Generalized Anxiety Disorder

Management and Resources

At home

Although people with GAD usually require professional treatment, there are some behavior changes individuals can try to provide some relief. These include meditation, progressive muscle relaxation, deep breathing, movement, nutrition, and sleep.

Meditation

The practice of meditation has been around for thousands of years. What was first a way for individuals to find spiritual connection is now widely used as a means of reducing stress and anxiety. Meditation, and specifically mindfulness meditation, involves setting aside time during the day to focus on the present, and not the typical stream of thoughts.

During this designated time, individuals try to keep their thoughts centered around this very moment: their sensations, an object, or a sound. When the thoughts stray, as they naturally do, meditation teaches us to acknowledge the distraction without judgement, and come back to the present. The repeated practice of meditation can be calming in the moment, but can also “build the muscle” that re-centers the brain through life’s ups and downs, even when one is not meditating.

Progressive muscle relaxation

Progressive muscle relaxation is a proven technique that many psychologists incorporate into their treatment because it helps individuals relax. Anxiety can cause significant muscle tension and when we worry we may even feel more tense. This technique essentially instructs individuals to purposely tense and release muscle groups throughout the body, which sends messages to the body that it can relax. One can use this technique at night in the comfort of bed when having trouble sleeping, or anytime they wish throughout the day.

Deep breathing

When individuals are more anxious, they may notice having a harder time breathing or just can’t catch their breath. Higher levels of anxiety can cause shallow breathing that often gives us less oxygen and requires us to breathe faster to get the oxygen our body needs. This is a common symptom of GAD and can make people feel uncomfortable and unwell.

When we breathe deeply and through our diaphragm specifically, we may feel calmer and more at ease. We call this technique deep breathing or diaphragmatic breathing. It is a simple technique that can be hard at first or uncomfortable, but with practice, it can become second nature. Deep breathing is easier to learn when we practice the skill at times when anxiety is low. As an individual becomes more skilled and can deep breathe when calm, they will be able to use this skill at times of higher stress as well.

Movement

Research shows that 30 minutes of walking per day can decrease anxiety. The proven benefits of exercise are vast. Exercise is one of the most effective ways to manage generalized anxiety. Starting a walking routine, taking the stairs, and yoga are just a few examples of low impact exercises that increase the heart rate, in turn releasing serotonin, and other brain chemicals that reduce anxiety. Even better, the anti-anxiety effects of exercise are both immediate and long term. Movement and exercise can be a great complement to a treatment plan and can even be social when a friend comes along.

Nutrition

Serotonin is a brain chemical that is involved in anxiety. Many are surprised to learn that 95% of serotonin is produced in the stomach which communicates information to the brain to influence emotion. Nourishing the body with fruits, vegetables, nuts, eggs, grains, and legumes may help to reduce anxiety. Similarly important is the frequency at which one eats. Eating regular, well-balanced meals helps to maintain a steady blood sugar, which creates a feeling of calm.

Sleep

Individuals with anxiety are in a near-constant state of overdrive, also known as fight or flight. This means that the body is always ready to escape danger, even if it may not actually exist. A full night of sleep, approximately 8 hours for most adults, helps the body control the fight or flight response associated with generalized anxiety.

Creating a consistent and calming bedtime routine, avoiding blue light (that light from phones and screens) one hour prior to bedtime, abstaining from daytime naps, and refraining from caffeine after noon all promote restful and continuous sleep.

In relationships

Anxiety can have an impact on relationships in many ways. If one's partner or friend does not have anxiety, it can be difficult for them to understand what the other is going through. They may expect the individual to be able to “just relax,” or “have faith” that things will work out, which can add to one's worry.

Even so, opening up about one's experience can help bridge the gap in understanding -- although, sharing these challenges is not always easy. Individuals may feel like they are burdening others with their thoughts or anxieties, but this may not be the case. Sometimes being open during these struggles can fortify relationships.

For some people, having anxiety, and also taking antidepressants can impact their sex lives. An individual may experience low libido, erectile dysfunction, etc... but there is hope: The first step to addressing this issue is to acknowledge it, but sharing this type of sensitive information with a partner or provider is not always easy.

A couple steps one might try to improve low libido include

Trying a new routine with one’s partner such as exercising before sex, or incorporating new types of stimulation.
It is possible that when anxiety improves, libido will also improve: Researchhas shown that depression and anxiety can cause these effects with or without taking an antidepressant.
A provider may adjust an individual’s dose of medication to find a level which balances effectiveness with libido.
Some of the commonly known medications for erectile dysfunction (Viagra, Cialis, etc..) can be helpful to antidepressant-induced sexual dysfunction in men.
Trying different type of medication that has fewer sexual side effects is sometimes called for.

During moments of intense worry, it can become impossible to think about anyone or anything else besides the object of anxiety, and this can be difficult for one's partner. It is important for both parties in the relationship to focus on treatment, and to remember that this self-focus is temporary. In most cases, the right combination of therapy and medication can bring a person back to being the partner they once were.

Anxiety in the family

Anxiety has a genetic component, and it can look different within the family. In children, anxiety can manifest as fear, and develop into full blown GAD after hitting puberty. Parents who have struggled with their own anxiety can be vigilant of their children. Getting early treatment for them can eliminate years of their potential suffering. And, getting treatment for the parent will ensure that their worries aren’t projected onto children.

At work

The workplace can be an anxiety-provoking environment for some individuals who struggle with GAD. When at work, individuals with GAD often find it helpful to keep a few tips in mind:

Being realistic

Unrealistic expectations may increase procrastination and stress at work. When setting or agreeing to goals, speak up early on accomplishing the task seems unrealistic or is too much to manage. It is okay to ask for help when needed.

Staying organized & prioritizing

When tasks seem to pile on, it can seem impossible to accomplish everything. Keeping one's desk clean, with an easily-visible to-do list -- and then prioritizing that list can often relieve the overwhelm that adds to anxiety.

Setting boundaries

As workplaces move remote, and work email is right in one's pocket, it is increasingly difficult to set clear parameters around time. However, it is important to carve out specific time that is for oneself, for their family/friends, and for work. Individuals with GAD find it helpful to let others know that they will not be responding to emails or chats outside of work hours. Being the first on the team to set boundaries like this can be scary, but others often soon join in keeping these kinds of boundaries.

Pausing to revel in small wins as much as failures

For those with GAD, their brains are often wired to think about what to improve or what went wrong. But, training the brain to spend as much time thinking about what went right can help achieve a more balanced focus.

Giving oneself grace

For some with anxiety, simply keeping in mind that they might need to take a break every so often is helpful. Or, reminding themselves that everyone makes mistakes, and goes through rough patches at some point or another. Productivity requires a person to feel energized, and these breaks and moments of self-forgiveness are necessary.

At school

The classroom can be an anxiety provoking environment for some individuals who struggle with GAD. When at school, it’s often helpful to keep a few tips in mind:

Student counseling

School administration likely offers student counseling services. Given the abundance of stress related to exams, and school performance, it is common for students to feel overwhelmed, anxious, and in need of support. Individuals can reach out to a dean or student services for information.

Being realistic

When assignments are due or exams are near, it can be helpful to speak up early on if one isn't sure they will be able to accomplish the task. It is okay to ask for help from teachers, their assistants or professors when needed.