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Specializing in marriage counseling, couples counseling and family relationship issues.

How does Generalized Anxiety Disorder (GAD) develop?

How does Generalized Anxiety Disorder (GAD) develop?

Man with depression and anxiety

We who are generally anxious often have developed a posture of alertness, even vigilance for what might become, or already is, out of control. One thing we cannot fully control is what others think of us, so many of us turn our efforts toward controlling self. If religious, or scrupulous without a religious background, this can take a form of controlling impulses, desires, and emotions to privilege good thoughts and good behavior. Sometimes we want to maximize the perception of goodness, including minimizing the appearance or temptation of superiority, such that we add humility to our many self directives about goodness. This all requires a persistence and energy investment which have a hurtful cost. We wear ourselves down scrutinizing our behavior, thoughts, even intentions. If not our thoughts, we examine others’ thoughts. Rest is difficult to find.

Constancy of effort, at some point, takes the form of worry, the examining of what might happen if…. This gives the mind infinite paths, some circular, to journey down with thought experiments and imaginings of how things might go wrong or become out of control such that we won’t be able to put it right. Oh the infinite iterations of how things can go wrong. We are enjoined, “Be vigilant!” To relax feels dangerous or irresponsible, even if we could accomplish it. If we honor the fear, we literally cannot stop the worry. Worry has become synonymous with goodness at an unconscious, habitual level. Our muscles, breathing, posture, and facial expressions embody the tension supported by our self-training to not relax our effort toward goodness, perfection or control.

What are the origins of identifying with such worry and tension? There are many possibilities. A word here of affirmation and compassion. Whatever our background, we can trust an anxious, worrisome posture was a perfectly understandable, if not necessary, solution to a dilemma we faced at one time or another, most typically a predicament faced during a period of rapid development and therefore formative years of our childhood. I hope any resonance you have with ideas on this page can be accompanied by self-acceptance and compassion. May you stand up to and resist the tendency to judge yourself or others for how things unfolded into a pattern of anxiety.

Worry without a history of trauma

Gratefully, mental health research and practice has learned much in the recent decade how trauma can affect a person’s wellbeing for some time after the trauma. This has been combined with the clinical zeitgeist the decade earlier, which the APA dubbed the Decade of the Brain, to delve into how the mind and brain, and therefore the victim/survivor, responds to and heals from trauma.

And yet, many who have no pronounced trauma in their lives develop anxiety. You should not presume you have a scarring trauma in your past if you have anxiety. Of course, if along the path of growth you recall or encounter periods of hurt that shake your very sense of self and being in the world, it can be very helpful to acknowledge it with self-compassion. Speaking with a counselor familiar with trauma recovery can be very helpful, even transformative. But what if we have no discernable trauma? Were we born broken? Am I weak? Do I have a fragile mind by nature?

However we answer these and other questions we may have about our anxiety, our answers can be a foundation for orienting ourselves to healing and growth. Here are some patterns from two decades of counseling experience that may help you find your answer, and I sincerely hope your answers serve as a solid ground from which you can make the next steps to drop worry and cultivate rest, safety, and contentment.

Fertile Ground for Perfectionistic Striving…and Worry.

A family with high but vague parental standards sets a context for striving for perfection. If parents have high but not well-defined standards for goodness, self-control, achievement, propriety, appearance, or other family value, a cooperative child will naturally endorse the values and set their sights on meeting parental expectations. But when is the expectation met? Because the high standard is not well defined, the child learns of the landscape of expectation only after falling short. Our only hope is in studying the contours of the many shortcomings to discover what is the standard of acceptance. From the child’s perspective, the landscape shifts. The standards of acceptance or affirmation are a moving target and continually refined. Will this next step be right or wrong? How might we know ahead of time? An ambitious and responsible child will continue to scour their world for the standard. And when in the grace of parents’ approval, we must study how we got there and how can one maintain this approval? As nice as approval is, there is no rest in it. The persistent surveilling, measuring, studying is exhausting. If not walking on eggshells, we at least walk through childhood braced for correction or reprimand. If the standard is one of goodness, reprimand is a corrective judgment, and that judgment stirs shame after years of trying to do better and never finding the place of rest, a place where our goodness is embraced and trusted as good enough.

Worry With History of Traumatic Upbringing: Anger, Substance Use, Mental Illness, Physical Abuse, Chaos from Poverty, Foster Care, Traumatic Death/Sudden Loss of Loved One

Generalized Anxiety also develops in those who grew up in family systems where there was unpredictability with high costs. Parents with explosive anger and unclear standards leaves the child in hyperarousal. A parent with substance abuse can create an unsettling relationship with the child. They child doesn’t know which parent they will get. This is made worse if intoxication coincides with parental behavioral or emotional dyscontrol. Poverty leaves children at risk for unstable neighborhoods, overly burdened parents, basic childhood needs inconsistently met.