MEDICAL MATTERS:General anxiety disorder is a chronic condition that often goes undiagnosed
IMAGINE LIVING in a secret world of continuous intense anxiety and worry, whether it be about health, job, family and so on; imagine living with a constant sense of foreboding about potential impending disaster; suffering from persistent mental and physical fatigue, irritable bowel syndrome-type symptoms (abdominal pain, cramps, alternating diarrhoea or constipation), poor memory and concentration, sleep difficulties and nightmares.
Ally all of these symptoms with indecisiveness, difficulty coping with everyday life, a tendency to constantly avoid everyday tasks, never wanting to start new jobs as finishing them will drain away any remaining energy reserves and bursts of acute anxiety symptoms and even occasional panic attacks and we can only just imagine the "hell" in which many Irish women find themselves!
Many wonder if they are depressed or simply mad, and constantly chastise themselves for their inability to cope. Others wonder if they are simply stressed.
Eventually they begin to feel it is "normal" to feel like this and try to tailor their lives accordingly. They come to dread times of acute stress - all of the above symptoms arrive with a vengeance.
Sometimes they will at such times stop eating, lose weight, grind their teeth at night, get tension headaches, all of which they will try to hide from those loved ones close to them.
It's hard to believe that so many women, suffering from the above symptoms, will go through their lives never realising that they are suffering from a chronic condition called general anxiety disorder (commonly called GAD).
Many will spend decades constantly visiting their family doctor, never opening up to how they feel, both unaware of the problem. Often they will have had multiple investigations for all kinds of physical symptoms, all coming back as "normal" even though the person feels anything but!
This condition can occur in both sexes but is twice as common in women. Many, in my experience, use alcohol as a coping mechanism with some unfortunately becoming "hooked", creating further difficulties.
Most will have at least one episode of the red flag of depression during their lives, as their emotional reserves become exhausted. Some unfortunately become addicted to tranquillisers.
There is a lot of work being done to try to elucidate the cause of this condition which is a cause of such distress to so many women. We now know that it is caused by a powerful mix of genes and environment. It is now felt that there may be up to 15 genes predisposing us to this condition. Some experts feel there are similar genetic patterns to depression.
But it is widely accepted that the environment that we develop in plays a major role in whether such genetic predispositions come to fruition. If we grow up in an anxious, perfectionist, abusive or addictive background then GAD in our adult life becomes more likely.
It is quite common for the "warning signs" to be present in children and teenagers, sometimes presenting with abdominal pain, tension headaches and lots of the perfectionist traits often found in adults with this condition.
Biologically, this condition is caused by an over-active stress box in their emotional brain, the source of all the negative worries and fears, and high levels of our stress hormone glucocortisol which interfere with the mood cables in the brain. The acute anxiety attacks are caused by bursts of adrenaline.
It is also a condition which for many women worsens with age, as the mounting stress of modern life builds up. It seems to take less stress to trigger acute episodes.
For me, the tragedy of this condition is that so many women could find their lives transformed if they recognised it for what it is and came for help.
Once again the treatment is holistic. Proper nutrition, exercise, yoga/Pilates/meditation and avoiding alcohol/stimulant drinks such as coffee and coke are all excellent places to start.
Drug therapy (usually modern SSRIs) in my opinion has a place but should only be used if essential. Tranquillisers should be avoided.
But for me the real treatment lies in the magical world of cognitive behavioural therapy (CBT), teaching women the skills to examine how their thoughts influence their anxiety (and thus their physical symptoms), which in turn affects their behaviour.
We need to put women back in charge of their own lives, no longer at the mercy of their excessively negative emotional brain. I have worked with many women and found they have a great capacity to "reshape" their lives, with extraordinary results.
If you are living in this secret but very distressing world of GAD, and have up to this not recognised your enemy for what it is, hopefully this piece will encourage you to open up to your family doctor and look for the help you need.
• Dr Harry Barry is author of Flagging the Problem - A New Approach to Mental Health(Liberties Press) and director of Aware