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Normal Worry vs Generalized Anxiety Disorder

by Mike on August 12, 2008 · 11 comments

worry man sm Normal Worry vs Generalized Anxiety DisorderAnxiety is a part of everyday life. We all worry. We all get anxious. And a little anxiety is natural, normal and even helpful.

Anxiety can act as a natural alarm system to an immediate threat. It can motivate you to foresee problems and figure out solutions. The physical symptoms of fear and anxiety can produce the adrenaline boost you need to confront real danger or a difficult situation. It can help you pass tests, be more productive and face the big challenges in your life.

Dr. Neil Rector, Head of the Centre for Addiction and Mental Health’s Anxiety Disorders Clinic in Toronto, says,

It’s important to remember that anxiety is normal and is experienced by every living organism, right down to the sea slug. It is necessary in humans for survival and adaptation, and it is not in the least harmful or dangerous. Anxiety is typically short-lived, and in some cases moderate levels of anxiety actually enhance performance.

But when worry and anxiety will not go away, will not “switch off,” it can grow and grow until it becomes a real problem. If it leads to significant distress and impairment, it may signal the beginnings of Generalized Anxiety Disorder (GAD).

So, when are anxiety and worry normal? And when are they symptoms of GAD?

What is normal worry and anxiety?

The complexity of our lives in the modern world makes sure there always being something troubling us or making us feel anxious. Matters such as credit card debt, car repair bills, an upcoming work review, whether your child will get into a good college — these all prey on our minds.

Our bodies are made to handle stress

Our bodies are made to enter a “fight or flight” mode when anxiety reaches a certain point. It’s what has helped humans survive all these years. This mode prepares our bodies for big physical and mental challenges, and is entirely natural. It helps us run faster from danger, to study harder for a big test, and to keep from procrastinating in the face of  an impending deadline.

In other words, some anxiety is normal and even helpful.

But the world can be a pretty hectic place sometimes, and stress can play on your nerves and make you question yourself about seemingly trivial matters. These thoughts go through everyone’s mind to a greater or lesser degree on a daily basis. Some are just fleeting thoughts, some are serious considerations, and sometimes these feelings are more than just worry.

When does normal worry and anxiety become a problem?

Anxiety is a continuum

As I have mentioned before, anxiety is a continuum, with one end being “normal” anxiety and the other being a full-blown Anxiety Disorder. Somewhere in the middle is a tipping point, where “normal” anxiety grows to be a problem. This point varies with every person, depending on their resilience, the way they handle stress, and how they control their anxiety.

Barlow and Durand (2005) say that “what distinguishes pathological worrying from the normal kind” is the level of difficulty in “turning off or controlling” the worry process. 

David Spiegel, MD, medical director of clinical and medical programs at the Center for Anxiety and Related Disorders at Boston University, said,

It’s not so much the things [people with [Generalized Anxiety Disorder] worry about, it’s the degree to which they worry. The worrying is so excessive, distressing, and intrusive that it interferes with normal functioning. It’s difficult or impossible to control the anxiety and focus on something else.

The tendency to worry excessively is probably more of an enduring personality characteristic than something that occurs only occasionally. We all have some tendency to worry a great deal about specific events, but we can usually get “back on track” by putting things into perspective fairly easily. 

Excessive worry, however, seems to be enduring, almost perpetual.  If someone suffering from stress has no way of overcoming it or putting things into perspective, worry can easily take over and become uncontrollable.  

Though we all experience moments of worry or anxiety, those with GAD have an enduring personality characteristic that causes them to be more anxious more frequently than an average “stressed” person.  To “worry” or “stress out” about an upcoming test is much different than uncontrollable worrying about any and all aspects of life.

What are the symptoms of GAD? How do I tell if I have it?

People with GAD are 24/7 fret machines

People with GAD are the worry experts. It’s not uncommon for people with the Disorder to assume that they are locked into daily uncontrollable worry. Untreated, these individuals learn to compensate in other ways, often settling for a lower quality of life. They resign themselves to continual physical and emotional discomfort.

If you suspect you have GAD, it’s very important for you to reflect on:

  • What situations cause anxious feelings
  • How long you have experienced these feelings
  • If the worry is reasonable 

For example: Someone in her 30s with no medical problems has had two normal physical examinations in the past six months. But she spends the day worrying about her health. She may be experiencing GAD.

People with Generalized Anxiety Disorder often experience several mental, emotional and physical symptoms, including:

  • Excessive and unreasonable worry over events or activities, such as work, school or health
  • Excessive worry about their capacity and confidence to deal with situations
  • Inability to control or stop their worrying
  • Feelings of apprehension
  • Muscle tension and restlessness
  • Feeling keyed-up or on edge
  • Fatigue
  • Tension headaches
  • Problems with concentration
  • Irritability
  • Sleeping problems, such as insomnia.

What if I suspect I have GAD?

Most people with GAD describe themselves as constant worriers. They acknowledge that this approach to situations is something they have done their entire lives. Others often describe them as “high strung,” “nervous” or “tense.”

Continual worries cannot be turned off

While the the subjects of worry may vary with age and from person to person, the common thread is the same: chronic and exaggerated worry over situations and topics that can’t be turned off at will. Whether it’s an uncommon dread of missing appointments, worry about routine tasks, such as needing to change the car oil, or daily concern about finances despite being financially secure, the thoughts can interfere with daily life functions.

GAD sufferers often have physical complaints along with their mental discomfort. Despite many visits to a medical professional, people with GAD are often not diagnosed with the disorder until they see their doctor for a secondary complaint. It’s estimated that as many as 10 percent of the people who repeatedly make visits to health-care providers have GAD.

If you suspect you have symptoms of GAD, you should see your primary care physician or a mental health professional. Be open and honest with your doctor and tell them all of your symptoms. Many people with GAD just assume that a high degree of worry is “normal” and will not tell their doctor about it. This degree of suffering can make diagnosing GAD difficult if you do not tell your doctor everything. 

Once diagnosed, GAD is very treatable. Treatment methods include medication and cognitive-behavior therapy. You will learn how to deal with worry, not only in the short term, but for the rest of your life. 

What do you think?

It may just be excessive worrying, or it may be the beginnings of GAD. I recommend seeing a counselor for either condition. They can help you resolve your worries and learn how to control them.

  • What is the level of your worry? Do you think it is excessive?
  • If you have been diagnosed with GAD, what has been the most effective treatment you have received?

What can you do now?

Your comments are always welcome, and are important to this blog’s community! Leave a comment now.

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Resources used in this post:

Barlow, David H. & Durand, V. Mark. (2005).  Abnormal Psychology: An Integrative Approach. Belmont: Thomson Learning, Inc.

Centre for Addiction and Mental Health. (2004, November 22). When it’s more than worry… . Retrieved August 12, 2008 from Centre for Addiction and Mental Health Web site: http://www.camh.net/Publications/Organizational_Publications/Breakthrough/Fall_2004/morethanworry_btfall2004.html

Disability Online. (2004, August 31). Worry. Retrieved August 12, 2008 from Disability Online Web site: http://www.disability.vic.gov.au/dsonline/dsarticles.nsf/pages/Worry?OpenDocument

Doheny, Kathleen. (2008, February 24). When Worry Consumes You. Retrieved August 12, 2008 from MedicineNet Web site: http://www.medicinenet.com/script/main/art.asp?articlekey=87386

Hauser, John. (2006, February 17). Normal Worry versus Generalized Anxiety Disorder. Retrieved June 27, 2008 from Psych Central Web site: http://psychcentral.com/lib/2006/normal-worry-versus-generalized-anxiety-disorder/

Stein, Loren. (2008, January 29). High Anxiety. Retrieved August 12, 2008 from HealthyMe Web site: http://www.ahealthyme.com/topic/gad

Wofford University. (2006). General Anxiety Disorder: Case 1-AH. Retrieved August 12, 2008 from Wofford University Web site: http://webs.wofford.edu/farrie/general_anxiety_disorder.htm

©2008 Anxiety, Panic & Health. All rights reserved.

{ 9 comments… read them below or add one }

JaneDeere August 13, 2008 at 8:27 pm

A lot of good information in your post. I have found self-help books to help sometimes better than meds and most times better than “talk therapy”. I always try to analyze my anxiety attacks to try and figure them out so I can “fix” them. More often than not, the frustrating part of anxiety is – there is no rational reason to be in such a panic!

Reply

Mike August 14, 2008 at 12:23 am

Thank you for the complement!

Yes, Anxiety Disorders are frustrating. Mine descended on me in a matter of a few months. I had been struggling with bipolar disorder for years, but the Anxiety Disorders really knocked me to my knees. And the Anxiety ≤i≥made no sense! At least I knew what to expect with bipolar disorder, but Anxiety has no rhyme or reason — even now after five years.

Reply

ASIAN Health and Medicine Forum August 16, 2008 at 7:12 am

what i am interested about is if food supplements like tryptophan, calcium and 5-htp can really help anxiery disorders. we really dont want to be dependent on prozac.

Reply

Kevin Barry July 15, 2009 at 11:54 am

I am 58 y.o. and now realize that the discussion in the text fits my anxiety when I am in the company of my girlfriend and does not switch off after I leave and is affecting my progress in the relationship. I am doing Yoga, Meditation and walk between 6-10 miles/day. At night, due to my worry, I sometimes have trouble falling asleep despite meditation and even sometimes find it hard to get into the meditation due to the anxiety. I think I need more help with my problem so that I do not lose my relationship, and since currently she has asked for her “space” and is appreciative that I am giving it to her, I wonder how I can convey during this time period that I am going the seek treatment from a medical doctor and am already seeing a clinical psychologist and have been seeing one for the last 3-4 months. My father recently passed away, and have sold his house recently and I am currently undergoing a divorce. I know these are big “hits” and I would like advice as to the best approach given my current situation. I have also been reading and outlining books by Scott Peck, “The Road Less Traveled” to try to understand about my spiritual growth and the issues to achieve mature mental health. However, the generalized anxiety is preventing my progress here as well. Again I would appreciate any ideas or thoughts where I might help my situation and how I might go about treating myself Kevin Barry

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Sandip March 29, 2012 at 4:57 am

Thank you for maintaining this wonderful informative site.This is true community service. The information is authentic , reliable and useful for doctors as well as lay people who would want to know more about their symtoms and related cause and treatment available.
Dr Sandip Kudesia MD,PhD

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Brenda April 4, 2012 at 12:54 am

I have read much about the topic of GAD. Everything says it’s about excessive worry. I won’t deny I worry, who doesn’t.. but the type of anxiety I experience is not always activated only when I am worried. My attacks come on for no apparent reason what so ever. I just don’t know if I even believe anything other than medication can work. Talk therapy? I talk about the things that bother me… and as soon as they bother me. I can be having a fine day, without even thinking about anything that may be going on.. and suddenly find myself with suffocating anxiety. I guess the only way to find out if therapy would work is to try it, but that is expensive, even with good insurance, and time consuming… It feels like a heart attack, on the right side of my chest. When I began having symptoms, it was under stress.. but it have evolved to seemingly nothing to bring the attacks on. And there are may times when even medication does not help. I’ve also read that it gets better with age… Not for me, it has gotten worse. Continues to get worse as I age. I hate it, and sometimes I could just cry bc it seems like I will never be rid of it.. Walking used to help .. it doesn’t any more. I am not even sure what I am asking, but… I guess any thoughts are welcome?

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Market Samurai Free June 9, 2012 at 12:28 pm

It’s really a cool and useful piece of info. I’m glad that you simply shared this helpful info with us. Please stay us up to date like this. Thank you for sharing.

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gaby February 26, 2013 at 5:36 pm

Hi all, this article is very helpful, id like to know if you could write more about therapy at home, my fiance is always worried about things, even if they are important or not, i love him so much but it breaks my heart to see him on the edge all the time. He bites his nails or peels his fingers skin when his nervous about something, he´s shy and has a hard time getting involved in social situations.. but with me he´s different, he´s very talkative and outgoing.. when its only the two of us. help.

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Bronny May 9, 2013 at 8:42 pm

Thank you for this information and the people above me seem to be in the same situation. Is this a new thing or has it been in society forever and only recognized now?

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