How Generalized Anxiety Disorder Evolves- The Negative Cycle of GAD

We had previously discussed how anxiety develops from the negative cycle of anxiety- the feared object or situation leads to thoughts about the event, and the thoughts lead to anxiety, and the anxiety leads to avoidant behaviors which serve to maintain the vicious, negative cycle of anxiety. Anxiety disorders have several different subtypes, and today we will talk about generalized anxiety disorder (GAD), and the negative cycle of GAD.

Generalized anxiety disorder is a major anxiety disorder in which you have worries, which leads to significant anxiety symptoms. According to cognitive behavioral therapy (CBT), you develop generalized anxiety due to the way you think, and also by the way you behave. So if you look at the three circles: thoughts, feelings, behaviors, they all interconnect to one another to maintain your generalized anxiety symptoms. I will go through each one of these circles, and discuss how they connect to one another.

Here’s an example of a negative cycle of generalized anxiety disorder (GAD):

Suppose you have generalized anxiety disorder. So how does this develop? Well, it first starts off with worried thoughts. It can be such worried thoughts as: “Something bad is going to happen,” or “I will not be able to cope,” or “I can’t stand uncertainty,” or “The future and risks are unknown,” or “I must be prepared to reduce the risk.” So when you have these worried thoughts or thoughts of uncertainty, this leads to feelings of anxiety. So the thought of worry triggers anxiety and you feel the adrenaline rush from the fight or flight response. The feelings that result include anxiety, nervousness, tenseness, being unable to relax, and having disrupted sleep. The anxiety then makes you overcompensate, and you resort to behaviors because of the anxiety. So when you are uncertain and it makes you anxious, then you resort to behaviors that increase the certainty. So then you may plan ahead, you make lists, you overprepare, you overeducate yourself, you avoid, and you put things off.

Although the overcompensating behaviors decrease your anxiety over the short term, the behaviors actually maintain your overall anxiety from GAD. So the behaviors maintain your intolerance of uncertainty, and the overcompensating behaviors are reinforced by the short-term relief from anxiety caused by your thoughts of worry. So in the negative cycle of generalized anxiety disorder, you have this vicious, negative cycle that continues. Your thoughts of worry induces the anxiety, which then compels you to act and overcompensate. The overcompensation then maintains your intolerance of anxiety. Instead of just accepting the uncertainty and finding out that nothing bad will occur, you overprepare and this maintains your intolerance of uncertainty.

What do you do then if you have this vicious negative cycle, and you’re worried, and you’re having thoughts of uncertainty, and you have all this anxiety, and your behaviors of overcompensating maintain this vicious cycle? So what do you do? Well, one of the things you can do is to follow this ‘Worry No More’ flowchart:

First off, you ask yourself: “What is the worry?” Then you ask yourself: “Can I do something about this worry?” If the answer is no, then you follow the flowchart down, and you let the worry go, and then you change your focus of attention. Piece of cake, right?

However, if you answer that question as ‘yes,’ that you can do something about that worry, then you ask yourself: “Can I do an action plan now?” If the answer is ‘no,’ then you schedule it, then you let the worry go, and then change your focus of attention, until the time comes when you can carry out the plan in your schedule sometime in the future. So instead of worrying about it constantly, you just schedule it, let the worry go, and then change your focus of attention until you really have to deal with it.

But if you can do an action plan now, then do the action plan now. Once you do the action plan to deal with the worry, then you let the worry go, and then you change your focus of attention. This flowchart may seem trivial, but it helps you to break down what your worries actually are, determine if you can actually do something about your worry, and then determine if you can actually do something about the worry now, or in the future. In the end, what it does is it gives you a choice- either you deal with it, or you can’t, then you let the worry go, then you change your focus of attention, and therefore you don’t have generalized worries in between, as you are either scheduling it in the future or not worrying about something you really can’t control.