Generalized Anxiety Disorder (GAD)

Case example

Mary is a highly qualified and much respected primary school teacher. The kids love her and her colleagues respect her skills. Seems perfect right? What people do not see is that she is constantly anxious and spends hours preparing for her class constantly ruminating about whether she is doing “a good enough job”. Her need to avoid any negative feedback means that her family get frustrated with her as she does not spend as much time with them, which feeds into Mary’s guilt and anxiety about failing. She worries about letting people down and losing her job. As much as she tries to stop the worry, it feels uncontrollable. She becomes agitated if things change and feels like “chicken little” wondering when the next “catastrophe” will strike. She is restless and on edge and not sleeping. Mary portrays the image of super Mum, wife and teacher but is the face of GAD.

What is Generalized Anxiety Disorder?

Generalized Anxiety Disorder (GAD) is characterized by a pervasive and excessive level of worry that is present even when there is no apparent reason for the worry. Those with GAD may worry excessively and unrealistically about everyday things such as finances, health, family, work or study as well as other issues. They anticipate disaster surrounding these issues such that the worry is typically future-focused and regards minor issues with disastrous consequences that are unlikely to occur. While anxiety and worry regarding these issues may, at times, be warranted and realistic, GAD is differentiated from this normal level of worry by the persistent and excessive nature of the worry that is difficult to control.

What Does Generalized Anxiety Disorder Look Like?

The common symptoms associated with Generalized Anxiety Disorder are as follows:

• Uncontrollable worry about a number of different issues typically focused on future consequences.
• A constant feeling of tension, irritability, restlessness or a feeling of being ‘keyed up’.
• Racing thoughts.
• Difficulty sleeping as a result of excessive worry.
• Heart palpitations, dry mouth, sweating, trembling or muscle tension.

Those experiencing GAD may described themselves as feeling constantly keyed up and unable to relax and describe themselves as a “worrier”. They may also state that they feel worried all the time even when there are no signs of actual problems and that they always imagine the worst possible outcome.

Why does it occur?

For multiple reasons, as with many disorders, it is difficult to pinpoint one specific cause of GAD and it is believed that a combination of genetic, social and psychological factors such as stressful life events or personality traits, such as harm avoidance, may contribute to the development of an anxiety disorder.

What treatments are available?
Metacognitive Therapy
Research has found Metacognitive Therapy to be an effective treatment of Generalized Anxiety Disorder and has since expanded to become a treatment of many different disorders. Metacognition is an aspect of cognition that controls mental processes and thinking. When an individual experiences GAD, thinking becomes difficult to control and biased in such a way as to lead to increased emotional distress. Metacognitive Therapy brings awareness to a client’s shifted pattern of thinking that involves worry, rumination, fixation of attention on threat and maladaptive coping behaviours. Metacognitive Therapy works to help clients to develop new ways of controlling attention and relating to negative thoughts and beliefs as well as modifying beliefs that result in unhelpful thinking patterns.

What Are Some Great Apps?


Pacific is a free app available on both iOS and Android that is aimed at helping those experiencing anxiety, stress and depression. It provides a range of different tools such as mood trackers as well as relaxation exercises, anti-anxiety experiments and thought recording tools to aid you to better understand your anxiety.


MindShift is a free app available on both IOS and Android targeted at young adults and teens who are experiencing Anxiety. MindShift includes strategies and tools to help track and deal with everyday anxiety as well as more specific types of anxiety such as test anxiety, perfectionism and worry.

Who do we recommend at Anxiety House?

Amber Rattray

Clinic Psychologist


• Extensive experience treating anxiety within a CBT framework
• Worked in inpatient and outpatient settings in the Public sector
• Four years in a speciality Eating Disorders Service working with CBT
• Worked in a Youth Speciality Service and in adult services
• Developed treatment pathways and a CBT group treatments
• Numerous workshops and additional training in (Metacognitive Therapy Workshop, Mindfulness Training)


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