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Generalized Anxiety Disorder (GAD)


Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention | Organizations

Definition

Generalized anxiety disorder (GAD) is chronic, exaggerated worrying and anxiety about everyday life. Everyone worries at times, but people with GAD can never relax and usually anticipate the worst. The worrying is often not related to anything in particular. Instead each day provokes tension and anxiety.

People with GAD often worry excessively about health, family, work or money. The worry is so severe that it interferes with their ability to live their lives. The anxiety can also progress to the point where people "worry about worrying." GAD usually starts in childhood or adolescence, but can also start in early adulthood.

Causes

The exact cause of GAD is unknown. Researchers think it may be related to chemical imbalances in the brain.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

  • Family member with an anxiety disorder
  • Long-term exposure to abuse, poverty, or violence
  • Low-self esteem
  • Poor coping skills
  • Sex: female

Symptoms

Symptoms of GAD usually build up 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
  • Difficulty concentrating, mind going "blank"

Physical symptoms include:

  • Fatigue
  • Muscle tension
  • Headaches
  • Trembling
  • Difficulty sleeping
  • Shortness of breath
  • Sweating

People with GAD often have other anxiety disorders, depression, and/or problems with abusing alcohol or drugs.

Diagnosis

The doctor will ask you about your symptoms and medical history, and perform a physical exam. The doctor will also look for other medical conditions that may be causing your symptoms. You will be asked about any medications you are taking. Some medications can cause side effects similar to the symptoms of GAD. Your doctor will also ask about addictive substances you may be using. These can include nicotine, caffeine, street drugs, prescription medications, and alcohol.

To make a diagnosis of GAD, symptoms must be:

  • Present more days than not
  • Present for at least six months
  • Interfering with your life (causing you to miss work or school, for example)

Treatment

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

Therapies include:

Cognitive Behavioral Therapy

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 Therapy

Your therapist will teach you relaxation techniques. 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 situation that is causing the worry and tension. This can allow you to reduce your anxiety in a safe environment.

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.

Medications may include:

  • Benzodiazepines - to relax your body and keep it from tensing in response to anxious thoughts (These medications need to be monitored closely because they may cause dependence.)
  • Buspirone - an antianxiety medicine that does not cause dependence
  • Antidepressant medication - to help control anxious thoughts

Prevention

There are no guidelines for preventing GAD. Early diagnosis and treatment can help symptoms from becoming debilitating.

Organizations

Anxiety Disorders Association of America
http://www.adaa.org/

National Mental Health Association
http://www.nmha.org/

SOURCES:

National Institute of Mental Health

American Psychiatric Association

National Mental Health Association

American Academy of Family Physicians


Last reviewed June 2001 by Medical Review Board



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