Generalized anxiety disorder (GAD) is a mental health illness in which a person has chronic worrying and tension. It is a common anxiety illness, affecting 3-4% of the population, that turns daily life into a state of worry, anxiety, and fear. Over thinking on “what ifs” results in a vicious anxiety cycle, and could lead to depression as well as the constant anxiety affecting them.
Generalized Anxiety Disorder GAD: An Overview
If we asked you to guess what the most common cause of disability in the workplace is, what would you think? Work-related injury? Depression? Actually, the answer might surprise you – it’s generalized anxiety disorder (GAD), which affects about 3 per cent of adult Americans annually. In addition, 3 per cent of American children, and up to 10 per cent of adolescents in this country experience GAD and the difficulties that come with it.
Of course, everybody knows what anxiety is and what it feels like when it’s happening to you. Perhaps it’s brought on by work stress, family worries, or bereavement; but in many instances there is no specific trigger and GAD – like many other psychiatric disorders – is a result of genes, early environmental influences, or a combination of the two. Unlike panic disorder where the anxiety is short-lived and intense, GAD symptoms are far more prolonged and typically involve anxiety symptoms for a significant portion of the day.
Generalized Anxiety Disorders GAD Symptoms:
- Constant uncontrollable worry, anxiety, or obsessiveness about multiple events or activities, such as health, money, work, school, and relationships, even when things may be running smoothly
- Routine life activities at home or at work being interrupted or not achieved at all, due to the anxiety or a sense of impending disaster
- Experiencing these symptoms for six months or longer
Generalizes Anxiety Disorder Physical Symptoms
- Sleep problems
- Feeling restlessness, on the edge, or easily irritable
- Inability to focus or concentrate
- Unexplained muscle aches or tension
Generalized Anxiety Disorder GAD Treatment
GAD treatment can include psychotherapy, medication and self-help. To discuss a potential treatment plan, please call for a consultation.
It is also worth noting that women are twice as likely to experience GAD than men, and that this may be due factors typically experienced more by women such as domestic abuse, discrimination, or poverty. The risk for GAD is also increased in abuse or trauma survivors, those suffering from chronic medical illnesses, or certain personality types. However in a majority of GAD cases an environmental cause is not identified and there is a genetic predisposition towards the condition.
If you are one of the 7-10 million Americans suffering from these symptoms, it’s important to seek assistance to help your condition because GAD does not go way on its own. The good news is that the condition is easily treated with psychotherapy, lifestyle changes, or medications. Remember: nobody has to expect to live in a state of constant fear and worry – assistance can all the difference.
In the first weeks to months after giving birth, many women experience feelings of sadness intermingled with the joy of having a new baby. Huge adjustments must be made quickly to adapt to the new life in your home and it is often a stressful period—especially for first time mothers. The effects of prolonged sleep deprivation do not help matters.
However, if symptoms of depression become apparent and linger after giving birth, something more serious might be occurring—you may be experiencing Post-Partum Depression (PPD). PPD occurs in about 13% of women, is a major cause of maternal and infant mortality, and can affect infant development. Many women who suffer from PPD frequently feel embarrassed or ashamed for not being able to leap into motherhood with all of the joy and enthusiasm that the rest of the world expects them to immediately have.
There are many reasons why PPD may occur, but the primary one appears to be a sudden drop in estrogen and progesterone hormone levels after childbirth. Also, a drop in thyroid hormones can deepen symptoms by causing fatigue, and, paired with changes in physical appearance brought on by pregnancy, feelings of depression can worsen. It is important to keep in mind that it can take weeks—sometimes even months—after the birth, for PPD to fully develop. In about 10% of cases PPD begins during pregnancy.
So how do you know if you are experiencing PPD, and not merely adjusting to your new baby? Here are some symptoms for you to look out for:
Post-Partum Depression Symptoms
- Swinging between restlessness and extreme fatigue
- Tearfulness, depressed feelings, and a sense of worthlessness
- An increase in indecisiveness and an inability to retain focus
- Increased anxiety caused by thoughts of harming one’s child (either accidentally or intentionally)
- Changes in appetite
- Extreme mood swings
- A lack of motivation
If you are suffering from the above symptoms, it is important to remember that you are dealing with legitimate physical changes and issues that far surpass what are commonly referred to as “baby blues.”
Thanks to a variety of celebrities—including Courteney Cox, Gwyneth Paltrow and Marie Osmond—speaking publicly and openly about their own problems with PPD, there is now a wider understanding of the condition. Brooke Shields even wrote a book on the subject, Down Came the Rain: My Journey Through Postpartum Depression, which has proved helpful to thousands of women who felt they were alone in this condition.
So what should you do if you are experiencing PPD? The good news is that for many women the condition subsides within three months of giving birth. But any woman experiencing symptoms for longer than a two-week period should consult with a physician (e.g., psychiatry, primary care, obstetrics/gynecology, or pediatrics), who can help her decide if further treatment is needed. This may involve medications, psychotherapy, or both.
Symptoms can worsen over time if left untreated, so it is important to seek help as soon as you realize, or even suspect that, you are suffering from PPD. First and foremost, remember: you are not alone in experiencing this condition and asking for help is the first step on the road to healing.
Stowe ZN et al. The onset of postpartum depression: Implications for clinical screening in obstetrical and primary care. Am J Obstet Gynecol 2005 Feb; 192:522-6.
Dennis C-L et al. Effect of peer support on prevention of postnatal depression among high risk women: Multisite randomised controlled trial. BMJ 2009 Jan 15; 338:a3064.
Guintivano J et al. Antenatal prediction of postpartum depression with blood DNA methylation biomarkers. Mol Psychiatry 2013 May 21; [e-pub ahead of print].
Insomnia and Depression: Which comes first?
It is well known that depression can result in sleep problems. But can sleep problems cause depression? Although most of us realize that poor sleep can result in daytime fatigue and irritability, scientific studies have provided evidence that insomnia can cause clinical depression. So there appears to be a bidirectional association between the two: each increases the risk for the other, even when controlling for factors such as lifestyle, demographics, and anxiety level. This is why it is important to screen for and treat insomnia in those that show signs of depression. Early treatment of sleep problems may prevent or mitigate a depressive episode.
How do we treat sleep? There is a wide assortment of drugs available for treating insomnia which I will discuss in a later blog, but for now I will mention some of the simple steps we can take to treat insomnia on our own without medications.
7 Tips to Treat Insomnia
- Go to sleep and rise at about the same time every day, including weekends. The mind and body rely on and adapt well to this consistent cycle.
- Minimize stimulation. Keep the bedroom as dark as possible and minimize ambient noise (use earplugs if needed, turn off the TV or music).
- Use the bed only for sleep or sex.
- If you wake up in the middle of the night and can’t fall back to sleep within five minutes, leave the bed and go to another room or seat to read until sleepy.
- Avoid meals at least three hours before sleep.
- Don’t use alcohol as a sleep aid. Alcohol may help you fall asleep initially, but it distorts your sleep architecture and ultimately robs you of the refreshing process your brain needs.
- Find a mantra to help you fall asleep. You’ve probably heard of “counting sheep.” However, a more functional and successful version is to think of non-stimulating topics that interest you, such as a song lyric or a movie plot. My favorite technique is based on mindfulness meditation: pay attention to the feeling, sound, and rhythm of your breathing and gently redirect your mind back to that each time it veers off to another thought.
Doing all of the above on a consistent and prolonged basis will significantly decrease the odds of having a sleep problem.
Sivertsen B et al. The bidirectional association between depression and insomnia: the HUNT study. Psychosom Med 2012 Sep; 74:758.