3.5 Experiencing anxiety
GAD is one of the most prevalent emotional disorders (Figure 1). It has been estimated that more than 5% of people will be diagnosed with GAD in their lifetime, and 12% of those who attend anxiety clinics are diagnosed with GAD (Kessler et al., 2005). Anxiety is also part of mixed anxiety and depression (MAD) one of the most common emotional disorders (Figure 1). We will return to MAD in Section 4.
The case report in Vignette 2 describes one woman’s experience of GAD.
Vignette 2 Generalised anxiety disorder (GAD) – Suzanna’s story
I have been suffering from GAD for nearly 2 years now.
I am no better now than when I was first diagnosed, and I have to say, that I ended up feeling very alone and afraid. […] I am on disability living allowance due to the severity of my symptoms. I’ll list them in the hope that someone else suffering will see them and realise that they are not alone:
- Chest pain
- Back pain
- IBS [irritable bowel syndrome]
- Stomach pain
- Pains in arms and legs
- Constant feeling that I’m going to die
- Headaches and feelings of tightness in the head
- Blurred vision
There are just too many symptoms to list them all. GAD can manifest itself in so many different physical ways that you end up not knowing what is real and what is part of the anxiety […] I ended up going to casualty thinking I was having a heart attack, so many times. I […] continue to believe my symptoms have physical causes. The fact that I’m even writing this shows that somewhere inside, I must be aware that my severe anxiety is causing it. There are just too many symptoms for it to be one physical illness. Doesn’t help when you’re sat on your own going through it. If I can help anyone, it is by saying that you must be the first person to help yourself. Be stronger than I have managed to be and demand the help you need. This is a real illness and I have been told that it is second only to depression in this country, and yet I cannot find the help I need.
(Anxiety UK, 2007)
Those suffering from GAD (Figure 11) are sometimes characterised as ‘worriers’, with daily life dominated by anxious thoughts. Their muscles may be unusually tense, and they may have hardening of the arteries (Thayer et al., 1996). It appears to be more common amongst poorer people, those with lower education, and those living in urban environments. In the USA it is more common amongst young black people (Blazer et al., 1991), and there is evidence that it is more common in countries in which there is war or political oppression than in countries at peace (Compton et al., 1991).
Why might GAD be more common in these situations?
These seem to be situations in which people experience a lack of control over their own destinies and future – about violence, their own safety, discrimination and lack of opportunity. These are just the kind of situations where people would be more likely to worry.