Generalized Anxiety Disorder

Written by Elea Carey | Published on July 30, 2012
Medically Reviewed by George Krucik, MD

What Is Generalized Anxiety Disorder?

People who suffer from generalized anxiety disorder, or GAD, worry uncontrollably about common occurrences and situations. The condition may also be called chronic anxiety neurosis.

GAD is different than normal feelings of anxiousness. For example, many of us feel anxious about our finances from time to time. But a person who has GAD may worry uncontrollably about his or her finances several times a day for months on end. This can happen even when there is no reason to worry, and even when the individual knows there is no actual cause for concern.

What’s more, the anxiety may shift uncontrollably from finances to another topic, such as the welfare of loved ones or the dangers of air travel.

This excessive, unrealistic worry can be frightening and can interfere with relationships and daily function.

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Symptoms of Generalized Anxiety Disorder

Symptoms of GAD include:

  • difficulty concentrating
  • difficulty sleeping
  • irritability
  • fatigue/exhaustion
  • muscle tension
  • repeated stomachaches or diarrhea
  • sweating palms
  • shaking
  • rapid heartbeat
  • alcohol and/or drug abuse

Distinguishing GAD from Other Mental Health Issues

Anxiety is a common symptom of many mental health conditions, including depression and phobias. GAD is different from these conditions in several ways.

People experiencing depression may occasionally feel anxious. People suffering from phobias worry about one particular thing, but people suffering from GAD worry about a number of different topics over a long period of time (six months or more).

What Are the Causes and Risk Factors of GAD?

Causes of and risk factors for GAD may include:

  • a family history of anxiety
  • recent or prolonged exposure to stressful situations, including personal or family illnesses
  • excessive use of caffeine or tobacco
  • being the victim of childhood abuse

According to the Mayo Clinic, women are twice as likely to experience GAD than men (Mayo, 2011).

How Is Generalized Anxiety Disorder Diagnosed?

GAD is diagnosed with a mental health screening that your doctor can perform. He or she will ask you questions about your worries, including how long you have been experiencing them. If you first go to your internist, he or she may refer you to a mental health specialist, such as a psychologist or psychiatrist.

Medical tests may also be used to determine whether there is an underlying illness or substance abuse problem causing your symptoms. According to the Mayo Clinic, anxiety can be tied to gastroesophageal reflux disease (GERD), thyroid disorders, heart disease, and menopause (Mayo, 2011).

If the doctor suspects a medical condition or substance abuse problem is the cause of the anxiety, he or she may perform any of a number of tests. These may include:

  • blood tests—to check hormone levels (thyroid disorders)
  • urine tests—to check for substance abuse
  • gastric reflux tests (X-ray of your digestive system, endoscopy procedure to look at your esophagus)—to check for GERD
  • X-rays and stress tests (monitoring your heart function while you exercise)—to check for heart conditions

How Is Generalized Anxiety Disorder Treated?

Cognitive Behavioral Therapy

This involves meeting regularly to talk with a mental health counselor. The goal is to change your thinking and behaviors. This approach has been successful in achieving permanent change in many patients.

In therapy sessions, you will learn how to recognize and control your anxious thoughts. Your therapist will also teach you how to calm yourself when upsetting thoughts arise.

Doctors often prescribe medicines along with therapy to treat GAD.

Drugs and Medication

Different types of medicines are used to treat GAD both in the short-term and for longer periods.

Short-term medications relax some of the physical symptoms of anxiety, such as muscle tension and stomach cramping. These are called anti-anxiety medicines. Some common anti-anxiety medications are:

  • alprazolam (Xanax)
  • clonazepam (Klonopin)
  • lorazepam (Ativan)
  • buspirone (Buspar)

Anti-anxiety medicines may be habit-forming. They are not intended to be taken for long periods of time.

Medicines called antidepressants work well for long-term treatment. Some common antidepressants are:

  • citalopram (Celexa)
  • escitalopram (Lexapro)
  • fluoxetine (Prozac, Prozac Weekly, Sarafem)
  • fluvoxamine (Luvox, Luvox CR)
  • paroxetine (Paxil, Paxil CR, Pexeva)
  • sertraline (Zoloft)
  • venlafaxine (Effexor XR)
  • desvenlafaxine (Pristiq)
  • duloxetine (Cymbalta)
  • bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL)

These medicines can take a few weeks to start working. They can also have side effects, such as dry mouth and nausea, which bother some people enough to stop taking them.

There is also a very low but acknowledged incidence of an increase in suicidal thoughts and actions in young adults at the beginning of treatment with anti-depressants. Stay in close contact with your doctor if you are taking anti-depressants. Make sure you report any mood or thought changes that worry you.

Your doctor may prescribe both an anti-anxiety medication and an anti-depressant. If so, you’ll probably only take the anti-anxiety medicine for a few weeks until your anti-depressant starts working, or on an as-needed basis.

Lifestyle Changes to Help Ease Symptoms of GAD

Many people can find relief by adopting certain lifestyle habits that may include:

  • regular exercise, a healthy diet, and plenty of sleep
  • yoga and meditation
  • avoiding stimulants, such as caffeine, and some over-the-counter medicines such as diet pills or caffeine pills
  • talking with a trusted friend, spouse, or family member about fears and worries

Alcohol and Anxiety

Drinking alcohol can make you feel less anxious almost immediately. This is why many people who suffer from anxiety turn to drinking to feel better. However, the Anxiety and Depression Association of America warns that “alcohol can also increase anxiety, irritability, or depression a few hours later or the next day. Even moderate amounts of alcohol can affect one’s mood and anxiety level” (ADAA, 2011).

If you find that your drinking is interfering with your daily functioning, talk to your doctor. You can also find free support to stop drinking through Alcoholics Anonymous (AA).

Outlook for Those with Generalized Anxiety Disorder

Most people can manage GAD with a combination of therapy, medicine, and lifestyle changes.

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