Hey everybody, today we’re going to talk about Generalized Anxiety Disorder (GAD). How do we diagnose it? And how do we treat it?musicNow, as always whenever I do a diagnosis video, ya know, I have my handy dandy DSM. So I’m gonna read from this and I know that a lot of you are like “Why do you always read from it?” but this is the criteria, this is how we diagnose, and I know that it’s not the end all, be all and I know different countries have different, you know, types of DSMs and call them different things, but this just gives you an idea, as a clinician, what I’m looking for when someone is struggling with anxiety and I think it might be GAD, or Generalized Anxiety Disorder. Now, the first portion of the criteria, I think, is the most important. And that is, that someone who has GAD struggles with excessive anxiety and worry, apprehensive expectation, occuring more days than not, for at least six months. And that’s always important. How long has it been going on? For at least six months. About a number of events or activities such as work or school performance, and (we’re moving onto the next portion) it says the individual finds it difficult to control the worry, and this is what I’ll hear in my office a lot. Is that “I just, I worry about this and I wake up in a panic and I’m thinking about this other thing” and it’ll be a bunch of different types of things, and I’ll say, “What have you tried to help? Have you done anything to try to help yourself?” “It just comes out of nowhere, I can’t even control it. I try to do breathing and that’s just bullshit.” And so I hear a lot of complaints about this because we’re unable to control it. It can feel like it controls us. It comes out of nowhere. The next criteria is, that the anxiety and worry are associated with three or more of the following six symptoms, with at least some symptoms having been present for at least more days than not in the past six months. Now, there are six of these and they’re gonna have to have three or more. An important note is that while we need three or more of the following six symptoms as adults, children only need one. Okay, the first is restlessness or feeling keyed up or on edge, next is being easily fatigued, third is difficulty concentrating or mind going blank. Remember, I’ve talked about that with a lot of things, like with depression, and with anxiety we can struggle to concentrate. The fourth is irritability, five is muscle tension, which can look like trembling, twitching, having the shakes, feeling achey or sore. And the last, number six, is sleep disturbance. This can be difficulty falling or staying asleep, restless or unsatisfied sleep. Like I’ve said, I’ve had clients whogaspwake up in a panic and then they look around and everything is fine. Now, there are three more components to this diagnosis. And the next is that the anxiety, worry, or physical symptoms cause clinically significant distress or impairment. This is what makes anything a diagnosis. It has to impair our level of functioning, it has to stop us from doing the things that we normally would want to do. And the next is, that the disturbance is not attributable to the psychological effects of substance. So it’s like, we can’t be high, or drunk, or anything like that. This can’t be coming from anything like that, it has to be coming from a natural origin, like our body just creating this worry and we don’t know why. And the final is that the disturbance is not better explained by another mental disorder. And so there’s a lot of different, we call is differential diagnosis, when we have to make sure that this is the proper diagnosis. And it says that we have to rule out social anxiety, social phobia, panic disorder, anxiety or worry, PTSD, gaining weight and anorexia and nervosa. There can be a lot of different things, the list goes on and on and on. So before we diagnose GAD, we need to make sure it’s not coming from some place else, that it’s not part of another diagnosis. I like that the DSM also mentions the way that GAD can look in adults versus children, because I’ve heard from many of you that when it comes to diagnoses, since you’re an adult or a child of that disorder, you feel like the symptoms that they talk about don’t quite fit you. And so I want to read what they talk about the difference being when it comes to GAD. They talk about adults who have GAD often worry about every day, routine life circumstances, such as possible job responsibilities, health and finances, health of family members, misfortune of their children, or minor matters like doing household chores, being late for appointments, etc. In children, they tend to worry about their competence or the quality of their performance. So it tends to be more focused around how they’re performing in sports or in other art activities, how they’re performing in school, or their competence overall in school, like “I don’t want to look stupid” or “I’m doing my best and I’m worrying about how I’m going to perform on that test”. Now, the median age of onset for GAD is the age of thirty, which was really surprising to me, but those that they talked to and interviewed for that information, stated that they had felt nervous their entire life. The DSM also talks about how GAD in children is often over-diagnosed and it needs to be diagnosed with extreme caution because there are a lot of other disorders that could better explain the symptoms, and they talk about Separation Anxiety Disorder, Social Anxiety Disorder (social phobia), or OCD are often accompanied by worries that can mimic the feelings in the diagnostic criteria of GAD. Okay, so what if we’ve been diagnosed with GAD, then what? Let’s get into the treatment options, and the first is talk therapy, hooray! But more specifically, CBT. And I’m looking at my notes here because they say that CBT is the best because it focuses on teaching us specific skills to get back to doing the things that we love. And often, when we struggle with GAD, we avoid situations due to our anxiety, and CBT can help us better slowly get back into doing those things so that our whole life isn’t spent trying to avoid anything that can give us anxiety. CBT is also the best because it helps us challenge those excessive worries, and then we can actually realize that they’re not based in fact at all that maybe we got really anxious that one time and we had no control, it came out of nowhere, it helps us challenge it so we can realize that that actually isn’t something we need to be afraid of. The second treatment option is medication, and I know not all of you want to be on medication, but I like to give you all the information so you can make the most educated decision for you, for the treatment that’s best for you. And SSRIs and NSRIs are the first line, and those are otherwise known as anti-depressants, and I talked also how benzodiazepines are used as well, but it’s more and more on a limited basis because they should only be used for acute stress/anxiety situations. These aren’t, benzodiazepines aren’t something that we should be using ever day, all day, because they are habit forming, it could be very dangerous. Benzodiazepines also aren’t a good idea if you have a history of any kind of substance abuse, just because they are so habit forming. But don’t worry, there are other things we can do to help ourselves. I wrote down some other relaxations techniques like progressive relaxation, breathing techniques, listening to relaxing music, you can also go for a walk, eat healthfully and regularly can help a lot, getting enough sleep and making sure that it’s actual restful sleep, remember back when I was reading the diagnostic criteria? Sleep disturbance is one of those, and so if we’re not getting proper sleep that can make everything else feel a lot worse, so working with your doctor or therapist on that could help also. Also avoiding coffee, obviously it’s an upper, it’s gonna maybe make us feel more anxious and it could even stimulate some of the physical feelings we have when we feel anxiety as a whole. And lastly, they say avoid alcohol because it can lead to racing heart, when we wake up in the middle of the night when our body’s processing the alcohol, it feels to some people like a panic attack. So just being aware of the things you can maybe change, lifestyle choices that you can change, to better help you with your GAD. I hope you found this helpful. I think it’s important to note, that if you struggle with this, there are treatment options available, like I said, there are things we can do on our own, there are medications that help, we can talk to a therapist, seeing someone who specializes in CBT can be so beneficial. So know that if you are struggling, help is out there and it can and will get better. If you’re new to my channel, and you like videos like this, give it a thumbs up and don’t forget to subscribe. I put out videos twice a week and you don’t want to miss them. And I will see you next time. Bye! Subtitles by the community

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  1. I have a question when I'm around exeamly close friends or family members I feel better and without worry but kn my own I panic and run and hide just to get away from people, so my question is how do I prevent this and how do I go it alone sorta speak

  2. I've been diagnosed with GAD, as I meet EVERY criteria, except the last one. I've also been diagnosed with panic disorder, agoraphobia, and schizoaffective disorder… So do I still have GAD? Or do the other dxs cancel it out? I'm a mess. Sorry…

  3. I DIDN'T HAVE GAD until I was exposed to toxic mold. It got worse once i got my tonsils removed too. Pleaseeee check your environment!!! If you have any water damage leave now!

  4. I haven’t been diagnosed but today I had a massive anxiety attack I couldn’t breathe and my heart was beating so fast. The tears wouldn’t stop coming and it felt like it was trapped in my own body. I’m rlly scared to tell anyone and just thinking about it gets me anxious so I avoid it. I’m only 13 but I’m rlly interested in learning more about GAD😁

  5. I loved this video thank you for sharing ❤️! I have always been an overthinker but now thst i have started college I don’t know if it made it worse . I have cerebral palsy and about 4 weeks ago i felt a pound in my head that made me start overthinking more . Afraid to talk it out but i dont know if i got ocd out of nowere because now when i stare at people there blinking annoys me and makes me anxious for no reason even though i know it’s normal but my mind doesn’t let me think straight and that’s all it focuses on and at night ive been having insomia and hard time sleeping and that worries me because i have never felt like that before any recommendations? ❤️

  6. I don't no what I have but whatever is it I hate it . I get worried ALOT and I don't no what to do I get very nervous around a big group of people and I sometimes cry because of my anxiety, my mom passed away 7 months ago and my anxiety has gotten worse what should I do ?.

  7. My only issue with the "avoid substances" advice (I've done it before) is that substances can help alleviate my GAD temporarily, and make it more bearable. Also, I'm not sure why just because I have GAD I should make my life more boring, that just feels sad :/

  8. This might sound disgusting but it’s really hard to take a bath or shower like I’ll do so once a week and that’s it. I can’t fall asleep at all so I have really sluggish movements throughout the day. I don’t really try my best in everything and I feel like I fail all the time although I know that I didn’t try. I don’t like being around people. And I’m scared to talk to anyone or ask to get therapy because I feel crazy I’d really like some advice

  9. I feel defeated, restless, and weighed down by my constant and persistent anxiety. I have felt horrible anxiety since I was young, and I now feel like I am slowly dying as I dive deeper into my 20's, and I don't know how to deal with it. Nothing seems to help. It feels chronic.

  10. Um it’s happened for my life, I don’t even know if I have it, but I worry about school and my body, and my “romantic” life or crushes(which ever you may call it), and I cant breathe and my heartbeat quickens, I cant focus on anything except that one thing, and I feel nauseous, it’s probably nothing serious though, I must just worry too much.

  11. I'd like to know why the medical industry isn't working harder to find treatments that include drug treatments that are based on non addictive drugs? I am sure there are chemicals that could help that would not be addictive..but I don't understand why this isn't a priority to any company that ,manufactures drugs these days… If I take something everyday that helps me that I can literally not take if I feel I don't need it or I run out without the addictive issues that come with addictive medications. Is that so hard to understand and address?

  12. BTW I just started blood pressure medication a few weeks ago. Until then I have never had a prescription for anything in my entire life. I was healthy and without a single health issue until I hit 59 years old a little over two years ago thereabouts. I will soon turn 62 years old and for the past year plus I have had anxiety almost everyday and night i can't sleep more then a few hours without waking up and yes I have had the wake ups that you mentioned …waking up in a panic for no reason. Here;s my point: How is it that I could live all those years without a single problem then all of a sudden out of the blue I have panic / anxiety issues every day… now? Surely there is something causing this and it's not worry..although sure I worry everyone does..I believe the body is telling us something and we aren't listening to it… we are to often trying to apply mental scenarios when we should be looking for health scenarios. Another words… you won't fix / treat a health problem with a mental trick like breathing.. or meditation. Nope if it's a health issue it can be medically proven to exist and medically treated… with medication ! Other wise you really aren't addressing the issue!

  13. My anxiety is like right at the back of my head like their thoughts I can’t control because they’re right at the back of my head so I don’t really know what they’re about and I can’t explain it my hands get sweaty in assemblies I can’t really sleep sometimes when I’m hungry my body thinks I feel sick so it flips out and I panic in my head that I’m going to be sick but I’m just hungry I love dance but I don’t have the energy or the confidence to go like sometimes I do loads of exercise and I can’t really breathe so my body flips out again and I procrastinate on doing homework then get into trouble because I can’t do it the night before it takes like 6 months to get on the waiting list for counciling and I try to talk to this teacher but I don’t want to tell her because I’m embarrasss and think I’m going to cry if I try to explain

  14. It’s so frustrating for people who don’t have it to understand it because they’re like just get over it and I can’t it’s not something I can just get over it just annoys me so much

  15. I've been diagnosed by multiple psychiatrists with 3 comorbid disorders. The ADHD diagnosis is very strong; I meet all but two of the diagnostic criteria. The chronic depressive disorder/dysthymic disorder/dysthymia diagnosis is similarly strong. I'm not sure the GAD diagnosis is valid in and of itself, but if two disorders come together like a DBZ fusion to make a third I can't argue.

  16. Kati I am not sure if I actually have anxiety or maybe even depression (I doubt it). I don't know how to bring it up with my therapist either.
    I usually have loads of adrenaline rushes every day 6-10 and feel panicked a lot too. I also start going through my head about these thoughts of panic and their outcomes and start worrying about them or other things and freaking out about things while being anxious. I'll also be anxious over I don't even know what I'll just be anxious. I'll be really anxious over school too. Also recently I have started to lose motivation and don't want to do anything like I normally would like hang out with friends during school or after school or sports or pretty much everything that I did do. At school sometimes I feel like I'm going to burst out and cry or start throwing a fit. Recently I have been feeling anxious and sad a lot of the time. I also have a couple of anxiety symptoms. At the same time however there is a voice at the back of my head saying that I'm drawing attention to myself I don't have this and it's all in my head. Idk what to think right now.

  17. I'm 12 and I have 5 of those symptoms that she said and a professional thinks I do. I also have mild(used to be severe) depression yay

  18. Whats DSM?? Thanks Kati,just bought your book… but I am so anxious and scattered and unable to focus that sitting to read a book is like mountain climbing..:(

  19. Hello Kati. I’m a college student and I feel like my anxiety gets out of control most of the time. I was on medication but recently stopped because my mom didn’t want me taking them and I wanted to see if I can handle not being on them. My anxiety is fairly high and recently started cutting myself again. I would prefer not to go back on medication but I will if that is the only thing that will help me. One of my professors has recommended me to go see a counselor. Would it be in my best interest to see a counselor or mental health professional? Thank you

  20. Thank you for posting this video. My GP diagnosed me with GAD during my first ever university exams, when my parents were high-pressuring me to become a doctor. Like, come on! I'm not anxious anymore because I'm more experienced in studying for uni now, and my parents have accepted that I want to be a psychologist <3 But my GP won't take away my diagnosis.

  21. Why am I watching this when I was already diagnosed. Haha I’m probably just trying to get to know it better.

  22. I’m watching this video because I believe I have GAD and this is a lot of the research I have been doing and I’m gonna talk to a therapist or a doctor thank you for making this video

  23. I have this and it’s pretty bad. I worry about absolutely everything and it’s not just school or anything. It’s like, end of the world, people breaking in, things that may never happen but I’m scared of. I’m on medication now.

  24. You say something about trouble sleeping

    Me: *looks at time* oh no it's 1 am already…. I need to wake up at 7 :/

  25. I tired cbt with my nerves about my neighbour. So i passed near by him. But he did beat me up after all. Bad advice. 👎

  26. So I’m a kid and for the list when she said kids only need to have 1
    I have all 6…
    And I have actually been diagnosed before this. I do have GAD and social anxiety.

  27. Yeah, my doctor and I talked about this and he wants to put me on medication. I dont want to go that route.

  28. I was diagnosed back in November I think but it's been bad this past couple years. I was told not to get a therapist by the doctor as he said that they dig too deep and look for things that aren't there. I didn't want one either because I honestly agree and we can't afford one anyway. But I'm not talking any medicine either and so I have to cope with my anxiety by myself. It's not something I tell to people as I find it embarrassing, and the one person I have told straight up said to me "Nah I don't think you have anxiety" which also made me doubt the severeness of my condition. Now I know I have it though, and the only thing I can do is live with it. I don't know what to do because school is usually the root of my major anxiety and this causes me to be depressed for long periods of time. I've still got plenty of school years left and it's not something I want to wish away but I feel like that's what I'm doing

  29. I have an anxiety disorder (my therapist never did tell me which one). I think I need to go back to therapy again. I'm struggling to do basic things and I know it shouldn't be that hard, but I can't help it.

  30. I got this from watching porn and too much masturbation but when i abstain i have an improvement

  31. I have recently started taking anxiety medication, after a lifetime of endless generalized anxiety, and the difference is like day and night! Therapy did help me A LOT with my social phobia and some other problems, but the generalized anxiety was ever present and persistent. Now with the medication I finally feel like I'm normal! The endless worries and ruminations are gone, situations that would have made me panic like hell no longer even bother me. When an occasional thought or event occurs which does bother me I can now easily make it go away by talking to myself… which is something that never worked before.

    I am a lot more focused and productive as well.
    A lot happier in general. Its amazing how much more energy I have now that anxiety attacks and constant high stress are no longer sapping at it on a daily basis!!

  32. Awww. I’d love for you to be my therapist. So relatable, comforting and good sense of humor.
    I have high hopes for CBT.

  33. 3:23 I’ve been diagnosed with GED, Social Phobia, and Selective Mutism all at the same time. Does that mean one invalidates the others?

  34. I’m 15. I’ve been told I’m perfectly normal, healthy even (mentally anyways). Yet I left something at my school and had to go back during the first couple days of summer to retrieve it from the lost and found. Just thinking about going in there made me uncomfortable and going in alone. No. I couldn’t do it. I asked my sister to go in with me but she didn’t want to so she called our mother to make me go in alone. My mother is talking with me, pleading even for me to go get my damned jacket alone so my sister wouldn’t have to get out of the car. While she is talking to me I’m crying. And not the one tear dramatic bull shit, but the tears streaming down my face, when did I get water on my face? Why is my heart rate so fast? And why can’t I just breathe like a normal person. Or in an instance like today I went to a few restaurants with both of my sisters and I actually ordered my own food. Granted my heart rate increased, I mumbled everything while staring at my feet, I ordered my own food. And when they gave me the wrong sandwich I was the one that went to the counter to ask for the correct one. That doesn’t seem like much but that was so amazing for me to do. But my doctor doesn’t know any of that. I want more than almost anything to know what is actually wrong with me, like why did the thought of talking to someone make me start hyperventilating when I shouldn’t have been uncomfortable at all. But of course. I’m too anxious to actually talk about it

  35. had bloodwork done and all was good they first thought my now I'm guessing GAD…been agorophobic for 6 years

  36. I’m a senior in high school… so I’m still a child but I’m also an adult. Anyone else relate to this!!

  37. I was so stressed and and had so much anxiety during the SAT and ACT that I developed a chronic tic disorder 🙁 doc said it would only last a couple months no longer than a yeah. It’s been 6 years

  38. I was doing ok until my grandma died last week my anxiety is making my emotions worse intense pain off anxiety. And knowing certain people make it worse and I want to punch someone

  39. Doing exercise and controlled sleeping patterns… coffee and tea I stop at a certain time of the day. Alcohol I quit 6 months ago… It all helps! Thank you Kati! You're the best!

  40. Can childhood bullying cause an anxiety disorder? What about bullying plus domestic violence in the home as a child, and substance abuse?

  41. I had an acute anxiety situation and had diazepam prescribed. Changing my job certainly helped. Haven’t needed anything like that in a while.

  42. my mind races to the point where I begin to believe that ppl can read my thoughts because I have become so self conscious about it and I struggle to understand others and myself. At that point Ive lost my mind. I have other more common symptoms of G.A.D. and severe depression after Ive reached the point of near insanity

  43. SYMPTOM…….of the real issue/problem/reason.
    But yes getting control of symptoms at the start and for life are very important!!!

  44. I was diagnosed with GAD 3 months ago. I feel my anxiety fading away but I still find difficult to do things I used to like. Lets hope by the end of August I'll be back to normal 🙂

  45. just feel like the only thing that truly helps are benzodiazepines and that sucks bc that means never feeling ok unless I'm on a drug. Not to mention they're hard to even get prescribed to and they're not an actual solution but damn, they provide so much relief and I wish I could just take them every day until I work through this bullshit and get to the root of it bc I can't function properly and it's driving me insane.

  46. I have a question about bruxism. I was told that I often grind my teeth in my sleep and a lot of the time I find that during the day, I tend to clench my jaw. I know it can be caused by a lot of different factors, one of them being anxiety and stress. I see a psychologist regularly for CBT and take an antidepressant. I was wondering why I still face these issues if I'm getting the help I need? Could something else be causing it?

  47. Ive been diagnosed with GAD MDD and PTSD since i was 17, im 30 now I WISH THEY WOULD GIVE ME BETTER DRUGS INSTEAD OF SSRIS, ITS NOT WORKING U FUCKING ASSHOLES, and now i have tonic clonic and focal seizures im not epileptic they found nothing. 🙁

    And your advice on medications and dealing with it.. Is wrong its a disorder for a reason.. Anti pyscotics work best!! Seraqul

  48. The fatigue is my biggest worry. It can come out of nowhere and it really terrifies me which I know only makes it worse. It's a vicious circle I don't know how to get out of

  49. i don’t worry about things right away i tend to not care and then let the stress build and then i just breakdown i really need to go to a psychiatrist but there isn’t one in my area that takes my insurance and i need medication to help since i’m already on it from my primary

  50. Had anxiety since a kid smoking weed made me derealized and boosted my anxiety by 10 times, anyone else feel like this?

  51. I just got diagnosed with anxiety I went to the doctors for a completely different reason (sore stomachs) And the doctor basically said it stems from having anxiety. My parents don’t believe in mental heath and think it’s just for attention/a fashion trend 🙄 so I have no one to talk to about it (my mum told me to not go to the therapy group I was recommended by the doctor) and I have no clue how to get better or even cope better

  52. I don’t think I have GAD, but I have panic attacks or anxiety attacks a lot, 50% of time it’s because I’m around bugs (I have entomophobia), is it possible I have another form of anxiety?

  53. Hey Kati people around me keep telling me that I look tensed all the time but in my head m just having a normal day……is this generalized anxiety……..n if so should I be taking therapy??

  54. I looked at this woman and i was like whoo is this bitch…OMG I KNOW i think is this shane dawson tell me please

  55. Are you a therapist cuus id rather talk to people on a phone cus i dont wanna tell my aunty ( my mum and dad is abusive) it gets me a little scared. Should I tell some body its just that I think she wouldn't bealive me like I'm ten years old i dont know why i even have anxiety i just get i think its becuse of someone i have a big fat crush on him and he dose not like me back and it kinda kills me a little but he's still a good friend.

  56. I want a therapist but in order to do that I'd need to ask my parents which I tried but didn't end well 😖😭

  57. my life is living hell. I suffered a lot with ADHD in my entire childhood from age 2-3 to 17-18 then i was all ok for a year or two,but then GAD and I m 37 now 😔

  58. I just have this knee jerk reaction to wait another 6 months to see if something 'actually' wrong with me. I get weirdly comparative about it: I won't say anything unless I still feel this way in 3 months time- (3 months later) yeah well I've been okay for a couple of those days, i think; it's probably nothing.
    This past month I've been as tired as I can possibly be, and I don't have anything to stress about aside the fact I can't relax. I'm so stressed by this fact I would be laughing at the irony if it wasn't so fucking painful lol.

  59. My mind:

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