View Full Version : GAD....how do you know?
Hi everyone,
Please could someone explain to me how you know if you have GAD and how to go to your doctor and explain why you think you might have it?
I know ive got OCD which probably doesn't help but I get over anxious about stupid things and I just don't know how to stop it!
Help needed please.
HB xx
GAD is characterised by an overwhelming sense that there is some lurking threat or danger which you can't see, but you know it's there. You feel afraid of everything - including yourself.
It causes you to become hyper-vigilant, ie permanently alert for danger, even where there is none (which is most of the time). Your body goes into a heightened state known as fight-or-flight, as your body is simply reacting to the signals your brain is sending it. It can create obsessive rumination (brooding about things that have happened) and worrying (fearful, negative expectations about what might happen) and obsessive compulsive behaviour.
Your thoughts and behaviour may become overwhelmingly negative. This is cognitive distortion - i.e. a bias - towards negativity. Cognitive distortions are always seen in anxiety and depression cases, and dealing with these is a major factor in your permanent recovery.
You will almost certainly be unable to stop ruminating/worrying/obsessing for long periods, because you feel something terrible will happen if you don't do these things. (This is a logical fallacy, i.e. it doesn't make sense.) When you start getting better, you will naturally find yourself spending more time free of these things, able to devote far more time and energy into enjoying life, rather than worrying about it.
I can best describe it like this: Imagine you are standing in a wide open field beneath a clear sky. If you feel like something is coming down from above, or something is going to appear on the horizon, and it's heading towards you with fatal intent, that's GAD.
A specific type of anxiety relates to one area, so someone diagnosed with health anxiety specifically has an overwhelming fear of dying due to illness or injury. GAD is a fear of all things.
A fear of one specific thing or circumstance is a phobia. (Eg a fear of snakes, or heights.)
Thank you NoPoet, that makes complete sense and definitely is how I'm feeling right now. It's always there lurking in the background even when there is nothing to run from...usually when things are going well which I don't understand :(
HB xx
Actually, you can feel worse when things are going well. This is one of the most frustrating aspects of the illness. It's a sure sign that you're recovering if you can enjoy the good times and put the anxiety on hold for a while.
I think we feel worse because we know we should be enjoying ourselves but the anxiety prevents this. In that case, we are probably having intrusive thoughts about "I'm not supposed to be happy" or the illogical, GAD thought "If I feel happy I'll end up feeling worse".
Really? How have I not noticed these things before? I've always thought that maybe it was just the depression I suffered causing this, I didn't know it could be something else completely.
It's this whole fight or flight thing that comes in to play and the feeling only seems to go if I do run and I can't soend my whole life running especially from such good things.
What do you recommend I can do? I'm just riding out the anxiety at the moment, letting it in because I'm so used to it, when I fight it, it just becomes worse.
HB xx
It's characterised by excessive worry; psychologist term it as 'rumination', which will be useful for you to look up if you think you might have GAD.
For me that's very true, and the worry is not proportionate to the situation. He other day, for instance, I hadn't heard from my friend who lives overseas in a couple of days. We normally chat on Facebook daily and since I hadn't heard from her, I was SURE she had died. Even though I knew she had patchy internet... turns out her net had died, lol.
I also have 'racing thoughts' which is linked to the rumination. Say if I have abdominal pain, I might think "oh, what if I have cancer? Then I will probably die and even if I don't I'll have to drop out of uni and then I won't be able to have a job that pays well and I'll have to live with my parents and they'll end up resenting me and I'll never get to move out and end up depressed and unfulfilled..." As you can see, it's a very extreme response to a situation and not especially logical. Having abdominal pain does not immediately mean cancer, OR all the other things I listed.
If that sounds familiar, I would talk to a GP or counsellor. To be considered Generalised Anxiety Disorder, I think one needs to have worried excessively (at least once a day over atypical concerns or very excessive worry about normal things like health, money etc) for a period of six months. Something like that.
Hopefully this doesn't end up being something you have but, if you do, there's a lot of effective ways to treat it.
Best wishes :)
MyNameIsTerry
04-04-15, 11:34
According to NHS Direct http://www.nhs.uk/Conditions/Anxiety/Pages/Diagnosis.aspx
Do you have GAD?
You may have generalised anxiety disorder if:
your worrying significantly affects your daily life, including your job and social life
your worries are extremely stressful and upsetting
you worry about all sorts of things and have a tendency to think the worst
your worrying is uncontrollable
you have felt worried nearly every day for at least six months
The thing about GAD is that it can cross over into other anxiety disorders very easily. You can experience agoraphobis, for instance. I did, but I realised it was GAD in reality because in exposing myself to it, I got over it quite quickly whereas a true agoraphobia will have a far harder time.
Don't worry about your GP, he/she will make the diagnosis based on their guidelines. In truth, its more likely going to be a GAD diagnosis than certain other anxiety disorders anyway which may require a specialist to work through to diagnose. GAD can be a catch all for GP's until they get a later diagnosis.
If you look at Emily's example of abdominal pain, this is something I have read about diagnosis when it comes to HA. They determine if there is a pre existing anxiety disorder such as GAD or OCD and if not then they continue onto HA. So, again its an example of how diverse GAD can be and how it mimics the other disorders.
Somebody without GAD won't have quite the same issues with other activities. However, going to NoPoet's potential asteroid, it doesn't mean that they won't also become anxious in those scenarious simply because their anxiety is already intense due to their HA concerns.
So, I think it can be an issue of what came first in some cases.
For me my doctor recomended I see a counselor. I went and spoke to them and that's when I was diagnosed with GAD. You can set an appointment with your doc for anxiety issues then ask her to refer you to a counseling center or something. I know the one I went to i had to be referred by a doctor but you maybe able to find a good therapist on google in your area and call them for info.
Thanks everyone for your kind replies.
I've done ok today as I've been out for the day visiting a friend in Cardiff, but it's always there lurking in the back of my mind and then I dread going to sleep as I know I'm just going to wake up with it again :(
Best bet is to go and see my doctor I guess?
HB xx
---------- Post added at 17:21 ---------- Previous post was at 17:19 ----------
Plus what is the best medication for this kind of thing? I'm on Venaflaxine but it doesn't seem to help :(
HB xx
Mornings are the toughest part of the day. At least, to begin with. Anxiety and associated conditions are well known to "reset" themselves so that you feel anxious in a morning no matter how confident you were when you went to bed.
This is all part of the process. We tend to think "Oh no, I've got another full day to get through!" and then imagine spending every waking moment feeling misery or fear. Experience, and plenty of positive thinking, will show you that this is just another falsehood - an illusion - caused by negative bias.
It's hard to over-emphasise the importance of bias in your thinking. You will reject, either knowingly or unwittingly, anything good that occurs; you will see the "clear" times, when the anxiety wasn't in control, as a period of tension as you waited for it to come again. It doesn't occur to you to think of this as a "free" period which proves that you can exist without anxiety, if even for a few minutes at a time.
Being able to exist without negativity or anxiety for even one second proves to you that it can be done.
I have a difference of opinion from my therapist on GAD. Since I believe all thought comes from memory there has to be a reason for GAD. The fear is very strong, strong enough to block any search for where it is coming from. If you could find a reason then there would be no reason for the reaction. This also happens with extreme PTSD. Access is blocked for survival reasons. Unfortunately that makes it worse and I agree Gad can lead to other things. It does though appear to come from nowhere and is hidden except the fear. Very bad fear. I just don't believe you can experience something with out previous experience.
So where do new thoughts come from? Associated memory puts them together from similar situations that it thinks can be the answer. Trial says if it is. And it can be wrong based on core beliefs. We have a lot of stuff in memory to choose from.
Just my opinion. Which doesn't make GAD any easier to live with.
Thank you everyone for your kind replies, it is much appreciated!
I drove to Wales today to go see a friend and it helped a little, although Herman (what I call my anxiety lol) was still there in the background trying to make an appearance but I told him to politely do one and leave me alone, just for a day and I've come back home after having a mini anxiety attack in the car on the way home feeling a bit more refreshed and relaxed (if that's something us people can do) and all I want to do is sleep now hoping I don't wake up at the crack of dawn with this dread feeling.
I'm going to make an appointment with my GP on Tuesday to discuss everything and see if I can change my medication and bump me up on the list for my CBT that ive been waiting over a year for!! Positive thinking!!
I won't let this beat me this time and trick me into running away from everything that is good for me. I've got an amazing job with amazing opportunities with really great people so I'll be dammed if I'm running or walking away this time!
HB xx
Have you looked at the online CBT course offered here?
No....I didn't know there was one?
HB xx
MyNameIsTerry
05-04-15, 07:11
I'm going to make an appointment with my GP on Tuesday to discuss everything and see if I can change my medication and bump me up on the list for my CBT that ive been waiting over a year for!! Positive thinking!!
Is there an Inproving Access to Psychological Therapies (IAPT) service in your area? If so, they should be offering CBT far quicker than that because 12 months was the old psychotherapy service which is now seen as Level 4 in the NICE Stepped Care Model. IAPT came in to provide a quicker access to services based on CBT at Levels 2 & 3 so they should be far faster than 12 months.
Have you already had CBT at Level 3?
I'm glad Wales went well. It could have been worse as I'm sure you know so I thought you should be commending yourself for that!
---------- Post added at 06:54 ---------- Previous post was at 06:43 ----------
Mornings are the toughest part of the day. At least, to begin with. Anxiety and associated conditions are well known to "reset" themselves so that you feel anxious in a morning no matter how confident you were when you went to bed.
Cortisol is high in the morning. Its what wakes us up.
This makes sense as to why anxiety is generally higher and how getting moving can make you feel better since thats a good way to flush it out.
---------- Post added at 07:00 ---------- Previous post was at 06:54 ----------
For me my doctor recomended I see a counselor. I went and spoke to them and that's when I was diagnosed with GAD. You can set an appointment with your doc for anxiety issues then ask her to refer you to a counseling center or something. I know the one I went to i had to be referred by a doctor but you maybe able to find a good therapist on google in your area and call them for info.
I think this depends where yo are and who you see. My therapist, who my doctor referred me to, said she was unable to make a diagnosis. I presume this is because those at CBT level working within our IAPT network are CBT only as a minimum and not trained psychologists/psychiatrists.
So, I think its more the GP over here unless you make it to the Level 4 side where you gain access to the specialist.
Its definately worth seeing a therapist though, meds only paper over the cracks while you do the real hard work to recover.
---------- Post added at 07:03 ---------- Previous post was at 07:00 ----------
Plus what is the best medication for this kind of thing? I'm on Venaflaxine but it doesn't seem to help :(
Thats a difficult one. Its more trial and error sadly.
It might be worth creating a thread in the general section on the meds board and see what others say.
Ven is one of those that GP's can increase so maybe that is an option. Have a word with some of the regulars on the ven board e.g. pulisa, SADNoMore, Nicola, Michelle, Pipkin (admin), etc as they might be able to offer some advice from their experience on this.
---------- Post added at 07:04 ---------- Previous post was at 07:03 ----------
No....I didn't know there was one?
HB xx
The one on here is for panic. Its worth a look.
However, NICE and NHS Direct's websites recommend several free online CBT courses that cover anxiety and depression as opposed to just panic so its worth a look. They are pretty easy to find via Googlr last time I looked but let me know if you need the names as I know where to find them on the NICE website.
---------- Post added at 07:11 ---------- Previous post was at 07:04 ----------
I have a difference of opinion from my therapist on GAD. Since I believe all thought comes from memory there has to be a reason for GAD. The fear is very strong, strong enough to block any search for where it is coming from. If you could find a reason then there would be no reason for the reaction. This also happens with extreme PTSD. Access is blocked for survival reasons. Unfortunately that makes it worse and I agree Gad can lead to other things. It does though appear to come from nowhere and is hidden except the fear. Very bad fear. I just don't believe you can experience something with out previous experience.
So where do new thoughts come from? Associated memory puts them together from similar situations that it thinks can be the answer. Trial says if it is. And it can be wrong based on core beliefs. We have a lot of stuff in memory to choose from.
Just my opinion. Which doesn't make GAD any easier to live with.
Something to consider is how neuroplasticity relates to this. And methylation, which is an interesting one. A memory can be formed based on a build up of issues that result in a point where the memory is formed due to heightened emotional arousal. The right Amygdala looks for more emotion in determaining the importance.
So, if you look at what happened to me, I was working far too hard and not having any play time, losing contact with my friends, etc. I then found myself being sick after a night out which is unusual for me. I went to work, got to my desk and couldn't quite hear what was going on and then felt very sick and had to escape. I did and when coming back in it happened again. From that point on, it got much worse for me in the classic spiralling we often see.
That buuld up of events had been setting the scene for something to happen. it happened, and then it became about that event (and the perceived danger) and not the build up issues that I didn't see or understand at the time.
So, my memory was a learnt response and it deepened from there on. I can see some occasions of OCD in my childhood but very sparse and most didb't even affect me anyway. It was when I hit 30 that the anxiety came. So, no memories going back to childhood would have been affecting me and my OCD only developed fully 4 years after my GAD started.
Thank you so much for the detailed reply Terry :) that helps greatly!
I will take a look into that and ive already started a thread on the Ven forum :)
HB xx
---------- Post added at 10:18 ---------- Previous post was at 10:07 ----------
I did have some CBT around 2 years ago which I paid for but couldn't really afford it anymore as it was £60 a session :(
HB xx
MyNameIsTerry
06-04-15, 05:05
So, it seems your treatment has been only drug based by a GP. This should mean you would access the levels provided within the NICE Stepped Care Model as long as you have an IAPT service in your area.
Here is the NICE guide so that you can see whether you are getting what you should:
https://www.nice.org.uk/guidance/cg113/chapter/1-guidance
You can search for your IAPT here:
http://www.nhs.uk/Service-Search/Counselling-NHS-(IAPT)-services/LocationSearch/396
Well finally making some progress, I've booked an appointment to see a hypnotherapist who also does work with CBT on Thursday just to see if she can help me and go from there it will cost me but I would happily pay to finally try and get rid of these demons! Or Herman as I call it lol....well when you're telling a person to f**k off it's easier plus you don't look so crazy lol.
So doctors then this, fingers crossed I'm on my road to recovery!
I'll keep you all update :)
HB xx
MyNameIsTerry
07-04-15, 05:37
Good luck with it!
Just be careful finding anyone in this sector as its still unregulated.
The BACP register is recommended and the NHS recommend the BABCP one.
There are so many associations out there and many of them are attached to training companies owned by the same people so they hand over your internet diploma and allow you to have some letters after your name from their association as a member. The BACP won't touch people who train without minimum client hours under supervision so none of these internet diploma trained counsellors & therapists are elligible to join.
They may not all be bad, but its the fact they are not supervised and anyone can do it without real experience that is the issue. Some of the training colleges offer hypnotherapy as well but there are more established hypnotherapy assocations out there who do require their training to be more robust to and a certain level of experience to become full members.
There is a Bill of Parliament raised to regulate this sector under the HCPC (they regulate such as the paramedics and they already regulate 2 forms of job role in this sector)
Well it seems she is regulated which is good! She's also very nice and helpful :)
I've got a doctors appointment today but it's with a duty doctor so god knows who I will see! Does anyone know the best thing to say, I get all tongue tied and get all blabbery....
HB xx
MyNameIsTerry
07-04-15, 10:51
Thats great! That means she is experienced in helping people with someone approving her work and monitoring her ongoing, so she must know what she is doing.
The best thing tends to be to write down the key points you want to discuss so that you are a rabbit in headlights as we sometimes are or get drawn of topic by something.
Just some bullet points will do so you have a prompt, its less to think about then.
Wow....panic attack from anxiety and parents arguing, that was quite intense. That did not make me feel good at all.
I'm hoping everything's headed in the right direction from here on out....
HB xx
MyNameIsTerry
08-04-15, 05:00
Its because you are so sensitised right now. I've had this too but it will go as you recovery as you are no longer as reactive to the things around you.
Thanks Terry :)
Started on my increase of Ven today, felt weird and panicky firstly but calm now just feel a bit more at ease which is good :)
HB xx
MyNameIsTerry
08-04-15, 10:56
Thats good then.
Keep in touch with the people on the ven board. There is a group of very supportive people on there who will help you through any adjustment period.
Thank god! Just got a call over a year later and I'm at the top of the waiting list for my CBT :)
Fingers crossed in the next week or so I get an appointment!
HB xx
Juliette14
08-04-15, 15:20
Actually, you can feel worse when things are going well. This is one of the most frustrating aspects of the illness. It's a sure sign that you're recovering if you can enjoy the good times and put the anxiety on hold for a while.
I think we feel worse because we know we should be enjoying ourselves but the anxiety prevents this. In that case, we are probably having intrusive thoughts about "I'm not supposed to be happy" or the illogical, GAD thought "If I feel happy I'll end up feeling worse".
Nopoet, thank you so much, i have been suffering with anxiety for many years but I could still function work etc... even if I was having had some personnel and health issues, but lately as my life is finally more stable and everything is good the anxiety suddenly became much worse! It finally all makes sense for me now!
Will this anxiety ever go away? I felt fine all bloody day and now I feel shite again :( I just want a few days where I don't feel this weight on my shoulders!
Please will it ever go away and stop ruining good things for me :(
HB xx
MyNameIsTerry
09-04-15, 05:54
The fact that you have had a good day proves it can.
Mine is there pretty much everyday but it depends on the level of it as unless it high, I can get on with things pretty well.
The thing is, if it goes away for a few days, when it comes back you will likely be as frustrated as we just want it all gone. Try to keep going with things and remember that you have times where it does go and these will lengthen as you recover.
Mine is really bad today :( got a feeling this will never end.
I have been fine for months but now things are good and I've got really good things going on in my life the anxiety is overwhelming. I don't know how to shut my brain up and to stop this general pressure in my head.
Just want it gone and to feel happier. Like I was.
HB xx
MyNameIsTerry
09-04-15, 09:06
You found a way out of it before to have those months where it was fine and I bet you thought it was never going to get better back then either which shows that despite how you currently feel, it can.
You have think of it as early days again. You have a job you enjoy with a good crew and you are obviously well thought of by them for asking you for help and your boss for recognising your potential.
You've had a bit of a knockback but you will get back to where you were.
I know it will pass but this is the feeling I had when I took my overdose and I keep remembering it and I don't want to be back in that place.
It just is a total body feeling and it overtakes everything.
I've asked for a callback from my doctor.
HB xx
MyNameIsTerry
09-04-15, 11:24
It might be due to the increase in the Ven.
I realise it brings back some memories that you really could do without but this seems to have all come on recently after a good few months so is it really as bad as then or is it more a worry that it could be taking you back to that?
If you describe the symptoms on your Ven thread, maybe Nicola & co could offer some advice based on their experience?
I'm not on Ven, but I am another SNRI, Duloxetine. I was not too bad going onto the 30mg to start the taper but the 60mg made me extremely anxious, far more than I have ever been. So, I wondering whether you have been having elevated anxiety, gone up with the Ven and its side effects are kicking in because I know how it piles on top of already elevated anxiety it makes it feel unbareable.
I just noticed that you were not too bad the other day when you increased and I wondering whether this is now worse than before you went to your GP? If so, that could be the Ven.
My anxiety is heightened but yesterday it calmed during the day after taking the increase but today is awful :(
I know if I run away my anxiety will decrease but I can't keep doing this!
HB xx
MyNameIsTerry
10-04-15, 04:35
Its a drug with a very short half life. If you take a greater dose at one time rather than the other, maybe that drop back to a lesser saturaion level is causing you some side effects right now?
Hopefully the people on the Ven board can answer this one for you.
Bonnibelle
05-05-15, 14:29
NoPoet your reply helped me alot. It has made me realise I really do have GAD and I need to stop fearing it's something else.
Thank you.
Bon
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