This article was originally published on My Mental Health on 13 October 2020.
Amid this pandemic, it can be normal to feel anxious about academic performance, job security, or even catching coronavirus through commuting via public transport. Everyone has feelings of anxiety at some point in their lives. It plays an important role in keeping us safe from perceived threats and preparing us for stressful situations. However, anxiety that is continuous, excessive, and difficult to control — to the point of interfering with day-to-day activities — may be a sign of generalised anxiety disorder.
Generalised Anxiety Disorder (GAD) is characterized by persistent and excessive worrying. People with GAD may constantly expect disasters and may be overly concerned about money, health, family, work, or other issues. They find it difficult to control their anxiety even when there are no clear reasons for concern. Sometimes, just the thought of getting through the day produces anxiety. People with GAD struggle to stop their cycle of continuous worrying and feel that it is beyond their control. This is even when they realize that their anxiety is more intense than the situation requires.
The onset of GAD is gradual and can begin at any stage in life, but the risk is highest between childhood and middle age. Although the exact cause of GAD is unknown, there is evidence that biological factors, family background, and stressful life experiences may play a role in its development.
General symptoms of GAD can vary and may include:
- Persistent worrying or anxiety that is out of proportion to the impact of the event
- Overthinking; making plans and solutions for all possible outcomes
- Perceiving a situation or event as threatening, even when it is not.
- Difficulty handling uncertainty
- Indecisiveness; fears of making the wrong decision
- Inability to set aside or let go of a worry
- Inability to relax, restlessness, and feeling keyed up or on edge
- Difficulty concentrating, or feeling that your mind “goes blank”
Physical signs and symptoms may include:
- Trouble sleeping
- Muscle tension or muscle aches
- Trembling; feeling twitchy
- Nervousness or being easily startled
- Nausea, diarrhea, or irritable bowel syndrome
Children and teenagers often have similar worries to adults. However, they may also have excessive worries about:
- Performance at school or sporting events
- The safety of family members
- Being on time; punctuality
- Disasters, war, or other catastrophic events
A child or teen with excessive anxiety may:
- Feel overly anxious to fit in
- Be a perfectionist
- Redo tasks because they are not perfect the first time
- Spend excessive time doing homework
- Lack confidence
- Strive for approval
- Require a lot of reassurance about performance
- Have frequent stomach aches or other physical complaints
- Avoid going to school or avoid social situations
Making lifestyle changes, learning coping skills, and using relaxation techniques can also help to alleviate GAD.
Generalised Anxiety Disorder Test
How do I know my total score?
The GAD-7 score is obtained by adding the score for each question (calculating the total points).
How do I interpret the scores?
When screening for anxiety disorders, a score of 8 or greater represents a reasonable cut-point for identifying probable cases of generalised anxiety disorder; further diagnostic assessment is warranted to determine the presence and type of anxiety disorder. Using a cut-off of 8, the GAD-7 has a sensitivity of 92% and specificity of 76% for the diagnosis of generalised anxiety disorder.
The following cut-offs correlate with the level of severity of anxiety:
- Score 0-4: Minimal Anxiety
- Score 5-9: Mild Anxiety
- Score 10-14: Moderate Anxiety
- Score greater than 15: Severe Anxiety
Based on a recent meta-analysis, some experts have recommended considering the use of a cut-off of 8 to optimize sensitivity without compromising specificity.
This self-assessment tool and recommendations are provided for informational purposes only and are not meant to be substitutes for advice provided by a doctor or other qualified healthcare professional. You should not use the information contained herein for diagnosing a health problem or mental health disorders. You should always consult with a doctor or other health care professionals for medical advice or information on diagnosis and treatment. If you have any concerns about your mood and mental health, you can speak to a clinical psychologist from Viriya Community Services by calling 6256 1311 or emailing firstname.lastname@example.org.
Living with generalised anxiety disorder can be a long-term challenge. It also often occurs together with other anxiety or mood disorders. In most cases, GAD can improve with psychotherapy and/or medications. Making lifestyle changes, learning coping skills, and using relaxation techniques can also help to alleviate GAD.
For mental health support, please contact
- IMH Mental Health Helpline – Tel: 6389 2222
- National Care Hotline – Tel: 1800 2o2 6868
The contributor is the Executive Director of Clarity Singapore.
The GAD-7 was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and their colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.
Header image by Freepik.