CBT for Anxiety Disorders

Generalised anxiety disorder (GAD) is a condition where you have excessive anxiety on most days. The most effective treatment is thought to be cognitive behavioural therapy (CBT). Other treatment options can include antidepressant medicines.

CBT is the effective therapy for Anxiety.

What is anxiety?

When you are anxious you feel fearful and tense. In addition you may also have one or more unpleasant physical symptoms. For example: a fast heart rate, palpitations, feeling sick, shaking (tremor), sweating, dry mouth, chest pain, headaches, fast breathing. The physical symptoms are partly caused by the brain which sends lots of messages down nerves to various parts of the body when we are anxious. The nerve messages tend to make the heart, lungs, and other parts of the body work faster. In addition, you release stress hormones (such as adrenaline) into the bloodstream when you are anxious. These can also act on the heart, muscles and other parts of the body to cause symptoms.

Anxiety is normal in stressful situations, and can even be helpful. For example, most people will be anxious when threatened by an aggressive person. The burst of adrenaline and nerve impulses which we have in response to stressful situations can encourage a 'fight or flight' response. Some people are more prone to normal anxieties. For example, some people are more anxious before examinations than others. Anxiety is abnormal if it:
•    Is out of proportion to the stressful situation, or
•    Persists when a stressful situation has gone, or the stress is minor, or
•    Appears for no apparent reason when there is no stressful situation.

What are anxiety disorders?

There are various conditions (disorders) where anxiety is a main symptom. This leaflet is about generalised anxiety disorder (GAD). There are other separate leaflets for other types of anxiety disorders (such as panic disorder, phobias, acute reaction to stress, post-traumatic stress disorder, etc).

What is generalised anxiety disorder?

If you have generalised anxiety disorder (GAD) you have a lot of anxiety (feeling fearful, worried and tense) on most days. The condition persists long-term. Some of the physical symptoms of anxiety (detailed above) may come and go. Your anxiety tends to be about various stresses at home or work, often about quite minor things. Sometimes you do not know why you are anxious.

It can be difficult to tell the difference between normal mild anxiety in someone with an anxious personality, and someone with GAD. As a rule, symptoms of GAD cause you distress and affect your day-to-day activities. In addition, you will usually have some of the following symptoms:
•    Feeling restless, on edge, irritable, muscle tension, or keyed up a lot of the time.
•    Tiring easily.
•    Difficulty concentrating and your mind going blank quite often.
•    Poor sleep (insomnia). Usually it is difficulty in getting off to sleep.
You do not have GAD if your anxiety is about one specific thing. For example, if your anxiety is usually caused by fear of one thing then you are more likely to have a phobia.
Who gets generalised anxiety disorder?
GAD develops in about 1 in 50 people at some stage in life. Twice as many women as men are affected. It usually first develops in your 20s and is less common in older people.

What causes generalised anxiety disorder?

The cause is not clear. The condition often develops for no apparent reason. Various factors may play a part. For example:
•    Your genetic makeup may be important. Some people have a tendency to have an anxious personality, which can run in families.
•    Childhood traumas such as abuse, or death of a parent, may make you more prone to anxiety when you become older.
•    A major stress in life may trigger the condition. For example, a family crisis or a major civilian trauma such as a toxic chemical spill. But the symptoms then persist when any trigger has gone. Common minor stresses in life, which you may otherwise have easily coped with, may then keep the symptoms going once the condition has been triggered.
Some people who have other mental health problems such as depression or schizophrenia may also develop GAD.
How is generalised anxiety disorder diagnosed?
If the typical symptoms develop and persist for at least six months, then a doctor can usually be confident that you have GAD. However, it is sometimes difficult to tell if you have GAD, panic disorder, depression, or a mixture of these conditions.

Some of the physical symptoms of anxiety can be caused by physical problems which can be confused with anxiety. So, sometimes other conditions may need to be ruled out. For example:
•    Drinking a lot of caffeine (in tea, coffee, and cola).
•    The side-effect of some prescribed medicines. For example, selective serotonin reuptake inhibitor (SSRI) antidepressants.
•    An overactive thyroid gland.
•    Taking some street drugs.
•    Certain heart conditions which cause palpitations (uncommon).
•    Low blood sugar level (rare).
•    Tumours which make too much adrenaline and other similar hormones (very rare).

What is the outlook?

Without treatment, GAD tends to persist throughout life. It is relatively mild in some cases, but for some it can be very disabling. The results from one clinic showed that at the end of twelve years 4 out of 10 people had recovered. The outlook was worse for people who had more than one anxiety disorder.

The severity of symptoms tends to wax and wane with some good spells, and some not so good spells. Symptoms may flare up and become worse for a while during periods of major life stresses. For example, if you lose your job, or split up with your partner.

People with GAD are more likely than average to smoke heavily, drink too much alcohol, and take street drugs. Each of these things may ease anxiety symptoms in the short-term. However, addiction to nicotine, alcohol or drugs makes things worse in the long-term, and can greatly affect your general health and wellbeing.

Treatment can help to ease symptoms, and can improve your quality of life. However, there is no quick fix or complete cure.

What are the treatment options?

Cognitive behavioural therapy (CBT)

This is probably the most effective treatment.
Cognitive therapy is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as anxiety. CBT helps you to understand your current thought patterns - in particular, to identify any harmful, unhelpful, and false ideas or thoughts which you have that can make you anxious. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. Any past events (major or minor) that have had an impact on you anxiety will also be addressed in therapy as this can enhance the outcome.

If you want to talk to someone about overcoming your anxiety problems please contact us - 0161 8345888