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Generalized Anxiety Disorder

Definition

Generalized anxiety disorder (GAD) is an anxiety disorder marked by chronic, exaggerated worrying and anxiety about everyday life. The worry is so severe that it interferes with a person's ability to live his or her life.

Causes

GAD may be caused by:

  • An abnormal neurotransmitter system
  • Genetics
  • Environmental factors
  • Developmental factors
  • Psychological factors

Risk Factors

GAD is nearly twice as common in women than in men. Other factors that may increase your chance of GAD include:

  • Family members with an anxiety disorder
  • Increase in stress
  • Exposure to physical or emotional trauma
  • Unemployment, poverty
  • Drug abuse
  • Medical condition or disability
  • History of self-harm as a teenager, with or without suicidal intent

Symptoms

Symptoms of GAD usually develop slowly. People with GAD often have both psychological and physical symptoms of anxiety.

Psychological symptoms include:

  • Excessive ongoing worrying and tension
  • Feeling tense or edgy
  • Irritability, overly stressed
  • Difficulty concentrating, forgetfulness

Physical symptoms may include:

  • Muscle tension
  • Lightheadedness
  • Trembling
  • Difficulty sleeping
  • Restlessness
  • Shortness of breath
  • Sweating
  • Heart palpitations
  • Chest pain
  • Choking sensation
  • Abdominal discomfort
  • Diarrhea
  • Nausea
  • Numbness or tingling
Symptoms of Anxiety
Physiological effects of anxiety
Copyright © Nucleus Medical Media, Inc.

People with GAD often have other anxiety disorders, depression, and/or substance use disorders.

Diagnosis

You will be asked about your symptoms and medical history. A physical and psychiatric exam will be done. Conditions with similar symptoms will be evaluated. Blood and urine tests may be done.

You will be asked about any medications that you are taking, including over-the-counter products, herbs, and supplements. Some medications can cause side effects similar to the symptoms of GAD. You will also be asked about any other substances that you may be using such as nicotine, caffeine, illegal drugs, prescription medications, and alcohol.

To make a diagnosis of GAD, symptoms must:

  • Be present more days than not
  • Be present for at least 6 months
  • Interfere with your life such as causing you to miss work or school

You may be referred to a psychotherapist for further evaluation.

Treatment

If you have a mild form of GAD, your doctor will probably first have you try therapy to learn to manage anxious thoughts.

Lifestyle Changes

Lifestyle changes may include:

  • Regular exercise
  • Getting enough sleep every night
  • Avoiding anxiety triggers, such as tobacco, caffeine, and drugs
  • Drinking alcohol in moderation
  • Awareness of stressful situations and learning how to manage it

Relaxation Techniques

Relaxation techniques may be helpful in reducing anxiety. These may include:

Social Support

  • Have a strong support system of family and friends
  • Consider family therapy to help with understanding and coping skills
  • Join a support group

Cognitive Behavioral Therapy

During cognitive-behavioral therapy (CBT), your therapist will work with you to change your patterns of thinking. This will allow you to notice how you react to situations that cause anxiety. You will then learn to change your thinking so you can react differently. This can decrease the symptoms of anxiety.

Behavioral and Relaxation Therapy

Your therapist will teach you relaxation techniques, including deep breathing, muscle relaxation, and visualization. Learning ways to relax can help you gain control over anxiety. Instead of reacting with worry and tension, you can learn to remain calm. Your therapist may also slowly expose you to the situations that cause worry and tension. This can allow you to reduce your anxiety in a safe environment.

Biofeedback

Biofeedback works by attaching sensors to the body. A therapist helps you understand your body’s signals so you can use them to reduce your anxiety.

Medication

Medication can be prescribed for symptoms that are severe and make it difficult to function. Medications can help relieve symptoms so you can concentrate on getting better. It is important to note that many medications cannot be stopped quickly but need to be tapered off. Check with your doctor before discontinuing any medication.

Medications may include:

  • Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)
  • Buspirone
  • Benzodiazepines

Talk to your doctor about the risks and benefits of these medications. Some types may cause dependence.

Prevention

There are no current guidelines to prevent GAD.

Revision Information

  • Anxiety and Depression Association of America

    http://www.adaa.org

  • Mental Health America

    http://www.mentalhealthamerica.net

  • Canadian Psychiatric Association

    http://www.cpa-apc.org

  • Canadian Psychological Association

    http://cpa.ca

  • Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated December 23, 2014. Accessed January 26, 2016.

  • Anxiety disorders. Mental Health America website. Available at: http://www.nmha.org/conditions/anxiety-disorders. Accessed January 26, 2016.

  • Generalized anxiety disorder. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114697/Generalized-anxiety-disorder. Updated July 28, 2016. Accessed September 28, 2016.

  • Generalized anxiety disorder (GAD). National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml. Accessed January 26, 2016.

  • Gliatto MF. Generalized anxiety disorder. Am Fam Physician. 2000;62(7):1591-1600.

  • 9/12/2012 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114697/Generalized-anxiety-disorder: Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.

  • 11/6/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114697/Generalized-anxiety-disorder: Mars B, Heron J, Crane C, et al. Clinical and social outcomes of adolescent self harm: population based birth cohort study. BMJ. 2014;349:g5954.