Generalized anxiety disorder Health Article

Definition

Generalized anxiety disorder (GAD) is a pattern of frequent, constant worry and anxiety over many different activities and events.

Alternative Names

GAD; Anxiety disorder

Causes, incidence, and risk factors

Generalized anxiety disorder (GAD) is a common condition. The cause of GAD is not known, but biological and psychological factors play a role. Stressful life situations or behavior developed through learning may also contribute to GAD.

The disorder may start at any time in life, including childhood. Most people with the disorder report that they have been anxious for as long as they can remember. GAD occurs somewhat more often in women than in men.

Symptoms

Generalized anxiety disorder has the following symptoms:

• Difficulty concentrating
• Difficulty controlling worry
• Excess anxiety and worry that is out of proportion to the situation most of the time
• Excessive sweating, palpitations, shortness of breath, and stomach/intestinal symptoms
• Fatigue
• Irritability
• Muscle tension -- shakiness, headaches
• Restlessness or feeling keyed up or "on the edge"
• Sleep disturbance (difficulty falling or staying asleep; or restless, unsatisfying sleep)

Depression and substance abuse may occur with an anxiety disorder.

Signs and tests

A physical examination and psychological evaluation can rule out other causes of anxiety. The health care provider should rule out physical disorders that may mimic anxiety, as well as symptoms caused by drugs. This process may include different tests.

Treatment

The goal of treatment is to help the person function well. The success of treatment usually depends on the severity of the generalized anxiety disorder.

Cognitive-behavioral therapy (CBT) and medications are the mainstays of treatment.

Selective serotonin reuptake inhibitors (SSRIs) are usually the first choice in medications. Serotonin-norepinephrine reuptake inhibitors (SNRIs) are another choice. Other antidepressants and some antiseizure drugs may be used for severe cases.

Other anti-anxiety medications may also be prescribed. Benzodiazepines may be recommended if antidepressants don't help.

Behavioral therapies that may be used with drug therapy include:

• Cognitive behavioral therapy to change distorted and possibly harmful perceptions of severe anxiety
• Pleasant mental imagery
• Relaxation techniques

Other counseling and therapy techniques may help people gain an understanding of the illness and the factors that protect against or trigger it.

A healthy lifestyle that includes exercise, enough rest, and good nutrition can help reduce the impact of anxiety.