Saturday, September 7, 2013

Anxiety: Generalized Anxiety Disorder

Reminder of Scenario #3:
One night, you and your spouse have a little argument. You're a little worried upon going to bed, but after a good night's rest, you both wake up realizing how silly the whole thing was in the first place.

Now for the do-over, Generalized Anxiety Disorder style:
One night, you and your spouse have a little argument. You're both a little worried upon going to bed, but after a good night's rest, your spouse wakes up realizing how silly the whole thing was in the first place. You, on the other hand, wake up even more worried and ask, "honey, is our marriage in danger?" Your spouse looks at you like you're crazy. It was just a little argument. Couples argue all the time. It happens. That doesn't mean the marriage is over. But you sense that your spouse is getting frustrated. That worries you more, so you keep explaining why it might be a problem and why you're still worried. Your spouse is really upset now because you've just made a mountain out of a mole hill and it's not even 8 am.

'What did I do? I was just explaining myself...showing concern...and my spouse got all upset. Maybe our marriage really is in danger.'

For months afterward, almost anytime you and your spouse disagree on something (not big, dangerous things, just petty things), you ask about the marriage. You start to think about it every once in a while at work, at home, or while trying to sleep. At times, you worry so much that you feel like you're on eggshells in the house, not wanting to say anything that could even spark a disagreement.

But then you start to wonder, "Is my own worry causing some of the problems? What if I'm worrying too much? What if I'm worrying about the wrong thing? I need to stop worrying." Hence, in addition to your normal worry, you've just started to worry about your own worrying. Fun.

If someone tells you that he/she has Anxiety, he/she's probably talking about Generalized Anxiety Disorder (GAD). It can be diagnosed anywhere on a mild-severe scale. While most of us have had some anxiety here and there, one has to have fairly consistent anxiety-filled experiences for at least 6 months before he/she can be officially diagnosed with the disorder. While they are usually centered around one specific thing (your marriage, relationships in general, schoolwork, work-work, finances, family life, etc.), they don't necessarily have to be. You don't have to be in an ever-constant state of worry, either. It just comes whenever the worry-inducing event does. But it comes more often than not.
Many who grew up or have lived in an anxiety-esque environment may have experienced anxiety just like anyone else, but never actually met even the consistent 6-month criterion to be diagnosed with it. That's not unusual; for most who do get it, it doesn't really "kick in" until their late teens or adulthood. Why? Because that's usually when major life changes happen. You may move out to go to school, leave the country for a while, have to pay your own bills and manage your own time, be in serious relationships, get know, stuff that you never had to do--or worry about--before. Sometimes, the worry related to sudden changes in life can trigger consistent worry about other things, too. Hence, GAD has come to fruition.

In mild cases of GAD, studies are starting to show that medication really isn't all that necessary. Taking care of yourself on a regular basis (enough sleep, exercise, and eating right) can work wonders in controlling mild anxiety-driven reactions to things. Many report that while they still get anxious, it's easier to stop themselves from worrying too much about something if they are taking care of themselves. However, for more moderate-severe cases, CBT (talked about here) plus medication can work quite well. The medication can help suppress major reactions, allowing the person to focus on small victories at a time. As time passes, the person can stop taking medication and focus only on the underlying cause.

There are a couple of barricades to therapy with someone who has been diagnosed with GAD and they are both related to problem solving.

Basically, there are five aspects of problem solving...

...and those with GAD generally have a hard time with the first two. 

Identifying the problem:
They are so preoccupied with the worry that they have a hard time stopping to think about what the problem might really be.
What's the problem?
My marriage is in trouble!
Has your spouse filed for separation, divorce, or even brought it up?
So, why is your marriage in trouble?
Because we argue all the time!
Everyone argues. What's so special about your arguments?
Nothing. We just argue and disagree on stuff.
Everyone disagrees. What's so special about your disagreements?
I don't know. Married people are supposed to just be able to agree on everything.
Who told you that?
No one. That's just the way it's supposed to be.
And that's most likely the problem: The person has the mindset that married people just think alike all the time and never disagree. That mindset is probably the underlying cause of the anxiety and, thus, needs to be addressed.

Brainstorming Solutions:
This part isn't easy, either. Most of the time, the person is still so worried about "it" that they have a hard time blocking "it" out and focusing on something different.
So, now that we've found at least one trigger of your anxiety, what are some ideas that you have to help you stop worrying?
My spouse and I need to stop arguing and disagreeing and then our marriage won't be in danger anymore!
While every couple needs to figure out which conflict-resolution steps work for them, we've already figured out that what's really got you anxious is your mindset that successful couples don't have any conflict at all.
Well, they don't.
Actually, disagreement helps you get to know each other better, so it can be a great contributor to the relationship.
But we should have already known everything about each other before we got married.
Marriage is a continuous learning process. You could be married 50 years and still be learning new things about each other.
Yes, really.
So, you're saying that married life isn't supposed to be perfect?
So, with that in mind, what can we do to help you remember that married life isn't perfect so that it's easier for you to see a small disagreement for what it is rather than an attack on your marriage?
Think about it: If you'd been worrying about something terrible for months, how easy would it be for you to just put it aside and put all of your energy on something else?

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