Generalized anxiety disorder

Definition

Generalized anxiety disorder (GAD) is behavior marked by a pattern of frequent, persistent worry and anxiety over many different activities and events.

Causes, incidence, and risk factors

Generalized anxiety disorder (GAD) is a common condition. It is characterized by excessive anxiety and worry, which is out of proportion to the impact of the event or circumstance that is the focus of the worry.

For example, while college students often worry about tests, a student who constantly worries about failure -- despite getting consistently good grades -- has the pattern of worry typical of this disorder.

The person finds it difficult to control the worry. The cause of GAD is not known, but biological and psychological factors play a role. Stressful life situations or maladaptive behavior, acquired through learning, may also contribute to GAD.

The disorder may start at any time in life, including childhood. Most patients with the disorder report that they have been anxious for as long as they can remember. GAD occurs somewhat more often in women than in men.

Symptoms

Anxiety and worry are often associated with the following symptoms:

• Restlessness or feeling keyed up or "on the edge"
• Being easily fatigued
• Difficulty concentrating
• Irritability
• Muscle tension -- shakiness, headaches
• Sleep disturbance (difficulty falling or staying asleep; or restless, unsatisfying sleep)
• Excessive sweating, palpitations, shortness of breath, and various gastrointestinal symptoms

Signs and tests

A physical examination and a psychological evaluation should be completed in order to rule out other causes of anxiety. Physical disorders that may mimic an anxiety state should be ruled out, as well as drug-induced symptoms. Various diagnostic tests may be done in this process.

Treatment

Treatment may involve specific medications that provide a sedative (sleep-inducing) or calming effect. Several antidepressant medicines are approved for generalized anxiety disorder.

Other drugs such as antihistamines, which have the favorable side effect of reducing anxiety, may be used. Benzodiazepines, a common class of anti-anxiety medications, are used with caution because they can cause judgment problems and can be addictive.

Two types of therapy are used to treat GAD:

• Relaxation training -- a systematic relaxation of the major muscle groups in the body
• Cognitive behavioral therapy -- helps patients identify thoughts that contribute to anxiety

Caffeine and other stimulants that can make anxiety worse should be reduced or eliminated.

Support Groups

Patient support groups may be helpful for some patients suffering from GAD. Patients have the opportunity to learn that they are not unique in experiencing excessive worry and anxiety.

Support groups are not a substitute for effective treatment, but can be a helpful addition to it.

Expectations (prognosis)

The disorder may be long-standing and difficult to treat, but the majority of patients can expect substantial improvement with medications and/or behavioral therapy.

Complications

People with GAD may eventually develop other psychiatric disorders, such as panic disorder or clinical depression. In addition, substance abuse or dependence may become a problem, usually because the person tries to self-medicate with drugs or alcohol to alleviate their anxiety.

Calling your health care provider

Call your health-care provider if you are experiencing the signs and symptoms of generalized anxiety disorder, especially if this has been going on for a period of 6 months or longer, or it interferes with your daily functioning.

References

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. St. Louis, Mo: Mosby; 2004: 174-175.

Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001:416.

Illustrations

Generalized anxiety disorder

Page Content:

GAD; Anxiety disorder ; anxiety disorder; anxiety disorder social; anxiety disorder generalized; anxiety depression disorder; anxiety disorder general; anxiety disorder symptom; anxiety disorder panic; anxiety disorder separation; anxiety disorder treatment; anxiety disorder generalized symptom; anxiety disorder social symptom; anxiety child disorder in; anxiety article disorder free magazine stress; anxiety attack disorder panic; anxiety child disorder; america anxiety association disorder; anxiety disorder social treatment; anxiety disorder medication; anxiety disorder test; anxiety disorder medication social; anxiety disorder generalized medication; anxiety cause disorder; anxiety disorder generalized treatment; acute anxiety disorder; anxiety disorder teen; anxiety disorder general symptom; anxiety cause disorder social; anxiety disorder social test; anxiety disorder stress; anxiety disorder sleep; anxiety disorder general treatment; anxiety child disorder in separation; anxiety childhood disorder; anxiety disorder treating; anxiety disorder journal; anxiety child disorder in symptom; anxiety article disorder; anxiety disorder type; anxiety cause disorder generalized; anxiety disorder help social; anxiety disorder statistics; anxiety child disorder generalized in; anxiety child disorder social; anxiety disorder generalised; anxiety depression disorder medication; anxiety disorder information; anxiety depression diego disorder san; anxiety depression disorder social; anxiety definition disorder; anxiety disorder health panic; anxiety disorder mood; anxiety disorder sign symptom; anxiety compulsive disorder obsessive; anxiety child disorder generalized; anxiety depression disorder sleep treatment; anxiety disorder group support; anxiety chronic disorder; anxiety clinic disorder; anxiety disorder separation treatment; anxiety disorder point power slide; anxiety disorder help; anxiety association disorder; anxiety disorder dsm interview iv schedule; america anxiety disorder; anxiety child disorder in social; anxiety case disorder study; anxiety disorder gad generalized; anxiety disorder sign; anxiety child disorder separation; anxiety cure disorder; anxiety disorder fact; anxiety disorder general medication; anxiety disorder severe; anxiety disorder overcoming social; anxiety disorder pregnancy; anxiety disorder self social test; anxiety disorder physical symptom; anxiety disorder panic symptom; anxiety disorder nos; anxiety article disorder generalized; anxiety case disorder generalized study; anxiety disorder medicine social; anxiety attack attack disorder panic panic symptom; anxiety depression disorder symptom; anxiety disorder history; anxiety disorder paxil social; anxiety condition disorder state; anxiety disorder famous people; anxiety disorder group social support; anxiety bipolar disorder; anxiety disorder dog; anxiety depression disorder treating treatment; anxiety disorder eating; adjustment anxiety disorder; anxiety disorder forum social; adolescent anxiety disorder; anxiety center disorder related; anxiety childhood disorder treatment; adhd anxiety disorder; anxiety disorder quiz social; gad; gad elmaleh; gad network; gad guard; gad symptom; gad elbaz; gad el maleh; anxiety gad; anxiety disorder gad generalized; pablo gad; gad treatment; gad elmaleh video; 30 gad guild; gad gad; depression gad; gad lexapro; gad medication; 30r gad guild; spectacle gad elmaleh; aaa gad get home.php logo logo.com maker32 ref; extranet gad marylandtaxes.com osvpi; hassan gad; jens gad; gad nassi; gad 2; gad antibody; cest elmaleh gad lautre moi; emma gad; guild gad 50; baal gad; prophet gad; anti gad; gad ball; lamb of gad; anxiety disorder gad; tribe of gad; azoulay gad; mri with gad; 30r gad; anti gad antibody; aph gad grab kmcuguwrmw qeun; forum on gad