The psychologist Catalina Briñez tells us about the keys to Generalized Anxiety Disorder.
Generalized Anxiety Disorder (GAD) is a psychological disorder that affects many people with very different lifestyles; It is an anxiety disorder that is difficult for the sufferer to understand, as it is not linked to a specific source of fear or fear, but to various life experiences in general.
Fortunately, decades of research in mental health have allowed psychotherapy psychologists to understand the functioning and dynamics on which GAD is based, as well as effective forms of intervention to solve it. For this reason, on this occasion we have interviewed one of these experts in emotional well-being, the psychologist Catalina Briñez, who will talk to us about generalized anxiety.
Catalina Briñez: GAD, seen from the perspective of a psychologist
Catalina Briñez is a General Health Psychologist and founder and Director of Brilo Psicólogos, a therapy center located in Benalmádena that also offers online services by video call. In this interview, she tells us about the characteristics of Generalized Anxiety Disorder and its treatment, based on her years of professional experience helping patients.
What are the main signs that a person is not experiencing simple anxiety, but is developing or has developed Generalized Anxiety Disorder?
To answer the question, we must first clarify that anxiety is an adaptive mechanism that human beings have to face situations that involve a high emotional demand because they arise from something that we interpret as a risk and we need to have our senses sharpened to be more effective; For this there is a change in the neuronal and visceral biochemistry, which allows us to react quickly according to the demand.
However, when anxiety begins to be recurrent, constant and causes significant discomfort, we are no longer talking about “simple anxiety” as you have formulated your question, we are talking about a condition that includes very uncomfortable physiological symptoms (muscle tension, tachycardia, fatigue, pain headache, difficulty breathing, sleeping), thoughts that cause you a lot of fear, emotions related to helplessness and avoidance behaviors which isolate us from others.
These circumstances are a recurring reason for consultation and are usually related to a particular aspect or trigger that is expressed mainly as phobias or panic disorder.
In Generalized Anxiety Disorder (GAD), the discomfort is not due to a specific stimulus or life experience, but to many aspects of life that even cover all the vital areas of a person: concern for the family, for health , by the neighborhood, by work, by the country’s economy, by global warming, by wars, by poverty … generating a very high intensity and frequency of discomfort that does not allow moments of relaxation, since the mind always has a concern to deal with. As you can see, it is something that causes a lot of suffering and should be addressed.
The 8 recurring signs that I observe in people who consult and can present GAD are the following: Intense worry for more than 6 months without a specific event that produces it, stress, fatigue, irritability, trouble concentrating, sleep disturbances, restlessness when awakening, physiological symptoms (pain in the body, muscle tension etc.).
Is it relatively easy to recognize these cases when people come for consultation? What are usually the reasons why they complain and report discomfort in their day to day?
It is not difficult to recognize cases of GAD, since they have specific characteristics that can be quickly identified; What is true is that many times they present in comorbidity or at the same time as other types of problems. For example, depressive states, traumatic experiences, family conflicts, lack of motivation, insecurity … to mention a few, so a good differential diagnosis must be made so as not to confuse GAD with the sequelae of another underlying disorder.
People who consult usually arrive encouraged by a member of their family or a friend, who are usually the ones who detect that something is wrong. Their main complaint is a constant worry that oppresses their chest, that they are never calm and do not know very well why, although when they begin to speak they refer to a number of fears. They also comment that this situation affects their interpersonal relationships and work life, they often feel misunderstood.
As a psychologist, have you detected a common pattern in the characteristics of people who usually develop GAD? Is there a specific profile that is more likely to suffer from this psychological alteration?
They are usually people with a high level of inhibition (what we commonly call shy or withdrawn people), tend to avoid harm, and therefore do not usually take risks or try new things. They are usually very aware of their bodily sensations (tachycardia, tension, pain …), dependent people with a need for protection and protection, as well as difficulty adapting to changes.
A person who has a biological predisposition or vulnerability to alert states will be more likely to present GAD, which is reflected in high levels of trait anxiety, which we measure through psychological tests. Such people tend to have a more apprehensive interpretation of life from childhood.
What goals do you usually set for these patients once you both recognize that their problem fits with the clinical picture of GAD?
On the one hand, achieve emotional self-regulation. Many times we believe that the problem is feeling fear, but the difficulty is not the feeling itself, but the intensity or the degree of discomfort it generates. When we learn to regulate the intensity of emotions, we can experience a negative emotion without causing me significant discomfort and therefore be more decisive.
On the other hand, analyze our internal dialogue: detect thoughts that cause us discomfort and propose thought alternatives that can explain the same concerns but that are more functional.
It is also necessary to learn to deactivate the body’s physiological reactions to fear. Negative thoughts are usually produced from a signal of discomfort in the body, and this in turn is given by the biochemistry of our body in relation to stress. Breathing exercises or muscle tension and strain, as well as guided relaxation, are often helpful.
You also have to face dreaded situations. Avoidance is often a component of our behavior that holds our interpretation of the world apprehensive. If, for example, my fear among many others is to go to a shopping center for fear that I will get dizzy or nauseous, even if I have to buy something I need, if I go several times and I do not feel bad, or I can manage anxiety, I am giving effectiveness information to my internal dialogue. This step is usually taken after having developed the previous points.
Finally, it is essential to strengthen emotional ties. Positive and quality interactions with others help us to get out of ourselves, which helps to take weight off our own feelings of apprehension; generous and empathetic attitudes, as well as feeling support and affection favor emotional intelligence.
And in what way does psychotherapy usually develop, based on the way you work?
For me, the most important thing is to know the person beyond their diagnosis, because according to their individual characteristics, strengths and context, an effective therapeutic strategy is proposed.
Thus, the first step is the evaluation where the person is known, their needs, and the factors that generate the discomfort are analyzed. Later in the intervention, techniques are applied that have demonstrated effectiveness to achieve the proposed objectives, but these are adjusted to the individual times and characteristics. Once the objectives are reached, there are some follow-up sessions.
Within sessions, people often find relief by feeling that they can express all their thoughts without fear of judgment; It is a deep interaction where empathy is essential since it allows you to propose solutions that really fit the client, which is usually very rewarding.
Assuming that psychotherapy is always a personalized process, what advice do you usually give to people with Generalized Anxiety Disorder to apply in their day-to-day life and between the sessions in which they meet with you?
The activities carried out at a general level in daily life are essential for consolidating the techniques used during psychological sessions; As you have said, there are various strategies that can only be used according to individual characteristics but also at specific moments in therapy and in specific circumstances.
However, at a general level, there are several guidelines that can help reduce anxiety, and they are the following.
First of all, do physical exercise: whichever is preferred, practice Pilates, yoga, dance, take walks especially in contact with nature or the sea.
Second, take care of your food. By eating properly, our energy and physical well-being will increase, therefore the physiological symptoms of anxiety and our attention to them will be reduced.
You also have to socialize: sharing with positive, affectionate people, doing different activities with them reduces the negative or catastrophic charge of thoughts.
Similarly, it is important to practice a hobby. Doing something that we really like generates positive affection and on the other hand helps us to focus on the present. It can be reading, painting, learning an instrument, cooking a dish that we enjoy … there are different ways to focus our mind on relaxing content.
Finally, take time to breathe. Something as simple as taking breaths to breathe making sure that oxygen reaches the abdomen (diaphragmatic breathing) helps to lower cortisol levels (a hormone that has a lot to do with stress).