A generalized anxiety disorder (GAD), also known as worrying disorder, is characterized by long-lasting, excessive and non-reality-based anxiety. You can constantly feel threatened, uncomfortable and restless, and you may always feel like something’s going wrong. The consequence is endless worrying over all kinds of daily issues and finding the worrying very difficult to control.

Your daily functioning and ability to maintain social contacts can suffer greatly due to an anxiety disorder. The feelings of anxiety and concern are usually accompanied by restlessness, difficulty concentrating, irritability, fatigue, increased muscle tension and/or trouble sleeping.


Origins of an anxiety disorder

Generalized anxiety disorder usually develops around the age of 20. The cause of the disorder is not known exactly but has to do with a combination of factors, such as heredity, neurobiological characteristics, long-term stress, major events, personality and upbringing.


Metacognitive therapy for generalized anxiety

The treatment used with GAD is called metacognitive therapy. The model associated with the treatment of GAD is based on the distinction between the content of the worrying (negative thoughts about events) and the negative interpretation of the worrying (worrying about worrying). An example of this is “Oh help, I am going crazy with all this worrying” or “see, all this worrying is giving me heart complaints”. Worrying about worrying increases the anxiety and negative thoughts, therefore creating several vicious circles.

Metacognitive therapy focuses on exploring and changing the positive and negative views you might have about worrying. This treatment focuses on the beliefs someone has about their own thoughts rather than on the content of the thought themselves. The treatment consists of fourteen sessions, which are divided into four phases. Homework exercises, such as registering complaints daily and conducting behavioural experiments, are agreed upon during each session. An example of such a behavioural experiment is the ‘worry delay’ experiment.


Source: Keijsers, G. P. J., Van Minnen, A., Verbraak, M., Hoogduin, C. A. L. & Emmelkamp, P., (2017). Protocollaire behandelingen voor volwassenen met psychische klachten.

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