate GAD symptoms.

Is your brain doing weights? The brain is like a muscle and will grow and shrink based on the parts that are used or underused.


Stress Management – A non-negotiable approach to GAD

No one can tell you to simply stop stressing. The body is designed to stress - it's an innate response. High bouts or prolonged stress however can be harmful and is a significant driver of anxiety.


Stress management assists the natural biological processes to return to a pre-stressed state. Seeing a Psychologist or Counsellor is the best way to get the right Behavioural, Cognitive and Emotional strategies for you.


Stress management techniques essential for GAD.


Some Actions to Take Now

Start with a couple of Behavioural Changes which are essential for everyone's mental health.


1. Choose a regular exercise - try high impact and low impact activities and find out what you enjoy. The idea is to be physical as many days a week as possible which is excellent for Anxiety and for Depression.


2. Choose a relaxation activity - find a meditation app or deep breathing exercises to start putting into your routine. Start small and work your way up. This will also help to manage symptoms.


Do what's good for your body

Since poor physical health is associated with more intense symptoms of GAD, then keeping fit and eating well are top priorities. Nutritional interventions have shown to be beneficial for Depression, but have not yet shown efficacy with Anxiety disorders. This is likely because of the increased need for nutrients that accompanies high stress and anxious states that cannot be achieved by diet alone. Another is that a stressed brain is unlikely to make long-lasting dietary changes. A combination of supplementation, stress management and very gradual dietary changes will assist in this case.



Herbal medicine is equally and often more effective than pharmaceutical interventions for GAD as demonstrated in clinical trials. Herbal Medicine provides the benefit of no side effects that may come with medications. Even medical practitioners agree that some pharmaceuticals for GAD are not beneficial long term for this reason. A great way to start without the help of a Herbalist is drinking Chamomile tea which acts as a mild relaxant. Don’t worry, it doesn’t exacerbate your fatigue, it will actually do the opposite.


Seeing a Naturopath will assist you with your Herbal treatment and explain why it will assist you.

Click to learn more about Naturopathic treatment: https://bit.ly/3CRF4C8


Make a goal list so you can incorporate them into your routine.


For more targeted advice suited to you, including assistance with Nutrition and Dietary choices, please get in touch via my website, via phone or email at enquiries@purpletreetherapies.com.au


Purple Tree Therapies is located in New Farm but I can also do video consultations via Zoom.


References


Dindo, L. (2017). Comorbidity of Migraine, Major Depressive Disorder, and Generalized Anxiety Disorder in Adolescents and Young Adults. Int.J. Behav. Med. 24:528–534. doi: 10.1007/s12529-016-9620-5


Gaudreau, C. (2015). Older Adults’ Rating of the Acceptability of Treatments for Generalized Anxiety Disorder. Clinical Gerontologist, 38, 68–87. doi: 10.1080/07317115.2014.970319


Gomes, A. P, Gonçalves, H; dos Santos Vaz, J., Kieling, C., Rohde, L. A., Oliveira, I, O., Gonçalves Soares, A. (2021). Do inflammation and adiposity mediate the association of diet quality with depression and anxiety in young adults? Clinical Nutrition, 40:5, 2800 – 2808.


Lawrence, V, et al. (2019). Optimising the acceptability and feasibility of acceptance and commitment therapy for treatment-resistant generalised anxiety disorder in older adults. Age and Ageing,48. 735–744 doi: 10.1093/ageing/afz082


Mao JJ, Xie SX, Keefe JR et al. (2016). Long-term chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial. Phytomedicine. 23(14): 1735-1742. doi: 10.1016/j.phymed.2016.10.012. PMID: 27912875


Mohlman, J., Eldreth, D. A., Price, R. B., Staples, A. M., Hanson, C. (2017). Prefrontal-limbic connectivity during worry in older adults with generalized anxiety disorder. Aging & Mental Health, 21(4), 426-438. doi: http://dx.doi.org/10.1080/13607863.2015.1109058


Moon, C. & Jeong, G. (2015). Alterations in white matter volume and its correlation with clinical characteristics in patients with generalized anxiety disorder. Neuroradiology (2015) 57:1127–1134. doi: 10.1007/s00234-015-1572-y


Preti, A. et al. (2021). The lifetime prevalence and impact of generalized anxiety disorders in an epidemiologic Italian National Survey carried out by clinicians by means of semi-structured interviews. BMC Psychiatry, 21(48). doi: https://doi.org/10.1186/s12888-021-03042-3


Ruscio A. M, et al. (2017). Cross-sectional comparison of the epidemiology of DSM-5 generalized anxiety disorder across the globe. JAMA Psychiatry, 74(5). 465–75. doi: https://doi.org/10.1001/jamapsychiatry.


Schoenleber, M., Chow, P. I. & Berenbaum, H. (2014). Self-conscious emotions in worry and generalized anxiety disorder. British Journal of Clinical Psychology, 53. 299–314


Terlizzi, E.P., Villarroel, M. A. (2020). Symptoms of Generalized Anxiety Disorder Among Adults. 378, 1 - 9