Normal Worry vs Generalized Anxiety Disorder

Anxiety 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?

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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

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