When we experience or someone we care about is experiencing GAD, or generalized anxiety disorder, chronic and uncontrollable worry can take over. Worries range about a variety of topics, from big concerns like family and personal health and finances to the more minor matters of being on time for appointments or keeping things clean and organized1.
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People diagnosed with GAD may also experience fatigue, muscle tension, irritability, difficulty sleeping, and other physical health problems1. GAD often has a chronic course and it affects between 4 and 7 percent of the United States adult population2-4. And it is associated with a higher risk of developing depression, social anxiety, and other mental health problems.3
GAD symptoms can make a big impact on individuals, so it is no surprise that research also highlights the impact they have on relationships—intimate couples, professional coworkers, friendships, and families. Relationships are a big focus of worries for those with GAD, and the worries themselves take a toll on relationships, which makes managing them even harder.
What Kinds of Relationship Problems?
When someone is diagnosed with GAD, if they are in a relationship, it likely has higher marital conflict4. Individuals diagnosed with GAD may perceive the actions and intentions of others with greater suspicion and vigilance than those who do not experience this anxiety disorder5. People experiencing GAD may also be more likely to feel easily hurt by others, and they relate to others with passive, aggressive, or intrusive interaction styles6,7.
In addition, people with this diagnosis have reported that their patterns of communication tend to be either overly critical or overly passive and that these patterns can happen automatically without awareness8. Further, they report wanting to avoid important relationship-strengthening activities due to having many worries or being emotionally and psychologically present in them but feeling so distracted by worries that they find it difficult to feel connected in their relationships or those activities8.
If you are in a relationship with someone with GAD, you may be struggling to understand their irritability, worries, or communication style. Or maybe you feel hurt by some of the passive or aggressive and critical interactions that have occurred.
4 Tips to Strengthen Your Relationships
Whether you are the person experiencing GAD or in a relationship with someone who has GAD symptoms, follow these four evidence-based tips to strengthen your relationship.
1. Tune into the present moment through mindfulness.
So often our worries take us completely out of the present and into the future or past. Tune into what your relational needs are in this moment: What are you feeling? What thoughts are coming up? What do you want or need from your partner or friend in this moment? Is it someone to listen? Someone to help solve a problem?
You may want to consider some formal mindfulness practices to help gain a deeper awareness of your thoughts and feelings, and to learn to relate to them with compassion instead of judgment or reactivity. There are many ways to practice mindfulness. For a link to free evidence-based mindfulness practices, visit mindfulwaythroughanxiety.com, and go to the “Mindfulness Exercises” tab.
2. Practice active, mindful listening.
This is a practice of focusing first on really understanding what others have to say and clarifying with them that you understand it correctly before sharing your perspective. This strategy may help with working through unhelpful patterns of overly passive or aggressive communication habits in your relationships.
It can help to check in at the beginning of a conversation and clarify: Do you need someone to listen and support you, or are you looking for someone to help with problem-solving? Sometimes when our partners want someone just to listen and we step in to problem-solve, it can lead to more conflict. This strategy can help make sure you are both on the same page with the communication goals in that moment.
3. Take time to reflect mindfully on positive things that people in your relationships do.
This can help draw attention to positive aspects of your relationships. Often, when our minds are consumed by worries and fears, it can be very easy to overlook things that are going well. Reflect on this, then thank that person for their actions, even small ones such as thanking them for taking out the garbage or for giving a warm welcome when you came home from work, as well as more substantial actions, like planning a nice outing or cooking a nice meal.
4. Reflect on your relational values.
What kind of spouse, partner, sibling, parent, or coworker do you want to be? What are the characteristics or traits you want to embody in these relationships? What are some small ways you can engage with those values today?
These can be small actions, such as committing to listen actively to your spouse when they come home from work or taking a time-out when you feel your irritability is increasing so a conflict does not escalate. It could also mean engaging in more self-care to recharge yourself, such as taking five minutes to breathe deeply so you can be more present with your family when you come home from work.
By strengthening relationships and social support networks, you can enhance the resilience of your relationships. Research suggests that stronger, healthier relationships may also sustain increased improvement from GAD symptoms9, 10.
Sources
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.
2. Roy-Byrne, P. P., Davidson, K. W., Kessler, R. C., Asmundson, G. G., Goodwin, R. D., Kubzansky, L., & Stein, M. B. (2008). Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30(3), 208-225. doi:10.1016/j.genhosppsych.2007.12.006
3. Ruscio, A., Chiu, W., Roy-Byrne, P., Stang, P. E., Stein, D. J., Wittchen, H., & Kessler, R. C. (2007). Broadening the definition of generalized anxiety disorder: Effects on prevalence and associations with other disorders in the National Comorbidity Survey Replication. Journal of Anxiety Disorders, 21(5), 662-676. doi:10.1016/j.janxdis.2006.10.004
4. Kessler, R. C. (2000). The epidemiology of pure and comorbid generalized anxiety disorder: A review and evaluation of recent research. Acta Psychiatrica Scandinavica, 1027-13. doi:10.1111/j.0065-1591.2000.acp29-02.x
5. Whisman, M. A. (2007). Marital distress and DSM-IV psychiatric disorders in a population-based national survey. Journal of Abnormal Psychology, 116(3), 638-643. doi:10.1037/0021-843X.116.3.638
6. Gasperini, M., Battaglia, M., Diaferia, G., & Bellodi, L. (1990). Personality features related to generalized anxiety disorder. Comprehensive Psychiatry, 31(4), 363-368. doi:10.1016/0010-440X(90)90044-S
7. Salzer, S., Pincus, A. L., Hoyer, J., Kreische, R., Leichsenring, F., & Leibing, E. (2008). Interpersonal subtypes within generalized anxiety disorder. Journal of Personality Assessment, 90(3), 292-299. doi:10.1080/00223890701885076
8. Williston, S. K., Morgan, L., Graham, J. R., Eustis, E., Roemer, L. & Orsillo, S. (under review). How does anxiety get in the way of living the life you want? Exploring the lived experience of generalized anxiety disorder from a phenomenological perspective in a treatment-seeking sample.
9. Durham, R. C., Allan, T., & Hackett, C. A. (1997). On predicting improvement and relapse in generalized anxiety disorder following psychotherapy. British Journal of Clinical Psychology, 36(1), 101-119. doi:10.1111/j.2044-8260.1997.tb01234.x
10. Millstein, D. J., Orsillo, S. M., Hayes-Skelton, S. A., & Roemer, L. (2015). Interpersonal problems, mindfulness, and therapy outcome in an acceptance-based behavior therapy for generalized anxiety disorder. Cognitive Behaviour Therapy, 44, 491-501.
Sarah Krill Williston is a PhD Candidate in the Roemer lab at the University of Massachusetts Boston. Sarah’s research primarily focuses on developing strategies to increase mental health literacy and reduce mental health stigma, to empower individuals to more effectively seek evidence-based mental health care for anxiety and trauma-related disorders. In addition, Sarah’s clinical interests include providing evidenced-based treatments (primarily CBT, ABBT) to individuals with mood, anxiety and trauma-related disorders, with a particular interest in working with military families, active duty service members, and veterans.
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