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Generalized Anxiety Disorder and Stress Management

Almost every mental health issue you can suffer from worsens when stress is involved. When you go to a therapist, the first thing they will assess for is stress. They will ask you about your stress level, and they will start to talk with you about how you are coping with it. Generalized anxiety disorder is no different. This page will look at some of the research and what it shows about generalized anxiety disorder specifically and stress management.



Points on this page about generalized anxiety disorder and stress management

  • Generalized Anxiety Disorder (GAD) gets worse with stress.
  • All the regular stress management tips apply: get sleep, get exercise, eat well, go to therapy.
  • What's unique about generalized anxiety and stress management? Evidence is compelling for mindfulness-based stress reduction (mbsr) helping. Research even shows it reduces biomarkers in those with GAD as well as other symptoms.
  • Evidence shows rumination plays a substantial role in GAD
  • Rumination increases anxiety symptoms, response to stress, and depression in people with GAD. I'll present some ideas to help with that.

Generalized Anxiety Disorder and Stress Management?: What Works

Generalized anxiety disorder is unique in that it is chronic and is associated with physical symptoms. 30 -60 percent of people who have GAD don't achieve remission with therapy and medication treatment. Therefore, any additional and supplemental therapy you can implement will be helpful. It's a good idea to try everything you can!

The general advice is usually to have good social support, manage your sleep and diet, and exercise. These ideas are also relevant when discussing stress management for generalized anxiety disorder.

However, two specific areas of importance can immediately and dramatically help: techniques that target rumination and emotional regulation.

Generalized anxiety disorder and stress management: MBSR

Studies show that people with GAD report:

  •  More intense emotions 
  •  Difficulty understanding emotions
  •  Trouble calming and soothing themselves after they have negative emotional experiences 
  •  A more significant adverse reaction to emotions

If this is you, you might find yourself impacted by your emotional experiences and easily overwhelmed when stressful things happen.

People who have generalized anxiety disorder generally also have lower levels of Mindfulness. Interventions that help you learn how to be mindful of managing your stress and anxiety are usually good ideas if you struggle with a generalized anxiety disorder. In particular, mindfulness-based stress reduction (mbsr) is an excellent generalized anxiety disorder stress management technique. These strategies show you how to learn to have a greater awareness of your present moment, thoughts and emotions, bodily sensations, and how to develop a more accepting attitude towards yourself by being less judgmental and compassionate.

Stress and Hormones

Chronic stress causes abnormalities in the stress hormones and inflammatory markers. This chronic stress increases the risk of physical illness such as heart disease. Miraculously, one study has shown that MBSR with generalized anxiety disorder reduces these biomarkers. This makes the argument for Mbsr as an intervention for generalized anxiety and stress management even more compelling.

Suppose you suffer from generalized anxiety disorder and want to try MBSR out. In that case, you can access the entire program for free or you can seek out an MBSR group in your area. They have them everywhere. 


Generalized Anxiety Disorder and Stress Management: Rumination

Another significant finding in the research on generalized anxiety disorder and stress management is that people who have generalized anxiety disorder ruminate when stress happens. Rumination is essentially dwelling on the negative in a stuck and circular way. 

Can't stop thinking about something bad that happened or is happening? Is it is making you feel awful worried or depressed? You are likely ruminating. 

Research shows that rumination:

  • Increases our response to stress
  • Increase our physiological response to stress
  • Causes us to react stronger and more intensely to stress
  • Increases our recovery time from stress
  • Increases our depression and anxiety symptoms

Generalized anxiety disorder also increases stress sensitivity, so when you pair this with rumination, you have a double whammy!

Generalized anxiety disorder and stress management: strategies to help with rumination

Learning how to let go of ruminative thinking is key to managing your stress. I have a page written on rumination where you can learn about the strategies here.

1. Leaves on the Stream. Work on letting your thoughts go like leaves floating down a stream. Do this without judgement, or struggle, noticing the tendency to want to ruminate, but understanding that it is not a helpful choice. 


2. Practice noting. Stating in a non judging way what is happening in your mind and body when you begin to ruminate, and gently pull your mind back to the task at hand. Do this like you would to a dog on a leash who was pulling you somewhere you didn't want him to go. 

3. Acknowledge your emotions without pushing them away. They are impermanent and will pass.

4. Keep a journal where you can note what the triggers are for your rumination to be aware of why your mind began to do so. Be prepared in the future about what the triggers are.

5. Think of your mind as a train station. When you have gotten on the wrong train, what happens? If you begin to ruminate, you have boarded the wrong train. Take a deep breath, and pick another train to get on. Label your rumination trains " The victim train," "The guilty train," "The angry train." Steer clear of those. Pay attention to trains that provide you with calmer states of mind. We call this thought diffusion.

References

Mennin, D.S., Heimberg, R.G., Turk, C.L. and Fresco, D.M. (2002), Applying an Emotion Regulation Framework to Integrative Approaches to Generalized Anxiety Disorder. Clinical Psychology: Science and Practice, 9: 85-90. doi:10.1093/clipsy.9.1.85

Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., . . . Simon, N. M. (2013). Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder. The Journal of Clinical Psychiatry, 74(08), 786-792. doi:10.4088/jcp.12m08083

Hoge, E. A., Bui, E., Palitz, S. A., Schwarz, N. R., Owens, M. E., Johnston, J. M., . . . Simon, N. M. (2018). The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder. Psychiatry Research, 262, 328-332. doi:10.1016/j.psychres.2017.01.006

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