An Overview of GAD
So even though you might feel ashamed about your anxiety and like you’re the only one who’s struggling, you’re absolutely not alone.
Being a sufferer of Generalized Anxiety disorder, knowing firsthand it’s debilitating effects, it’s imperative to see a Mental Health Provider and develop a treatment plan.
Make sure you feel comfortable with your Mental Health Provider, that they listen to your concerns and are flexible in the various treatments.
I had probably one of the best psychiatrists in New York City, and back then psychiatrists not only prescribed medication but also were psychotherapists. Sessions lasted 40 minutes.
Today, psychiatrists specialize in medication and other than the initial visit, sessions don’t last more than twenty minutes.
This post will focus on the different therapies and on a follow up post will concentrate on Medications.
For moderate GAD, CBT or a selective serotonin reuptake inhibitor (SSRI) or serotonin and norepinephrine reuptake inhibitors (SNRI) is recommended. For severe GAD, the most effective option is a combination of CBT and medication.
That’s the suggested method of treatment. We will get into the medications further in the next post. It’s important to note that medication does not cure Generalized Anxiety disorder. Psycotherapy generally is the method to get to the root of the issue
CBT or Cognitive Behavioral Therapy is fancy way of saying talk therapy. It might involve exercises and homework to do. Meditation, sometimes is employed, for me these helped, but I needed something to calm my nerves before I could even think about meditation or talking through my issues.
Co-occurring conditions also are common with GAD—and will guide the specifics of your treatment. For instance, some individuals who have GAD and severe depression might not be able to fully participate in CBT.
So they would start taking medication usually either a SSRI, which is todays first line of defense.
Overview of Medications
The problem with SSRI’s is they take up to a month to work. Benzodiazepines generally work within an hour or less, but are recommended for only short term use and may or may not start CBT then, as well.
The first-line treatment and gold standard for treating generalized anxiety disorder (GAD) is cognitive behavioral therapy (CBT). CBT for GAD is a multimodal treatment, meaning that it includes various components that target the different symptoms of the illness: physical, cognitive, and behavioral.
Cognitive Behavioral Therapy Explained
CBT typically consists of eight to 15 sessions (about 50 to 60 minutes per session). The number of sessions really depends on the severity of your symptoms, whether you have other co-occurring disorders, and the number of treatment components your therapist will be using.
In CBT, you’ll also learn progressive muscle relaxation and other techniques to reduce the physical symptoms of GAD. You’ll challenge unhelpful thoughts that spark and exacerbate your anxiety.
For instance, you might over-estimate that something terrible will happen, and under-estimate your ability to cope with a difficult situation.
You’ll learn to change your worries into problems you can actually solve, and create actionable plans. You’ll gradually confront situations and activities that you tend to avoid, such as situations with an uncertain outcome (since avoidance only amplifies anxiety).
Lastly, you and your therapist will come up with a relapse prevention plan. It’ll include the strategies you’ll continue to practice, along with a list of early warning signs and a plan to effectively navigate those signs. You’ll also identify future goals.