You often say you feel anxious. But lately, what with world events and personal challenges, it’s been getting worse.

How can you know when you’ve gone from anxiety, to anxiety disorder? And it’s time for a diagnosis?

All about anxiety

First of all, it’s important to clarify what anxiety is and isn’t.

We often say ‘we’re anxious’ when we’re actually worried or stressed. We have a certain thing we don’t know how to deal with and we feel overwhelmed. If we deal with it, or get some help to navigate it, we go back to feeling ourselves again.

Anxiety tends to happen without an exact source. Either we simply don't know what has started the feeling, or we are worried about all sorts of things at once. And the more anxious we get, the more illogic our thoughts become. Another major part of anxiety is a feeling not just of overwhelm, but of fear. And like anxiety, there are many physical symptoms, like muscle tension, a change in appetite and/or sleep, a racing heart and sweaty palms.

Generalised anxiety disorder

Generalised anxiety disorder, or “GAD”, is the clinical diagnosis for severe anxiety.

You can have ‘pure’ GAD, where you only have anxiety, or you can have what’s called ‘comorbid’ GAD. This means your generalised anxiety occurs alongside something else like depression, or one of the other sorts of anxiety disorders like panic disorder, social phobia, or obsessive compulsive disorder.

In order to be diagnosed with generalised anxiety disorder, you need to be overly worried about a number of different things in a way that leaves you excessively tense. The worry will also jump from one subject to another, and will be difficult to impossible to control.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) also then requires you have an additional three symptoms from the following list of six:

  • edginess/restlessness
  • fatiguing more than usual
  • irritability even if others don’t notice and it’s internal
  • increased muscle tension and soreness
  • difficulty concentrating or feeling as if your mind is blank
  • sleeping problems, from restlessness and sleeplessness to interrupted sleep.

And note that these symptoms cannot be related to other things, such as drug or alcohol use, or another medical issue.

Anxiety or anxiety disorder?

The main difference here is of severity and duration.

Generalised anxiety disorder has to disrupt your ability to cope on a daily basis, both socially, at work, and/or elsewhere, and should be present for at least six months.

Normal anxiety clears up in a few weeks, or is only in one or two areas of life, such as having anxiety only about work or only about relationships.

Read more in the National Institute for Health and Care Excellence (NICE) Guide to Generalised Anxiety.

But should I be having panic attacks?

Panic attacks form their own disorder, ‘panic disorder’. You can have panic disorder alongside generalised anxiety disorder. But you don’t have to be having panic attacks often or at all to receive a diagnosis of GAD and to have a serious problem.

Do not wait to experience panic attacks to seek help. If your feelings of fear and worry are directly affecting your ability to cope, take the step to speak to a health professional.

Can therapy help me with anxiety?

Yes, definitely.

It is possible that you will be offered medication, if you see a psychiatrist or your GP.

But you don’t have to take meds if you don’t want to. And it’s best to also do therapy even if you do try medication, otherwise you are simply masking your symptoms.

CBT therapy is particularly recommended for generalised anxiety disorder. NICE recommends it, as well as applied relaxation.

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