Generalized anxiety disorder
Information, Symptoms, Treatments and Resources
Generalized anxiety disorder (GAD) is a pattern of frequent, constant worry and anxiety over many different activities and events.
Generalized anxiety disorder (GAD) is a common condition. The cause of GAD is not known, but biological and psychological factors play a role. Stressful life situations or behavior developed through learning may also contribute to GAD.
The disorder may start at any time in life, including childhood. Most people 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.
Generalized anxiety disorder has the following symptoms:
- Excess anxiety and worry that is out of proportion to the situation
- Difficulty controlling the worry
- Restlessness or feeling keyed up or "on the edge"
- Being easily tired
- 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 stomach/intestinal symptoms
A physical examination and a psychological evaluation can rule out other causes of anxiety. Physical disorders that may mimic an anxiety state should be ruled out, as well as symptoms caused by drugs. This process may include different tests.
The goal of treatment is to help the person function well. The success of treatment usually depends in part on how severe the generalized anxiety disorder is.
The standard approach combines cognitive-behavioral therapy (CBT) and an antidepressant medication.
Selective serotonin reuptake inhibitors (SSRIs), such as Paxil, are usually the first choice. Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor), are another choice. Other antidepressants and some anti-seizure drugs may be used for severe cases.
Other anti-anxiety medications may also be prescribed. Benzodiazepines may be recommended if antidepressants don't help.
Behavioral therapies that may be used together with drug therapy include relaxation techniques, pleasant mental imagery, and cognitive behavioral therapy to change distorted and possibly harmful perceptions of severe anxiety.
Other counseling and therapy techniques may help people gain an understanding of the illness and the factors that protect against or trigger it.
A healthy lifestyle that includes exercise, enough rest, and good nutrition can help reduce the impact of anxiety.
The disorder may continue and be difficult to treat, but most patients see great improvement with medications or behavioral therapy.
People with GAD may develop other psychiatric disorders, such as panic disorder or depression. Substance abuse or dependence may become a problem if you try to self-medicate with drugs or alcohol to relieve anxiety.
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.
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.
Gale C, Davidson O. Generalised anxiety disorder. BMJ, 2007;334:579-581.
Schneier FR. Social anxiety disorder. NEJM, 2006;355:1029-1036.
Katon WJ. Panic Disorder. NEJM. 2006;354:2360-2367.
Bernstein GA, Shaw K. Practice parameters for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry, 2007;46:267-283.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. � 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
