Generalized Anxiety Disorder

What Is Generalized Anxiety Disorder?

People who suffer from generalized anxiety disorder, or GAD, worry uncontrollably about common occurrences and situations. It’s also sometimes known as chronic anxiety neurosis.

GAD is different than normal feelings of anxiousness. It’s common to feel anxious about the things happening in your life — like your finances — every once in awhile. A person who has GAD may worry uncontrollably about their finances several times a day for months on end. This can happen even when there isn’t a reason to worry. The person is often aware that there is no reason for them to worry. Sometimes people with this condition just worry, but they are unable to say what they are worried about. They report feelings that something bad may happen or may report that they just can’t calm themselves.

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

Symptoms of Generalized Anxiety Disorder

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Symptoms of GAD include:

  • difficulty concentrating
  • difficulty sleeping
  • irritability
  • fatigue/exhaustion
  • muscle tension
  • repeated stomachaches or diarrhea
  • sweating palms
  • shaking
  • rapid heartbeat
  • neurological symptoms such as complaints of numbness/tingling of different parts of the body

Distinguishing GAD from Other Mental Health Issues

Anxiety is a common symptom of many mental health conditions, like depression and various 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), or may not be able to identify the source of their worry.

What Are the Causes and Risk Factors of GAD?

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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 (which can make existing anxiety worse)
  • being the victim of childhood abuse

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

How Is Generalized Anxiety Disorder Diagnosed?

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GAD is diagnosed with a mental health screening that your primary care provider can perform. They will ask you questions about your symptoms and how long you’ve been experiencing them. They can 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. Anxiety has been linked to gastroesophageal reflux disease (GERD), thyroid disorders, heart disease, and menopause.

If your primary care provider suspects that a medical condition or substance abuse problem is the cause of the anxiety, they may perform more 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?

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Cognitive Behavioral Therapy

This involves meeting regularly to talk with a mental health professional. The goal is to change your thinking and behaviors. This approach has been successful in achieving permanent change in many people who suffer from anxiety, and is considered first-line treatment of anxiety disorders in persons who are pregnant. Others have found that the benefits of cognitive behavioral therapy have provided long-term relief from anxiety.

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

Your prescriber will most likely create a short-term medication plan and a long-term medication plan.

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 aren’t meant to be taken for long periods of time, as they have a high risk for dependence and abuse.

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)

These medicines can take a few weeks to start working. They can also have side effects, such as dry mouth, nausea, and diarrhea. These symptoms bother some people so much that they stop taking these medications.

There is a very low risk of young adults experiencing an increase in suicidal thoughts at the beginning of treatment with antidepressants. Stay in close contact with your prescriber if you’re taking antidepressants. Make sure you report any mood or thought changes that worry you.

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

Lifestyle Changes to Help Ease Symptoms of GAD

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Many people can find relief by adopting certain lifestyle habits. These 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 alcohol to feel better.

However, it’s important to remember that alcohol can have a negative effect on your mood. Within a few hours or the day after drinking, you may experience more irritability or depression. It can also interfere with the medications used to treat the condition. Some medication and alcohol combinations can be fatal.

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

Outlook for Those with Generalized Anxiety Disorder

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Most people can manage GAD with a combination of therapy, medicine, and lifestyle changes. Talk to your doctor if you’re concerned about how much you worry. They can refer you to a mental health specialist.

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