Generalized Anxiety Disorder is Characterized by Persistent Worry
Jim Folk’s anxiety odyssey began in 1974 with an upset stomach. Next came muscle tension, dizziness and heart palpitations. At the time, Folk was 21 years old and working in his family’s auto-repair shop in Regina. When his symptoms didn’t go away, he grew worried. “Whenever I had an ache or pain, I’d freak out,” says Folk, now 64.
After a few months, he saw his doctor, who told him it was just stress and to go home and rest. “But I didn’t feel stressed,” Folk says. “And I couldn’t figure out why every time I tried to relax, my symptoms went full tilt.”
At first, Folk was convinced he had multiple sclerosis, or maybe cancer, even when doctors reassured him that he didn’t. He began experiencing non-stop nausea coupled with debilitating panic attacks. “I’d start trembling all over, feel dizzy and have hot flashes,” he says. “I was in the bathroom countless times, heaving with intense stomach upset. My symptoms were robbing me of more and more of my life.”
Years passed, but his health failed to improve. Folk saw several doctors and mental health professionals and tried an array of pills and herbal remedies. Nothing worked. “My whole life revolved around a few blocks—to work and back home again. I could barely drive, couldn’t visit friends, couldn’t enjoy my family.”
Eventually his wife at the time told him he needed to get better or their marriage was over. Folk booked an appointment with a psychologist. Two weeks later—and 10 years after the onset of his symptoms—he was finally diagnosed with generalized anxiety disorder and panic disorder.
Generalized anxiety disorder, or GAD, is a condition characterized by persistent, excessive worry—even when there’s nothing concrete to worry about. “People with GAD try to plan for every eventuality, all the time,” says Dr. Melisa Robichaud, a psychologist in Vancouver. “It’s cognitively exhausting.” It can be physically taxing, too, with symptoms ranging from fatigue and irritability to difficulty maintaining concentration to restlessness or agitation.”
At its core, Robichaud says, anxiety is the body’s most basic survival mechanism, the fight-or-flight response you get when you feel threatened. “Anxiety is like the body’s smoke alarm: whether there’s smoke or fire, it makes the same noise.” It can be triggered by real danger but also by anything we perceive as dangerous.
People with GAD think through “what-if” scenarios excessively, and this cycle of worries can end up provoking even more anxiety. The thought of an unpaid bill can quickly escalate to worrying about what they’ll do if they wind up homeless. “They’re constantly in their heads and they can’t stop their worrying once it begins,” Robichaud says.
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Generalized Anxiety Disorder is Common in Older Adults
While scientists aren’t entirely sure why some people are more prone to GAD than others, part of the risk is genetic, says Simon Sherry, an associate professor of psychology and neuroscience at Dalhousie University in Halifax. The condition also often coincides with other illnesses, such as depression, and women are twice as likely as men to be affected, according to Sherry.
As anxiety disorders go, GAD is one of the most common, especially in older adults. Studies suggest it affects somewhere between three and 10 per cent of people, says Julie Wetherell, a psychologist at VA San Diego Healthcare System and professor of psychiatry at the University of California, San Diego who focuses much of her research on psychological treatments for GAD in elderly patients. “GAD is more common in seniors than social-anxiety disorder, panic disorder, post-traumatic stress disorder and major depression.”
It also manifests a little differently in people who are 55 and older. Wetherell says they tend to worry less about work and more about personal health and family issues. “Sometimes people have a lifelong history of anxiety that they’ve coped with through distraction or workaholism,” she says. “The pervasiveness of the worry becomes apparent when they’re no longer working or once they’re unable to engage in previous coping strategies.”
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Generalized Anxiety Disorder is Difficult to Diagnose
Anxiety symptoms are associated with several health issues, which can make diagnosis difficult. Conditions that can cause—or mimic—anxiety include coronary artery disease, chronic obstructive pulmonary disease, dehydration and hyperthyroidism. “It’s possible to have both a medical condition and anxiety, so when a medical condition is diagnosed, anxiety may remain untreated,” Wetherell says. Anxiety-like symptoms can be caused by medications, including blood pressure pills, hormones, steroids, antidepressants and over-the-counter drugs that contain caffeine, like some cough syrups and decongestants.
GAD sufferers rarely turn to psychologists and will instead often see a medical doctor about their physical symptoms. In some cases, professionals brush off both physical and psychological concerns. “Many people think that worry isn’t a legitimate mental health complaint since everybody frets,” Robichaud says. She’s seen patients who endured symptoms for 15 years before seeking help. Older adults tend to downplay problems with anxiety. GAD sufferers often get accustomed to their extreme patterns of thinking, Sherry says. “If worry is your normal, you may not appreciate the extent to which you’re living in distress,” he says. “But while GAD is common, costly and impairing, it’s also highly treatable, which is why it’s important to seek help.”