Everyone has worry and anxiety sometimes, however, some people experience worry and anxiety almost all the time, and about almost everything. This condition is known as Generalized Anxiety Disorder (GAD) and is characterized by chronic anxiety. This kind of anxiety can be incredibly exhausting and is distinct from the more acute anxiety one may experience around an isolated incident.
GAD is particularly distinguished by an uncontrollable worry about things that the average person would not give much thought to. Other distinguishing characteristics of GAD include:
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over-thinking things or events that have happened in the past or that may happen in the future
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unrealistic or unreasonable patterns of thinking (i.e. thinking of worse case scenarios)
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difficulty setting aside worry and being present
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feelings of restlessness and nervousness
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physical symptoms such as nausea, sweating, and muscle tension
While the effects of GAD have the potential to disrupt one’s quality of life (or that of friends and family), there are effective treatment options for those looking for relief. Cognitive Behavioral Therapy (also known as CBT) is one of them.
Cognitive Behavioral Therapy
CBT is one of the most researched treatments for Generalized Anxiety Disorder. Developed by Aaron Beck, it is based on the premise that people’s thoughts or cognition determine their responses to situations. Beck thought that by helping to change people’s thoughts (especially unhelpful ones, such as doomsday thinking) that he could help to change their overall mental health.
With CBT, therapists help individuals to become more aware of their unhelpful thoughts and beliefs, to challenge them, and to replace them with healthier ways of thinking. For example, if someone is experiencing intense worry about a situation, CBT may help them to recognize and allay the worry, and then establish a more productive and gentle thought pathway.
Beck also believed that thoughts cause people to engage in particular behaviors- the behavioral aspect of CBT. As such, one of his goals was to help people reclaim their agency through a re-shaping of behavior. For example, individuals with GAD will often engage in avoidance behavior- avoiding people, places, and things that would make them anxious. Unfortunately, the more people avoid the source of their anxiety, the worse it is likely to become. Beck believed that by changing behavior, choosing to engage instead of avoid, people would be able to reduce their overall anxiety and make decisions from a place of agency not dictated by anxiety.
Another behavioral characteristic of GAD is obsessive planning and over-preparing, even for things that may never happen. As people become convinced that planning is helpful and serves to minimize stress and anxiety, they will continue to do it- forming a self- reinforcing behavior. What may be less obvious to them is that the planning itself most often leads to heightened anxiety. Individuals begin to dedicate more and more time and energy to preparing for these hypothetical situations, and begin to associate anxiety with a wider array of scenarios. In these cases, CBT can help to minimize or stop the planning behavior and reduce overall anxiety.
the evidence for CBT and GAD
Dr. Lewis is a scientists at heart and encourages all members of Mind Body Seven to also keep an eye on research on psychotherapy to stay current on the latest findings. The research on CBT for GAD is outstanding with many studies showing its effectiveness for all types of people, across ages and genders. Perhaps the greatest benefit of CBT is that it is extremely versatile- it can be tailored according to each person’s unique set of disruptive beliefs and unhelpful cognitions.
Early research from Borkovec and Ruscio demonstrated back in 2001 how helpful CBT is for GAD. The researchers conducted a review of studies that used techniques such as self-monitoring, relaxation training, and rehearsal of coping skills to assess the utility of GAD for CBT. What they found was that not only did these techniques help to reduce symptoms of GAD, but patients were able to maintain their improvements long after therapy had ended.
Covin and colleagues were also curious about whether CBT could really help people reduce their worrying. Encouragingly, they found positive and lasting results for their study participants– an important finding considering worry is such a core characteristic of GAD. This study also revealed that CBT seemed to work slightly better for younger adults, which potentially points to a benefit in seeking treatment early.
Final Recommendations—When to Seek Help
If you experience occasional anxiety and worry, there is little need to be concerned. However, if you are experiencing anxiety and worry more days than not, if it is interfering with your ability to function, or if you are starting to feel depressed (perhaps, even suicidal) then it is strongly recommended that you seek out professional help. And the earlier the better, before you feel even worse.
Finding the right professional may feel intimidating, but there are mental healthcare practitioners across the country who are well trained to help individuals with GAD. Try an internet search for what you need in your location. For example, search for Psychotherapist in Brooklyn or Cognitive Behavior Therapy in New York. You can often then view the therapist’s website and do a preliminary screening to make sure the person you found will be a good fit for what you are looking for. Contact to schedule an appointment and be on the way to feeling better.
