Diagnosed with GAD

[NoPoet]

Hi all,

I've now had 8 sessions of CBT and my therapist has, at long last, managed to provide me with a new (and final) diagnosis: I've got generalised anxiety disorder (GAD). The GAD manifests itself in near-constant worry, fears which seem to change and become other things once I start to challenge them, and a persistent sense that something is out there waiting to get me.

We haven't actually done any therapy in CBT yet as I have been doing various tests and discussing things that might have had a bearing on the illness. I've been ill for 3 years now but I have been an anxious person all my life; I've had counselling a couple of times over the last 3 years and it helped me get back on track, but didn't fix the anxiety.

I have been feeling worse in the last 3-4 weeks as we have identified a lot of issues and I have been actively challenging them. Exposure therapy doesn't work at the moment because I do not have one specific fear, so I have been listening to positive and motivating thoughgts instead, but we are starting a new treatment plan tonight and I am nervous and hopeful about it.

At this point I just feel overwhelmed. How do I beat something that doesn't exist as a single entity? (My GAD sometimes "transfers" into episodes of depression, OCD or health anxiety, but I do not meet diagnostic criteria for these things as they blow over on their own.)

I guess I don't have any more problems now than I did a year ago, it's just that I now know what I am up against and I'm not avoiding or denying it any more!

[theharvestmouse]

Hi PP, I am similar to you in that my anxiety crosses the different areas and i can't really be put into any specific box. I have some GAD but also in certain situations I have social anxiety but its just not black &white. My anxiety has also caused some episodes of depression.

I'm just doing as much as possible in spite of the anxiety, my CBT therapist said that the anxiety is the last thing to change. I think that she meant that only by doing lots of things that normally make me anxious and eventually it will stop.

However I have an argument against this theory. One day I can go and speak to someone confidently and be capable of feeling fine and not anxious. Yet another day I can just be really anxious and feel really uncomfortable. So its not like its a gradual improvement, maybe the bad days will become less often in time.

[NoPoet]

Hi Harvestmouse, I forgot all about this thread, thank you for your reply!

If your anxiety is transferring into different things, it seems to me that your real issue is Generalised Anxiety Disorder. Maybe this is why you're having a hard time with your recovery. GAD is known to be tough to treat because it can basically mean a fear of everything - once you start getting better, the anxiety simply turns into something else. If we just had health anxiety or social anxiety, for example, you can use exposure therapy to gradually get used to what you're afraid of and that should nullify the fear in the long run.

I am suffering GAD which transfers into health anxiety, depression and social anxiety. If I spent a lot of time treating health anxiety, the underlying GAD would still be there and would come back as something different at some point later in life. This is why people like us always seem to relapse. Have you ever noticed that when you start feeling better about something, something totally different pops into your head and you feel even more anxious? That's GAD.

At the moment my main problems are a terrible fear of depression and fears that my relationship with my girlfriend is on the verge of ending. It isn't, but by constantly needing her reassurance that we are ok, I risk pushing her away.

Who knows what will take the place of these things once I start to deal with them -- but my therapist is as convinced as ever that we will prevail.

EDIT: Anxiety is obviously a killer for your confidence - confidence is also a major factor in social anxiety. Very low self-worth would reinforce or create anxiety and depression. The trick when dealing with depression is to find out what makes you depressed, so the root of it might be "I am worthless, I am useless at everything", and then you can train yourself to believe the opposite: "I am a good and worthy person, I am equal to anyone else, I deserve happiness, I succeed at whatever I do". I also think anyone with GAD should try positive exposure therapy like this. It's helped me a lot more than trying to expose myself to negative thoughts.

[Bill]

These are just some thoughts based on what I do to cope with GAD.

At this point I just feel overwhelmed. How do I beat something that doesn't exist as a single entity?

How do you beat a cold? It has lots of symptoms associated to it and when you think about GAD, it creates lots of symptoms too such as OCD, health anxiety etc. As ou say, it's a fear of everything so it's going to find different ways to create symptoms to attack us.

My feeling is that comes down to prevention and cure. It's like having a package which I guess is probably how CBT works because for every event that GAD causes, you can then use the appropriate tool in your package to help you fight it off.

For instance, you can be sitting doing nothing when suddenly you get a thought that frightens you. You can then sit there analysing it until you freeze with panic or you can use one of your tools by getting and doing something that helps you to stop thinking about it. The more we think, the more anxious we feel and the more power the thought has. You take it's power away by not dwelling on it, your body relaxes and the thought loses its strength.

What then if you are doing something and a thought attacks you? Well, you will probably tense up, start feeling anxious and not be able to concentrate in which case you need to find something more interesting to do or use a relaxation technique such as deep breathing to keep you relaxed.

If you're doing something and you have an intrusive thought, you could then feel you need to perform an OCD ritual. If you do repeat an action, the intrusive thought gains power so you have to try and ignore it, keep relaxed and keep doing whatever it is. The more you repeat, the power anxiety gains over you.

When a health anxiety arise, the more you dwell on the worry, the more anxious you become, the more you'll feel the need for reassurance but if you do, another health anxiety will arise. If the health issue doesn't sort itself then of course see a doctor but often if you learn to train your mind away from it, and allow yourself to forget it, when you do think about it at a later time, the health worry will not feel so powerful. In other words, you'll have found reassurance for yourself.

If you're having an anxious day so you feel bad in a crowd or at work, learn another tool in relaxation tehniques. Different methods help different people. Find what works for you to keep your breathing controlled and that helps to stop your mind focusing on feelings.

Another thought - we often get depression with anxiety and this I feel is because anxiety stops us from doing the things we want to. Therefore, don't give in to fear. You need to fight it but learn how to fight it in the right way. In other words, let fear through you and don't allow it to tense you up. Fighting means learning how to keep calm to take the power away from anxiety.

A couple of thoughts regarding prevention - Too much stress in whatever form will create tension which then triggers anxious thoughts so remember your limitations, don't take on too much and leave what you can for another day or allow yourself to delegate. Try not to be a perfectionist. Remember, anxiety has no power when you learn how to keep relaxed, do what you want to do regardless and not allow anxiety to bully you. Remember to bring Enjoyment into your life and give yourself things to look forward to. Create a plan so you have a goal to work towards. Things you want to achieve and don't allow fear to hold you back. Bring in enjoyable hobbies to keep you occupied at home or in your free time.

I know I've rushed through this but it's just to give some examples of ways that have helped me by building my own package of tools I've used against the various symptoms of anxiety.:hugs:

[NoPoet]

Bill... wow, there is a lot of good stuff in that post. And that was rushed? Thanks mate. You clarified what I need to be doing, as I am still sort of at the "aargh, there's too much, what do I do" point, and it's at times like this you need someone to calmly say "Remember this, then this."

I have moved forward quite a bit since making the original post in this thread through CBT and self-affirmation. I have been feeling more upset and depressed than anxious lately - and I actually think this is a sign that I am getting better, because it means the anxiety has backed off and now the hidden layers of depression have arrived to try to kick my arse personally.

It may be that GAD can only attack you so many different ways before it backs off, so while this is more of a remission than a cure, it means I am making progress and will try to press my advantage. As for the depression, well there are some extremely painful CBT sessions ahead because the sadness and guilt that are attached to depression link intimately with my fears of loss, death and abandonment; I have asked my therapist if we can try concentrating on this from now on.

There are dark waters ahead, but as the saying goes, the only way is through.

[Bill]

Hello psychopoet,

Yes, my post was a bit rushed because I didn't have much time so I raced through various points and didn't get time to cover others.

I've read alot of your posts and always found them very interesting. I've learnt alot of stuff from you. By the way, I used to be a member with Anxiety UK too.

Anyway, I must admit I don't know a great deal about your current fears so this is just going by what you've said in these couple of posts. Hope it's of some help to you.

the sadness and guilt that are attached to depression link intimately with my fears of loss, death and abandonment;

At the moment my main problems are a terrible fear of depression and fears that my relationship with my girlfriend is on the verge of ending. It isn't, but by constantly needing her reassurance that we are ok, I risk pushing her away.

Your g'f must mean alot to you which is really nice but there is a price we pay for having something we hold dear and that is the fear of losing what is precious to us. The more we have, the more our fear grows because the more pressure we put on ourselves.

One of the subjects I didn't raise before was being Intense. It's something I feel we often are. I reckon alot of us are deep thinkers and analyse every thought to the enth degree. We twist ourselves in knots with "what if" this happens and "how will I cope" etc. We fill our minds with worries and blow everything out of proportion instead of trying to take a more relaxed approach towards life.

I'm guessing that your depression is linked to your fears of losing her but also your fears of pushing her away because of your anxiety. Whenever we are in a relationship there has to be Trust and I feel you need to put your trust in what she says and does for you. ask yourself if you can think of any rational reason why she would want to leave you or why you should suspect her wanting to leave, and if not, "accept" what is before you and focus on being happy together. Remind yourself, that if she wasn't happy with the relationship, she would tell you or you would see obvious reasons that she isn't happy.

Instead of focusing on your fears, focus on doing all you can to show she is No. 1 and do all you can to make her happy. If then she did ever leave, there would be nothing more you could have done so again it would be a case of just "accepting" it wasn't to be. You could have done no more.

Rightly or wrongly, what I would do is, I would suggest turning your negative fears into positive actions by finding ways to show your love for her because in that way, you'll relieve the pressure you're putting on yourself through your worries so you won't feel the need to seek reassurance. This will help you to feel more secure and less depressed because you'll be able to focus on enjoying life together because through your actions you'll see her happy being with you which will be all you need to remind yourself with for the reassurance you need to feel content yourself.

Hope something in that makes some sense.:)

[NoPoet]

Hi,I completely forgot about this thread. Thanks for your input Bill, you really know your stuff. We should swap notes more often.

Things have moved on a lot since I made my previous post. Before I reply to you I would like people to know that listening to positive, self-affirming mp3s which I have created and refined through trial and error, has started to take root now. Case in point: the other day I was on my own at lunch and drove to Subways which I normally go to with my colleagues. Instead of feeling lonely and demotivated, I found myself singing and feeling brighter than usual. The positive messages I listen to are gradually starting to bloom, but the human mind can be a rocky garden and the "flowers" of positive thought require constant maintenance until they eventually become able to support themselves. Your positive thoughts take on a life of their own. Your rockery becomes a garden. A bit naff perhaps, but there's nothing wrong with nice metaphors.

My feelings of depression and low mood have started to recede somewhat. I spoke to someone who said people with anxiety require one session of anxiety for each year they have been alive. I feel that I am perhaps halfway, or just before halfway, through my therapy. Unfortunately the half that's left is the shitty, horrible part.

I am finding that real life issues (work and relationships) are starting to take priority over the illness for the first time in months. Unfortunately I've spent so long thinking about myself and my problems that I am simply not equipped to deal with the real world.

My girlfriend and I are experiencing issues which I will talk about in another thread. It's complex and I feel frustrated not to be able to influence things, but at least my therapy is getting somewhere and my self-help is starting to take effect, even though I have got a lot of work ahead. I'll reply to Bill in the other thread.