What is GAD?

So…you’re planning a trip, but things are starting to really bother you.  What if something goes wrong?  What if you get sick?  What if you are scuba diving and you completely freak out?

One of the things you might be wondering is– what is GAD?  GAD stands for Generalized Anxiety Disorder, which is actually a really common problem impacting millions of people each year.  Unlike panic attacks, which can come on out of nowhere and cause everything from nausea to shortness of breath to a feeling that the walls are closing in, generalized anxiety disorder is more of an overall feeling that something is wrong but you don’t know what it is, like something terrible is coming (this can also go along with superstition), and an avoidance of things like can be anxiety-provoking, like stressful situations or people.

Wikipedia defines Generalized Anxiety Disorder as such:  Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive, uncontrollable and often irrational worry, that is, apprehensive expectation about events or activities.[1] This excessive worry often interferes with daily functioning, as individuals with GAD typically anticipate disaster, and are overly concerned about everyday matters such as health issues, money, death, family problems, friendship problems, interpersonal relationship problems, or work difficulties.[2][3] Individuals often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, excessive stomach acid buildup, stomach pain, vomiting, diarrhea, bouts of breathing difficulty, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, rashes, and inability to fully control the anxiety (ICD-10).[4] These symptoms must be consistent and ongoing, persisting at least six months, for a formal diagnosis of GAD.

I just excerpted that for you so you could see if those symptoms apply to you.   They most certainly apply to me– I was a “nervous” child and could not sit still– not from lack of focus, but mostly because I felt like I was coming out of my skin with anxiety.  My stomach constantly hurt, I couldn’t sleep, I was always worried that something terrible was going to happen, I bit my nails, I preferred to be at home, and probably many more symptoms that I can’t remember anymore.  I was a kid in the 70s and 80s so I didn’t get the benefit of the “anti-anxiety medication revolution,” in case you are wondering why someone didn’t just medicate me and put me out of my misery (I wish they would have, believe me).  Prozac didn’t really become a thing until I was in college.   But then my anxiety problem had morphed into an official case of “Panic Disorder,” where I would have full-on panic attacks, get dizzy/ sometimes black out, plus I had some horrible phobias that I had to work on with Cognitive Behavior Therapy.

In my thirties, the Panic Disorder morphed again into “Generalized Anxiety Disorder,” which totally sucks but at least I can do more things, like go to the movies or fly on a plane without having to drug myself into a stupor because I’m afraid I’m going to have a panic attack and feel like I have to get up and run away (not possible when you are on an airplane, obviously).

So, what does this have to do with you?   Well, one thing people don’t always know is that Generalized Anxiety Disorder can go back the other way into Panic Disorder, especially in high-stress situations like scuba diving or other stuff you might be doing on your adventure vacation.   Another thing that might be adding to the high-stress part of the equation is the cost of the vacation, the fact that it is in a foreign country where you don’t speak the language, or if you’re traveling with a group of people.  If you think I am kidding about this, allow me to tell you a scary story about my friend M., who already had GAD but was not really doing anything about it.    She always figured that she was “just a worrier like her mother,” and just fought through it so she could travel.   I’m not even sure how an anxious person agrees to do something like this, but she went on a big trip with a group where they were climbing Machu Pichu.  She ended up having a major panic attack and having to receive medical attention on the mountain, and now she takes strong medication and receives Cognitive Behavior Therapy for Panic Disorder and is no longer able to travel.

I’m saying this not to scare you, but to impress upon you that Generalized Anxiety Disorder can’t really be ignored like that.  You need to get it under control or at least give yourself some tools to deal with it before you go traveling.  Do not just stick your head in the sand and hope it will go away.

Here are some things you can do, in order of my personal preference.  Medication does not really work for me, but that doesn’t mean it won’t work for you, so definitely give it a try if you want to, if your doctor recommends it, and if you are typically the kind of person who does well on medication.

Here is what I would try:

  1.   Work on your breathing.  I know, you’re probably thinking “Duh, I’m alive, I know how to breathe,” but if you have GAD or Panic Disorder, chances are pretty good that you have gotten into the habit of breathing shallowly or rapidly, and this is most likely contributing to your symptoms.  Get yourself an anti-anxiety breathing program, play it every day, do the exercises, and that may be enough to solve your problem.   If you don’t like that one, here are a few more options:

    Profound Relief from Stress and Anxiety

    Relieve Anxiety and Depression (free audio download)

  2. Change your diet.  To start, drink more water, start taking fish oil, and cut out all caffeine, including soda and coffee.  If you still feel anxious, cut out sugar.  If you still feel anxious, cut out gluten.   You also might want to see a nutritionist to see if you are deficient in one or more vitamins, because this can also be a cause of anxiety.  Ask about things like pyroluria, MTHFR, and other issues that can be treated with vitamins.
  3. Balance your hormones.  This is probably more applicable to women, but if your hormones are out of whack, it can definitely contribute to anxiety.  If you suspect you have something like estrogen dominance, see a naturopathic doctor so he or she can get you some progesterone and recommend some other supplements and dietary changes to balance this out.
  4. Go on medication.  Again, this is last on my list because medication does not really work for me, but things like Zoloft and Lexapro are typically used to treat generalized anxiety disorder.  Oh, and can I recommend that you NOT accept any type of benzodiazepine (like Xanax, Ativan, or Clonezepam) for short-term relief?  Believe me when I tell you that once your body and brain get used to these, it is almost impossible to quit without help.   If you must, take the prescription, and only use it on a “once in a blue moon” basis.

I hope that with all of these tips, you now have an increased understanding of what Generalized Anxiety Disorder (GAD) is and how to get it under control before you travel.  Don’t wait– start now!


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