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Generalized Anxiety Disorder (GAD) Explained

We all worry about things like money, relationships, or health. But people with generalized anxiety disorder (GAD) are excessively worried about these and many other things, even when there is little or no reason to worry about them. They can be very anxious about just getting through the day. They think things will always go badly. Worrying can even keep people with GAD from doing everyday tasks.

Causes of Generalized Anxiety Disorder

Although GAD sometimes runs in families, no one knows for sure why some people have it while others don't. Scientists have found that several parts of the brain are involved in fear and anxiety. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. They are also looking for ways in which stress and environmental factors may play a role.

Symptoms of Generalized Anxiety Disorder

Typically, people with GAD can’t seem to get rid of their concerns, this is despite the fact that they realize that their anxiety is more intense than the situation warrants. They have difficulty relaxing, startle easily, and have difficulty concentrating. Often they have insomnia, trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include fatigue, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, headaches, nausea, feeling dizzy or lightheaded, having to go to the bathroom frequently, feeling out of breath, and hot flashes.

Generalized Anxiety Disorder develops slowly. Usually it starts during the teen years or young adulthood. Symptoms may fluctuate at different times, and often are worse during periods of increase stress. When their anxiety level is mild, people with GAD can function socially and hold down a job. Although they don’t necessarily avoid situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if the anxiety is severe.

Who Can Get Generalized Anxiety Disorder?

GAD affect about 3.1% American adults (about 18%) in a given year, causing them to be filled with worry, fearfulness, and uncertainty.The average age of onset is 31 years old. GAD affects about 6.8 million American adults, with twice as many women as men affected. Generalized Anxiety Disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age.

Accurate Diagnosis of Generalized Anxiety Disorder

Generalized Anxiety Disorder is diagnosed when a person worries excessively about a variety of everyday problems for at least six months. People with GAD may visit doctors many times before they find out they have this disorder. Oftentimes they ask their doctors to help them with headaches or trouble falling asleep, which can be symptoms of GAD but they don't always get the help they need right away. It may take doctors some time to be sure that a person has GAD, ruling out other medical conditions first.

Treatment for Generalized Anxiety Disorder

Generalized Anxiety Disorder is generally treated with Cognitive Behavioral Therapy (CBT), medication, or both. Follow this link to a chart comparing the effectiveness of CBT to other treatments for OCD. Cognitive behavior therapy is especially useful for treating GAD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and worried. Click for more information on Cognitive Behavioral Therapy in Los Angeles

A licensed psychologist typically provides psychotherapy. However, social workers and Marriage and Family Therapists (MFT) can also legally provide therapy, though their training is of shorter duration. Your psychologist should work with your psychiatrist to track your progress. Your unique treatment needs should determine the number and frequency of sessions. Following the doctor's instructions for any psychotherapy will likely provide the greatest benefit. 

Medication for Generalized Anxiety Disorder

Doctors may prescribe medication to help treat GAD. Two types of medications are commonly used to treat GAD—anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods due to their addiction potential.

Antidepressants are generally used to treat depression, but they also are helpful for anxiety disorders, such as GAD. They usually take several weeks to a month to start working. These medications may cause side effects such as headache, nausea, or difficulty sleeping. Usually these side effects are not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.

Although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults. A "black box"—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts. Anyone taking antidepressants should be monitored closely, especially when they first start treatment with medications. Most people do better with cognitive behavior therapy, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you.

What to Do if You Have Generalized Anxiety Disorder

If you think you have GAD or another anxiety disorder, the first person you should see is a mental health professional. The practitioners who are most helpful with anxiety disorders are psychologists who have training in cognitive-behavioral therapy and/or behavioral therapy, and who are open to using medication if it is needed. You should feel comfortable talking with the mental health professional you choose. If you do not, you should seek help elsewhere. Once you find a mental health professional with whom you are comfortable, the two of you should collaborate to make a plan to treat your anxiety disorder together. Remember that once you start on medication, it is important not to stop taking it abruptly. Certain drugs must be tapered off under the supervision of a doctor or bad reactions can occur. Make sure you talk to the doctor who prescribed your medication before you stop taking it. If you are having trouble with side effects, it’s possible that they can be eliminated by adjusting how much medication you take and when you take it.

Luckily, most insurance plans, including health maintenance organizations (HMOs), will cover treatment for anxiety disorders. Check with your insurance company and find out. If you don’t have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.

Make Treatment for Generalized Anxiety Disorder More Effective

It is not uncommon for people with anxiety disorders to benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms can also be useful in this regard, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common. Talking with a trusted friend or member of the clergy can also provide support, but it is not a substitute for care from a mental health professional.

Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy. There is preliminary evidence that aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided. Check with your physician or pharmacist before taking any additional medications.

Finally, the family is very important in the recovery of a person with GAD or another anxiety disorder. Ideally, the family should be supportive but not help perpetuate their loved one’s symptoms. Family members should not trivialize the disorder or demand improvement without treatment.

This information is provided courtesy of the National Institute of Health.