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Oh GAD – when some people can’t stop worrying
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Oh GAD – when some people can’t stop worrying

A disorder often triggered by life’s concerns can be managed with a blend of mindful therapies and adjustments in one’s lifestyle, say experts
woman facing anxiety issues
Representational image | Shutterstock

Anxiety is our body’s natural response to stress. When it assumes paralysing proportions and extends beyond a reasonable period, it is called a ‘disorder’. It is a feeling of disproportionate fear and apprehension and is usually triggered by the uncertainty of future events. 

Excessive, uncontrollable worry and anxiety that interfere with daily tasks are signs of Generalised Anxiety Disorder (GAD). According to the World Health Organization’s estimates, over 38 million Indians suffered from anxiety disorders in 2017. 

Understanding the problem  

“Free-floating anxieties, or unwarranted worries which a person is powerless to stop, are at the root of GAD,” says Dr Dharmendra Singh, consultant psychiatrist at Batra Hospital in Delhi. He adds that its symptoms include restlessness, palpitations, fatigue, irritability, sleep disturbances and decreased concentration. 

If an individual has been experiencing any of the two major symptoms and three minor symptoms for more than six months, they are diagnosed to have GAD. However, signs such as headaches can be easily confused for migraines and spondylitis, when in fact the underlying cause may be GAD. 

Addressing life’s concerns 

“A person with GAD finds it difficult to control the thoughts about particular circumstances,” Dr Ajit Dandekar, honorary psychiatrist at Nanavati Super Speciality Hospital in Mumbai, explains further. Individuals with GAD tend to struggle with both emotional and physical responses when such thoughts are triggered. 

Dr Dandekar adds that in individuals with the condition even normal issues or situations are likely to create fear or worry. This is because the anxiety-triggering situation may not be dangerous, but their minds interpret it that way.  

“Mostly, anxieties revolve around career, work, money, family affairs, and health which demand a person’s attention,” says Dr Dandekar. “If you already experience anxiety, get assistance as soon as possible.”  

“One’s perception, mindset, attitude, or overall personality makeup are important,” he adds.  

Take the example of Delhi-based engineer Payal Batra’s mother, who would call her at least ten times in a span of just five minutes when she was out at night. “This caused a strain in our relationship,” says Batra, whose viewpoint changed once her mother was diagnosed as having GAD.  

Some tell-tale signs 

  • Sweating, breathlessness, or dizziness 
  • A sinking feeling 
  • Trembling, and increased heartbeats 
  • Butterflies in the stomach 
  • Nausea or headaches 
  • Tensed body 
  • Confusion, indecisiveness 
  • Loss of focus, poor concentration, an inability to perform daily tasks 
  • Restlessness, fidgetiness, fatigue 
  • A choking sensation in the throat 
  • Feeling of a load on the chest 
  • Highly strung or easily startled 
  • Feeling unusually forgetful, worried, scared, or irritable 
  • Occurrence of phobic symptoms or panic attacks 
  • Excessive irrational worry about future events and situations 

Psychotherapy helps 

People in any age group can experience GAD, but adolescents and young adults as well as those in the post-retirement age group are prone to anxiety disorders. Although panic disorder, obsessive compulsive disorder and other forms of anxiety share some symptoms with GAD, they are all distinct medical conditions. 

One of the biggest difficulties with GAD is its management over the long term. It frequently co-occurs with other mood or anxiety disorders that are typically treated with psychotherapy, medications, or a combination of the two.  

Lifestyle changes and therapy help 

However, it is possible to manage the condition by altering one’s lifestyle, developing coping mechanisms, and using relaxation techniques. 

The most well-researched and efficient therapy for treating GAD is cognitive behavioural therapy (CBT). More specifically, a form of CBT called Dialectical Behaviour Therapy (DBT) is used, which was first developed as a treatment for borderline personality disorders. 

The main objective of CBT or DBT is to assist affected individuals in changing their anxiety-causing behavioural patterns. CBT is the most popular therapy for treating all kinds of anxiety disorders. Compared to most other types of therapy, it can help individuals reach their treatment goals in fewer sessions.  

With the help of healthy coping mechanisms, this research-backed therapy aims to alter harmful thought patterns and basic beliefs.  

What is DBT? 

DBT, with its roots in CBT, is a type of counselling that aims to help patients build effective coping mechanisms, emotional control, and life balance through individual and group treatment sessions. DBT usually lasts six months, but this might vary from person to person. 

“DBT may be especially beneficial to anxiety disorder sufferers who [may] self-harm or have unhealthy coping mechanisms,” says Dr Singh. Some people pick up relaxation techniques such as yoga, meditation, autogenic training, or progressive muscle relaxation which, he says, may equip them to fight the disorder. 

A multi-pronged approach 

Treatments are decided depending on how much GAD is impeding one’s daily life. Long-term and preventive measures include physical exercise, relaxation techniques, yoga, and lifestyle changes. In-depth psychotherapeutic sessions like mindfulness therapies, and CBT are also among the options.  

“The body has tremendous healing power. More hands-on, physical therapies must be used. The only way ahead, in my opinion, is the adoption of integrated medicine,” said Dr Mohammad Mohsin Ali, director and practitioner at Integrated Medical Centre, New Delhi. 

A blend of food, massage and yoga 

“Traditional medicine needs to incorporate and concentrate on the three most important factors – circulation massage, digestion with a healthy diet, and physical and emotional stress management through yoga,” he added. 

Helpful systems but unproven 

Pranayama, which is an ancient breath technique, is very effective in calming the mind,” says Kolkata-based yoga teacher Anita Chowdhury. “However, as yoga practitioners, we do not treat only the primary symptom. We try to look at the root cause of the problem and assess the person’s lifestyle before suggesting asanas that can help them to heal holistically,” she adds.  

However, the efficacy of alternative practices like yoga and ayurveda in managing anxiety disorders remains unclear. Experts point to the lack of adequate scientific studies to determine how effective these methods are when applied in isolation. So, when it comes to deciding on the treatment, the severity of GAD in impeding the ability to function in daily life is considered.  

Suffering individuals and their mental health professionals can best determine what is stressing the persons out and what might make them feel better – by keeping track of their personal life. 

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