What is generalized anxiety disorder?
We all worry. Relationships, deadlines, being on time to an appointment – you name it, there’s plenty in life to worry about. But people with generalized anxiety disorder, or GAD, experience persistent, excessive, and unrealistic worry that goes on every day, possibly all day. They feel it’s beyond their control. People with GAD often expect the worst, even when there is no reason for any concern. Their worrying occurs on more days than not for at least six months and often concerns health, family, money, or work. The exaggerated, unrelenting worrying interferes with every day living. Physical symptoms often accompany it and include restlessness, irritability, muscle tension, fatigue, and difficulty sleeping or concentrating
Anxiety is normal. It helps us get out of harm’s way and prepare for important events. It warns us when we need to take action. But if you have anxiety that is persistent, irrational, and overwhelming and interferes with daily activities, you may have an anxiety disorder.
The term “anxiety disorders” refers to generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, and specific phobias.
People with Generalized Anxiety Disorder (GAD) Symptoms
- Worry very much about everyday things for at least six months, even if there is little or no reason to worry about them;
- Excessive worry about everyday things
- Restlessness and being unable to relax
- Being easily startled
- Difficulty concentrating
- Sleep issues, such as trouble falling asleep or staying asleep
- Feeling that everything will turn out badly
These issues may be accompanied by a number of physical symptoms, such as:
- Muscle tension and muscle aches
- Difficulty swallowing
- Trembling and twitching
- Nausea and other gastrointestinal issues, including diarrhea
- Frequent need to go to the bathroom
- Difficulty breathing
- Profuse sweating
Children with GAD may also show other signs of the condition, such as refusing to go to school, worrying about their safety or the safety of their loved ones, and clingy behavior.
Generalized Anxiety Disorder (GAD) Causes
Like heart disease and diabetes, anxiety disorders are complex and result from a combination of genetic, behavioral, developmental and other factors.
Using brain imaging technologies and neurochemical techniques, scientists are finding that a network of interacting structures is responsible for the emotions that are present in an anxiety disorder. Much research centers on the amygdala, an almond-shaped structure deep within the brain. The amygdala is believed to serve as a communications hub between the parts of the brain that process incoming sensory signals and the parts that interpret them. It can signal that a threat is present, thus triggering a fear response (anxiety). It appears that emotional memories stored in the central part of the amygdala may play a role in disorders involving very distinct fears, like phobias, while different parts may be involved in other forms of anxiety.
By learning more about brain circuitry involved in fear and anxiety, scientists may be able to devise more specific treatments for anxiety disorders. Someday, it may be possible to increase the influence of the thinking parts of the brain on the amygdala, thus placing the fear and anxiety response under conscious control. In addition, with new findings about neurogenesis (birth of new brain cells) throughout life, perhaps a method will be found to stimulate growth of new neurons in the hippocampus in people with severe anxiety.
Studies of twins and families suggest that genes play a role in the origin of anxiety disorders. However, experience also plays a part. Childhood adversities and parental overprotection have both been associated with the later development of generalized anxiety disorder, but no environmental factors have been identified as specific to or predictive of anxiety. Researchers are attempting to learn how genetics and experience interact in each of the anxiety disorders—information they hope will yield clues to prevention and treatment.
Generalized Anxiety Disorder (GAD) Treatment
Generalized Anxiety Disorder Diagnoses (GAD)
As with other anxiety disorders, there’s no specific test to diagnose generalized anxiety disorder.Your doctor may conduct a physical examination and order blood tests to exclude other possible causes of your symptoms.A diagnosis of generalized anxiety disorder is based on both your psychological and physical symptoms.According to the American Psychiatric Association’s diagnostic criteria, you have GAD if you’ve had difficult-to-control, excessive worry — more often than not — for at least six months, and experienced at least three of the following six symptoms:
- Restlessness or edginess
- Becoming easily fatigued
- Difficulty concentrating, or feeling as if your mind has gone blank
- Muscle tension
- Sleep issues
Your symptoms must also be severe enough to impair your ability to go about your daily life, and must not be due to substance abuse or other disorders or health issues.
The two main treatments for GAD are psychotherapy and medications. Your doctor may prescribe a combination of both treatments.Therapists often use an approach called cognitive behavioral therapy, or CBT, to treat generalized anxiety disorder.This popular form of psychotherapy — which is used for a variety of psychological disorders — helps people identify, understand, and change the thoughts and behaviors that contribute to their condition.
Through CBT, people with GAD learn to:
- Recognize and address overestimation of the severity of situations (the feeling that minor problems will become much worse)
- Enhance their problem solving skills
- Reduce their worry-related behaviors
- Improve relaxation to reduce muscle tension
- Better deal with intense negative mental images
A number of different medications may be used to treat GAD, including:
- BuSpar (buspirone), an anti-anxiety drug
- Antidepressants, such as Cymbalta (duloxetine), Lexapro (escitalopram), or Paxil (paroxetine)
- Sedative drugs, such as Ativan (lorazepam), Valium (diazepam), or Xanax (alprazolam)