Generalized Anxiety Disorder
Generalized anxiety disorder (or GAD) is characterized by excessive, exaggerated anxiety
and worry about everyday life events with no obvious reasons for worry. People with
symptoms of generalized anxiety disorder tend to always expect disaster and can't stop
worrying about health, money, family, work, or school. In people with GAD, the worry
often is unrealistic or out of proportion for the situation. Daily life becomes a
constant state of worry, fear, and dread. Eventually, the anxiety so dominates the
person's thinking that it interferes with daily functioning, including work, school,
social activities, and relationships.
What Are the Symptoms of GAD?
GAD affects the way a person thinks, but the anxiety can lead to physical symptoms, as
well. Symptoms of GAD can include:
- Excessive, ongoing worry and tension
- An unrealistic view of problems
- Restlessness or a feeling of being "edgy"
- Muscle tension
- Difficulty concentrating
- The need to go to the bathroom frequently
- Trouble falling or staying asleep
- Being easily startled
In addition, people with GAD often have other anxiety disorders (such as panic disorder,
obsessive-compulsive disorder, and phobias), suffer from depression, and/or abuse drugs
What Causes GAD?
The exact cause of GAD is not fully known, but a number of factors -- including genetics,
brain chemistry and environmental stresses -- appear to contribute to its development.
Some research suggests that family history plays a part in increasing the likelihood
that a person will develop GAD. This means that the tendency to develop GAD may be
passed on in families.
GAD has been associated with abnormal levels of certain neurotransmitters in the brain.
Neurotransmitters are special chemical messengers that help move information from nerve
cell to nerve cell. If the neurotransmitters are out of balance, messages cannot get
through the brain properly. This can alter the way the brain reacts in certain
situations, leading to anxiety.
Trauma and stressful events, such as abuse, the death of a loved one, divorce, changing
jobs or schools, may lead to GAD. GAD also may become worse during periods of stress.
The use of and withdrawal from addictive substances, including alcohol, caffeine, and
nicotine, can also worsen anxiety.
How Common Is GAD?
About 4 million adult Americans suffer from GAD during the course of a year. It most
often begins in childhood or adolescence, but can begin in adulthood. It is more common
in women than in men.
How Is GAD Diagnosed?
If symptoms of GAD are present, the doctor will begin an evaluation by asking questions
about your medical history and performing a physical examination. Although there are no
laboratory tests to specifically diagnose anxiety disorders, the doctor may use various
tests to look for physical illness as the cause of the symptoms.
The doctor bases his or her diagnosis of GAD on reports of the intensity and duration of
symptoms -- including any problems with functioning caused by the symptoms. The doctor
then determines if the symptoms and degree of dysfunction indicate a specific anxiety
disorder. GAD is diagnosed if symptoms are present for more days than not during a
period of at least six months. The symptoms also must interfere with daily living, such
as causing you to miss work or school.
How Is GAD Treated?
If no physical illness is found, you may be referred to a psychiatrist or psychologist,
mental health professionals who are specially trained to diagnose and treat mental
illnesses like GAD. Treatment for GAD most often includes a combination of medication
and cognitive-behavioral therapy.
Drugs are available to treat GAD and may be especially helpful for people whose anxiety
is interfering with daily functioning. The medications most often used to treat GAD in
the short-term are from a class of drugs called benzodiazepines. These medications are
sometimes referred to as "tranquilizers," because they leave you feeling calm and
relaxed. They work by decreasing the physical symptoms of GAD, such as muscle tension
and restlessness. Common benzodiazepines include Xanax,
Ativan. Antidepressants, such as Paxil, Effexor, Prozac, Lexapro, and Zoloft, are also being used to treat
GAD. These antidepressants may take a few weeks to start working but they're more
appropriate for long-term treatment of GAD.
Cognitive Behavioral Therapy
People suffering from anxiety disorders often participate in this type of therapy, in
which you learn to recognize and change thought patterns and behaviors that lead to
anxious feelings. This type of therapy helps limit distorted thinking by looking at
worries more realistically.
In addition, relaxation techniques, such as deep breathing and biofeedback, may help
to control the muscle tension that often accompanies GAD.
Are There Side Effects of GAD Treatment?
Dependency on anti-anxiety medications (benzodiazepines) is a potential complication
of treatment. Side effects of antidepressants vary by specific drug and the person
taking them. Common side effects can include sleepiness, weight gain, and sexual
What Is the Outlook for People With GAD?
Although many people with GAD cannot be cured and symptoms can return from time to
time, most people gain substantial relief from their symptoms with proper treatment.
Can GAD Be Prevented?
Anxiety disorders like GAD cannot be prevented. However, there are some things that you
can do to control or lessen symptoms, including:
- Stop or reduce your consumption of products that contain caffeine, such as coffee,
tea, cola and chocolate.
- Ask your doctor or pharmacist before taking any over-the-counter medicines or
herbal remedies. Many contain chemicals that can increase anxiety symptoms.
- Exercise daily and eat a healthy, balanced diet.
- Seek counseling and support after a traumatic or disturbing experience.
- Practice stress management techniques like yoga or meditation.