Therapy for generalised anxiety in Glasgow

What generalised anxiety looks like

Generalised anxiety disorder, usually shortened to GAD, is worry that has become a habit of mind rather than a response to a particular problem. One concern is barely settled before the next arrives. You may recognise some of these:

• You worry about several things at once, and the topic changes but the worrying does not
• You find it hard to stop once you have started, even when you know it is not helping
• You feel on edge, restless or keyed up for no obvious reason
• You are tired a lot of the time, and your sleep is light or broken
• Your shoulders, jaw or stomach are tense more often than not
• You struggle to concentrate because part of your mind is always somewhere else
• You plan for every outcome, ask for reassurance, or put decisions off because you cannot be sure

People with GAD are often capable and conscientious. The worry is not a sign that you cannot cope. It is a sign that your mind has learned to treat uncertainty as a threat.

Why the worry keeps going

Worry feels productive. It feels like preparing, or caring, or keeping bad things at bay. Because nothing terrible usually happens, the mind quietly concludes that the worrying worked, and does it again. Over time, worrying becomes the default way of dealing with any uncertainty at all.

Two other things keep the cycle turning. The first is intolerance of uncertainty: not knowing feels so uncomfortable that any amount of mental effort seems worth it to get certainty, even though certainty never comes. The second is worry about worry itself, the sense that you cannot control it or that it is doing you harm, which adds a layer of anxiety on top of the original concern. Willpower rarely helps here, because trying hard not to think about something is itself a way of thinking about it.

How we treat it

Cognitive behavioural therapy is the treatment recommended by NICE for generalised anxiety, and it is where we usually start. The version of CBT for GAD is not about arguing with each worry. It targets the engine underneath. Depending on what your assessment shows, the work is likely to include:

1. Understanding your worry: mapping what triggers it, what you do in response, and what keeps it going, so the pattern makes sense.
2. Worry postponement: learning to notice a worry, park it for a set time later in the day, and return to what you were doing. Most worries have lost their urgency by then.
3. Building tolerance of uncertainty: small, planned experiments in leaving things unchecked, undecided or unplanned, so you learn that not knowing is uncomfortable but survivable.
4. Changing your relationship with worry: testing the beliefs that worrying keeps you safe or that it is out of your control.
5. Settling the body: practical work on tension, sleep and the physical side of anxiety.

Some people find acceptance and commitment therapy a better fit, particularly if they have tried to control their thoughts for years. ACT helps you let worry be there without following it, and put your energy into what matters to you. If your worry is tied up with being hard on yourself, compassion-focused therapy can be woven in.

What to expect

Sessions last 50 minutes. How often you meet is agreed between you and your psychologist. A course of therapy for generalised anxiety is usually between 12 and 16 sessions. Between sessions you will try things out: postponing worry, leaving something unchecked, noticing when you have been pulled into a what-if. That practice is where most of the change happens, and you will review what is working together as you go.

If your anxiety comes in sudden waves with a racing heart and a fear of collapsing or losing control, our page on panic attacks may describe it better. If it centres on other people's judgement, see social anxiety.

Who you might work with

Dr Humera Millar is a clinical psychologist who works with anxiety, perfectionism and stress using CBT, ACT and schema therapy.

Dr Claire McGuire is a clinical psychologist working with anxiety, perfectionism and stress through CBT, ACT and compassion-focused therapy.

Dr Andrew Wood is a consultant clinical psychologist who works with anxiety and stress using CBT and ACT.

View our full team to find a psychologist who feels right for you, or tell us what is going on and we will suggest someone.