CBT for Worry London

What is Generalized Anxiety Disorder (GAD)?

Generalized Anxiety Disorder (GAD) is an anxiety disorder characterized by excessive and uncontrollable worry. It is often referred to as the “Worry” disorder. GAD differs from other anxiety disorders in that the worries are not specific to a particular theme. People with GAD tend to worry about a number of different themes/topics, including day-to-day events, “what if I am late to my meeting”, the health of their loved ones or their own health, their finances, getting lost on the way to an appointment, etc. People with GAD can worry about anything and everything.

Doesn’t Everyone Worry?

Everybody worries from time to time. It’s normal to worry at times of stress, i.e., when you are trying to conceive, going for a job interview, thinking of changing jobs, or perhaps leaving your relationship. But there is a difference between appropriate worry, and unproductive worry. Those who suffer with GAD tend to engage in unproductive worry and experience unhelpful thoughts and feelings that keep the worry cycle going.

Unproductive worry has the following qualities:

• Catastrophic thinking: predicting that a negative outcome will occur, and if it does, doubting your ability to cope.
• Intolerance of uncertainty: you find it very difficult to accept the unknown and so seek every ounce of reassurance you can that your worst fear will not happen.
• Ineffective problem-solving: since most of the events that you worry about are future-oriented, (i.e., they haven’t yet happened), attempting to solve them only leads you to a heightened state of anxiety.
• Difficulty accepting risk: unproductive worry leads to attempts to abolish any possibility of future danger, or at least minimize the chances of negative events occurring. These attempts are exhausting, time-consuming and unrealistic because accepting an element of risk and uncertainty is part of life!
• Worry about Worry: worriers don’t only worry about day-to- day events, but also about their inability to control their worries. Common worries include:

How Common is GAD and What Causes it?

It is thought that 5% of the population experience GAD. Many sufferers say they have been a worrier for years, and that they worry about everything. Like many anxiety disorders, there are different risk factors involved in the development of Generalized Anxiety Disorder.

Temperament/Biology: it is thought that individuals born with particular temperaments are more likely to develop Generalized Anxiety Disorder. “Children who are behaviourally inhibited are more easily distressed and react quite easily to novel stimuli” (Fox & Frenkel, 2013). We also know that individuals with GAD are often found to have an imbalance of brain chemicals (serotonin, dopamine and norepinephrine) and this could be a contributing factor to developing GAD; an imbalance of these chemicals can affect emotional stability. It’s also thought that in people with GAD, the amygdala has become highly sensitive and thus it reacts with a high stress response.

Genetics: many anxiety disorders are hereditary and GAD is no different. In fact, GAD has a higher genetic component than other anxiety disorders. One twin study found that genes accounted for nearly 40% of the development of GAD in twin males.

Stress: it is thought that individuals exposed to stressful events either during their childhood, or in adulthood, are at a higher risk of developing GAD. Examples of stressful events include the death or illness of a loved one, or going through an illness oneself. Often when we experience an illness, either of our own, or of a loved one, it can trigger worries and anxiety, which sometimes don’t improve, even if/when the illness does.

Traumatic Experiences: abuse in childhood can also put an individual at a greater risk for developing GAD. The experience of abuse can lead to a state of hyper-vigilance (always on the lookout for danger) -a feeling of constantly being on edge, and feeling wired up. This is a normal and natural response to abuse. The problem is when the response carries on, long after the abuse is over.

Individuals who suffer from GAD typically spend a lot of time predicting the future. They engage in “what-if” thoughts, thinking that if they can anticipate the future this will reduce the uncertainty of what lies ahead. These negative thought patterns are often targeted in exposure therapy and other CBT techniques.  

Some examples of uncertain situations include:

• Helps me to problem-solve
• Prepares me for bad outcomes
• My child has a cold but what if it’s something more serious?
• up for promotion but what if I won’t get it?
• What if I lose my job and won’t be able to afford my standard of living?
• partner and I argue all the time; what if our relationship doesn’t last?
• I booked a hotel abroad; what if it looks nothing like it did online?

What is CBT for Generalized Anxiety?

Cognitive Behavioural Therapy or CBT for Generalized Anxiety Disorder is an evidence-based, highly effective therapy which has been proven effective in helping individuals like you manage anxiety.

CBT is recommended by the National Institute for Health and Care Excellence (NICE) in the treatment of GAD.

CBT involves a variety of tools and treatment techniques to help you control anxiety, and our work will primarily include helping you to:

• Understand the difference between real life problems and worries about the future (the former you can do something about, the latter you cannot).
• Apply problem-solving to real-life problems
• Increase your tolerance for uncertainty
• Identify your positive beliefs about worry (the beliefs that keep worry going)
• Reduce your safety behaviours
• Design behavioural experiments to test out what happens when you reduce your safety behaviours

Through our work together you will learn how to cope with anxiety and discover that you don’t have to control every possible outcome and situation, and that doing so doesn’t really have any bearing on the outcome.