What is Generalized Anxiety disorder?
Generalized Anxiety disorder (GAD) is characterized by excessive, persistent, and unreasonable anxiety about everyday things like money, family, work, and relationships, even sometimes the thought of getting through the day causes anxiety. If the anxiety’s persistent, then it does not seem to go away if it is excessive, its usually more than someone else might feel, and if it is unreasonable, they probably should not have a reason to feel anxious about it. People who have Generalized Anxiety disorder (GAD) might even understand that their anxieties are excessive and unreasonable, but they feel it is out of their control and doesn’t quite know how to stop it.
People with severe generalized anxiety disorder might be completely debilitated and have trouble with the simplest daily activities, or they might be only mildly affected and be able to function socially and hold down a job. Sometimes the feelings might worsen or improve over time. In addition to having feelings of worries and anxiety, other symptoms include edginess and restlessness, difficulty concentrating or feeling like the mind just goes blank, and also irritability. These psychological symptoms can also lead to physical manifestations of symptoms like digestive problems from eating more or eating less. They might also have muscle aches and soreness from carrying tension in their muscles. Finally, difficulty sleeping is a really common symptom that can have a serious impact on physical well-being, since the body is not resting and can lead to issues of chronic fatigue. Although the decision that someone’s worry is excessive and unreasonable has a subjective quality, diagnosing generalized anxiety disorder (GAD) is aided by the diagnostic and statistical manual of mental disorders, or DSM-V, this manual gives a list of criteria to meet in order to be diagnosed with a generalized anxiety disorder. First, excessive worry and anxiety have to have been present for more days than not over the course of 6 months. In other words, a person should have the symptoms of excess or unreasonable worry on 90 or more days out of 180 days. Generally, people can’t quantify or track their feelings in that way, so again, this is meant to offer a general guideline. The person finds it hard to control their anxiety, meaning that they have a hard time calming themselves or self-soothing to help themselves regain control over their feelings.
In children though, typically defined as school-age, between the age of 6 – 18 years only have one symptom is needed for the diagnosis of generalized anxiety disorder. Another criteria is that anxiety causes impairment in important daily activities like school or work. For example, they might miss deadlines or find it difficult to even go to work because of their symptoms. The symptoms are not attributable to the physiologic effects of drugs or medication, or due to a medical condition like hyperthyroidism which creates an excess of thyroid hormone, which can sometimes cause symptoms of anxiety and worry. Finally, their anxiety is not better explained by another mental disorder like social phobia or panic disorders. Just like a lot of mental disorders, it is unclear exactly why some individuals develop a generalized anxiety disorder, but it is thought to be a combination of genetic and environmental factors, as it seems to run in families. It also has been shown to be twice as prevalent in females than in males. Treating generalized anxiety disorder, like many mental disorders, may involve psychotherapy, medication, or a combination of the two. If it is psychotherapy, cognitive behavior therapy has been effective since it teaches the patient to think and behave in different ways and react differently to situations that would usually cause anxiety and worry. Medications like benzodiazepines or antidepressants might tenser as well, benzodiazepines are a type of psychoactive drug that has a relaxing and calming effect. Antidepressants might also be prescribed, like selective serotonin reuptake inhibitors, or SSRIs, which regulate the serotonin levels in the brain and help elevate mood. Even though both medications and cognitive behavior therapy have similar effectiveness in the short-term, cognitive behavior therapy has major advantages over medication in the long term, due to unwanted effects of the medications like tolerance, dependence, and withdrawal.
What are the causes of Generalized Anxiety Disorder (GAD)?
No one knows the cause of GAD, but a lot of factors including genetics, brain chemistry, and environmental stresses appear to contribute to its development.
- Genetics: Some researchers show that family history plays a part in increasing the chances that a person will develop a generalized anxiety disorder (GAD). This means that the tendency to develop GAD may be passed on in families.
- Brain Chemistry: GAD has been linked with abnormal functioning of certain nerve cell pathways that connect particular brain regions involved in thinking and emotion. These nerve cell connections depend on chemicals called neurotransmitters that transmit information from one nerve cell to the other. If the pathways that connect particular brain regions do not run efficiently, problems related to mood or anxiety will arise. Medicines, psychotherapies, or other treatments that are thought to tweak these neurotransmitters may improve the signaling between circuits and help to improve symptoms related to anxiety or depression.
- Environmental Factors: There are many environmental factors that will contribute to GAD such as abuse, the death of a loved one, divorce, changing jobs or schools, trauma, and stressful events. It may become worse during periods of stress. Excessive use of addictive substances like alcohol, caffeine, and nicotine, can also worsen anxiety.
What are the symptoms of GAD?
GAD affects the way a person thinks, but the anxiety can lead to physical symptoms as well. Following are the symptoms of GAD:
- Excessive Worrying & Tension: One of the most common symptoms is excessive worrying. Individuals worry about everything and they feel helpless because they do not know how to control their worry they often realize their worries and fears are unrealistic they worry about their job, school, work, friends, family, finances and more. The more they worry the tenser their muscles become.
- Tiredness & Difficulty Sleeping: Generalized anxiety disorder causes individuals to worry to the point they cannot sleep they may have difficulty falling or staying asleep. It is not uncommon for them to toss and turn at night the lack of proper sleep causes them to feel tired throughout the day. This can affect how they function at work, school and in other situations.
- Headaches: The tension that builds with constant worrying often results in headaches these can range in severity and the headaches may disappear when the person is relaxed and reappear as they begin worrying again. Taking OTC headache medications may or may not help.
- Problems Concentrating: The excessive worry ruins a person’s concentration because all their thoughts are focused on their current worries and they have difficulty concentrating on anything else. They often notice their performance degrading at everyday tasks because they cannot focus, they feel distracted and cannot seem to pull their thoughts into order.
- Frequent Urinating: Some individuals with generalized anxiety disorder have to go to the bathroom more often because the worry increases their stress levels causing them to need to urinate more frequently. Some mistake this for a urinary problem instead of anxiety this symptom on its own may be a urinary issue.
- Irritability: Worrying often causes people to feel irritable because they do not know how to solve their problems or prevent bad things from happening. This causes an increasing amount of stress and it causes them to shout at loved ones, co-workers and strangers and they may also cry or feel depressed along with being irritable.
How to diagnose Generalized Anxiety Disorder (GAD)?
To help diagnose a generalized anxiety disorder, your doctor or mental health professional may do the following procedure:
- Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition
- Order blood or urine tests or other tests, if a medical condition is suspected
- Ask detailed questions about your symptoms and medical history
- Use psychological questionnaires to help determine a diagnosis
- Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
What are the treatment options of GAD?
Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.
- Psychotherapy: It is also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you have avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.
- Medications: Several types of medications are used to treat generalized anxiety disorder, including those below. Talk to your doctor about the benefits, risks, and possible side effects.
- Antidepressants: Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and Serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first-line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), Venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants.
- Buspirone: An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective.
- Benzodiazepines: In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications are not a good choice if you have or had problems with alcohol or drug abuse.
Are there any side effects of GAD treatment?
By taking the GAD medication, some of the side effects such as feeling sick, an upset stomach, problems sleeping and feeling agitated or more anxious are more common in the first one or two weeks of treatment, but these usually settle as your body adjusts to the medication.
How to prevent GAD?
While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here’s what you can do:
- Keep physically active: Develop a routine so that you are physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
- Make sleep a priority: Do what you can to make sure you are getting enough sleep to feel rested. If you are not sleeping well, see your doctor.
- Use Relaxation Techniques: Visualization techniques, meditation, and yoga are examples of relaxation techniques that can ease anxiety.
- Eat healthily: Healthy eating such as focusing on vegetables, fruits, whole grains, and fish may be linked to reduced anxiety, but more research is needed.
- Avoid alcohol and recreational drugs: These substances can worsen anxiety
- Quit smoking and cut back or quit drinking coffee: both nicotine and caffeine can worsen anxiety.
- Stick to your treatment plan: Take medications as directed. Keep therapy appointments. Practice the skills you learn in psychotherapy. Consistency can make a big difference, especially when it comes to taking your medication.
- Take action: Work with your mental health professional to figure out what is making you anxious and address it.
- Let it go: Don’t dwell on past concerns. Change what you can in the present moment and let the rest take its course.
- Break the cycle: When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.
- Socialize: Don’t let worries isolate you from loved ones or enjoyable activities. Social interaction and caring relationships can lessen your worries.
- Join a support group for people with anxiety: Here, you can find compassion, understanding and shared experiences. You may find support groups in your community or on the internet, for example, the National Alliance on Mental Illness (NAMI).
Generalized anxiety disorder (GAD) is a normal, but highly subjective human emotion. It can also become the cause of tremendous suffering for millions of people. This disorder is common in most of the people and remains chronic if not treated. Effective treatment, regular exercising and following a healthy diet will help you to reduce your anxiety levels.