Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is an anxiety disorder marked by chronic, exaggerated worrying and anxiety about everyday life. The worry is so severe that it interferes with a person's ability to live their life.
GAD may be caused by:
- An abnormal neurotransmitter system
- Environmental factors
- Developmental factors
- Psychological factors
GAD is nearly twice as common in women than in men. Other factors that may increase your chances of GAD:
- Family members with an anxiety disorder
- Increase in stress
- Exposure to physical or emotional trauma
- Unemployment, poverty
- Drug abuse
- Medical condition or disability
- History of self-harm as a teenager, with or without suicidal intent
Symptoms of GAD usually develop slowly. People with GAD often have both psychological and physical symptoms of anxiety.
Psychological symptoms include:
- Excessive ongoing worrying and tension
- Feeling tense or edgy
- Irritability, overly stressed
- Difficulty concentrating, forgetfulness
Physical symptoms may include:
- Muscle tension
- Difficulty sleeping
- Shortness of breath
- Heart palpitations
- Chest pain
- Choking sensation
- Abdominal discomfort
- Numbness or tingling
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People with GAD often have other anxiety disorders, depression, and/or substance use disorders.
You will be asked about your symptoms and medical history. A physical and psychiatric exam will be done. Conditions with similar symptoms will be evaluated. Blood and urine tests may be done.
You will be asked about any medications that you are taking, including over the counter products, herbs, and supplements. Some medications can cause side effects similar to the symptoms of GAD. You will also be asked about any other substances that you may be using such as nicotine, caffeine, illegal drugs, prescription medications, and alcohol.
To make a diagnosis of GAD, symptoms must:
- Be present more days than not
- Be present for at least 6 months
- Interfere with your life such as causing you to miss work or school
You may be referred to a psychotherapist for further evaluation.
If you have a mild form of GAD, your doctor will probably first have you try therapy to learn to manage anxious thoughts.
Lifestyle changes may include:
Relaxation techniques may be helpful in reducing anxiety. These may include:
- Have a strong support system of family and friends
- Consider family therapy to help with understanding and coping skills
- Join a support group
Cognitive Behavioral Therapy
During cognitive-behavioral therapy (CBT), your therapist will work with you to change your patterns of thinking. This will allow you to notice how you react to situations that cause anxiety. You will then learn to change your thinking so you can react differently. This can decrease the symptoms of anxiety.
Behavioral and Relaxation Therapy
Your therapist will teach you relaxation techniques, including deep breathing, muscle relaxation, and visualization. Learning ways to relax can help you gain control over anxiety. Instead of reacting with worry and tension, you can learn to remain calm. Your therapist may also slowly expose you to the situations that cause worry and tension. This can allow you to reduce your anxiety in a safe environment.
Biofeedback works by attaching sensors to the body. A therapist helps you understand your body’s signals so you can use them to reduce your anxiety.
Medication can be prescribed for symptoms that are severe and make it difficult to function. Medications can help relieve symptoms so you can concentrate on getting better. It is important to note that many medications cannot be stopped quickly, but need to be tapered off. Check with your doctor before discontinuing any medication.
Medications may include:
- Antidepressant, such as selective serotonin reuptake inhibitors (SSRIs)
Talk to your doctor about the risks and benefits of these medications. Some types may cause dependence.
There are no current guidelines to prevent GAD because the cause is unknown.
Anxiety and Depression Association of America
Mental Health America
Canadian Psychiatric Association
Canadian Psychological Association
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Anxiety disorders. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Updated March 2016. Accessed January 31, 2018.
Generalized anxiety disorder. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114697/Generalized-anxiety-disorder. Updated December 22, 2017. Accessed January 31, 2018.
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11/6/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114697/Generalized-anxiety-disorder: Mars B, Heron J, Crane C, et al. Clinical and social outcomes of adolescent self harm: population based birth cohort study. BMJ. 2014;349:g5954.
Last reviewed November 2018 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 1/26/2016