Generalized anxiety disorder (GAD) is characterized by six months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. People with this disorder usually expect the worst; they worry excessively about money, health, family, or work, even when there are no signs of trouble. They are unable to relax and often suffer from insomnia and an inability to concentrate. Many people with GAD also have physical symptoms, such as fatigue, trembling, muscle tension, headaches, irritability, or hot flashes.
Approximately 6.8 million American adults develop GAD during the course of a given year. It most often strikes people in childhood or adolescence, but can begin in adulthood, too. It affects women more often than men. Some research suggests that GAD may run in families, and it may also worsen during stressful times.
Research shows that GAD often coexists with depression , substance abuse, or other anxiety disorders. Other conditions associated with stress, such as irritable bowel syndrome, often accompany GAD. Tell your doctor if you have physical symptoms, such as insomnia or headaches, or emotional symptoms, such as constant feelings of worry and tension. This information will help your doctor determine if you are suffering from GAD.
What are the treatments for generalized anxiety disorder?
What are the risk factors for generalized anxiety disorder?][6]
[What are the symptoms of generalized anxiety disorder?
[How is generalized anxiety disorder diagnosed?
Are there screening tests for generalized anxiety disorder?
[How can I reduce my risk of generalized anxiety disorder?
[What questions should I ask my doctor?
Where can I get more information about generalized anxiety disorder?
References:
Generalized anxiety disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/anxiety-disorders/generalized-anxiety-disorder-gad.shtml . Update June 2008. Accessed October 29, 2008.
Muller JE, Koen L, Stein Dj. Anxiety and medical disorders. Curr Psychiatry Rep.2005;7:245-251.
Statistics and facts about anxiety disorders. Anxiety Disorders Association of America website. Available at: http://www.adaa.org/ . Accessed October 29, 2008.
Generalized anxiety disorder (GAD) is characterized by six months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. People with this disorder usually expect the worst; they worry excessively about money, health, family, or work, even when there are no signs of trouble. They are unable to relax and often suffer from insomnia and an inability to concentrate. Many people with GAD also have physical symptoms, such as fatigue, trembling, muscle tension, headaches, irritability, or hot flashes.
Approximately 6.8 million American adults develop GAD during the course of a given year. It most often strikes people in childhood or adolescence, but can begin in adulthood, too. It affects women more often than men. Some research suggests that GAD may run in families, and it may also worsen during stressful times.
Research shows that GAD often coexists with depression , substance abuse, or other anxiety disorders. Other conditions associated with stress, such as irritable bowel syndrome, often accompany GAD. Tell your doctor if you have physical symptoms, such as insomnia or headaches, or emotional symptoms, such as constant feelings of worry and tension. This information will help your doctor determine if you are suffering from GAD.
What are the treatments for generalized anxiety disorder?
What are the risk factors for generalized anxiety disorder?
What are the symptoms of generalized anxiety disorder?
How is generalized anxiety disorder diagnosed?
Are there screening tests for generalized anxiety disorder?
How can I reduce my risk of generalized anxiety disorder?
What questions should I ask my doctor?
Where can I get more information about generalized anxiety disorder?
References:
Generalized anxiety disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/anxiety-disorders/generalized-anxiety-disorder-gad.shtml . Update June 2008. Accessed October 29, 2008.
Currently, there are no guidelines for reducing your risk of generalized anxiety disorder (GAD). As scientists learn more about the condition, your doctor may have more information regarding steps for reducing your risk of GAD.
References:
Generalized anxiety disorder. American Psychiatric Association website. Available at: http://www.aafp.org/afp/20001001/1591.html . Published October 2000. Accessed October 30, 2008.
Hettema JM, Prescott CA, Myers JM, et al. The structure of genetic and environmental risk factors for anxiety disorders in men and women. Arch Gen Psych.2005;62:182-189.
References:
Generalized anxiety disorder (GAD). Anxiety Disorders Association of America website. Available at: http://www.adaa.org/GettingHelp/AnxietyDisorders/GAD.asp . Accessed October 29, 2008.
Generalized anxiety disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/anxiety-disorders/generalized-anxiety-disorder-gad.shtml . Update June 2008. Accessed October 29, 2008.
A risk factor is something that increases your likelihood of getting a disease or condition.
It is possible to develop generalized anxiety disorder (GAD) with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing GAD. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.
Risk factors for developing GAD include:
Women have twice the risk of developing GAD as men. Reasons for this include hormonal factors, cultural expectations (taking care of others’ needs at home, in the community, and at work), and more willingness to visit doctors and talk about their anxiety.
Anxiety disorders tend to run in families. This may be due to family dynamics, such as the failure to learn effective coping skills, overprotective behaviors, abuse, and violence. There may be a genetic component to feelings of anxiety that is passed down through generations.
Approximately one out of four (25%) of first degree relatives with GAD will be affected.
Nicotine, alcohol, cannabis, and cocaine abuse can increase the risk of GAD.
Patients with unexplained physical complaints,irritable bowel syndrome, migraine, or chronic pain conditions have a greater risk of GAD.
Members of poor minority groups, particularly immigrants, tend to be at greater risk for developing GAD. This may be due to problems adjusting to a new culture, feelings of inferiority, alienation, and loss of strong family ties.
Generalized anxiety disorder often occurs concurrently with depression, particularly major depression or dysthymia (chronic mild depression). Adolescents with depression seem particularly at risk for developing GAD in adulthood.
Two studies in 2000 found that anxiety rates among children and adolescents had increased significantly since the 1950s. Both studies suggested that anxiety was related to lack of social connections and a sense of increased environmental threat.
The initial appearance of GAD often follows a highly stressful event, such as the loss of a loved one, loss of an important relationship, the loss of a job, or being a victim of a crime.
Generalized anxiety disorder (GAD) can affect both adults and children. People with GAD often have psychological and physical symptoms. They may visit the doctor many times before they are diagnosed. They often ask the doctor to help them with the complaints related to GAD, such as headaches or trouble falling asleep. Reluctance to discuss emotional problems and worries may lead to a delay in the diagnosis.
Psychological symptoms of GAD include:
Physical symptoms of generalized anxiety disorder include:
References:
Anxiety and panic: gaining control over how you're feeling. Family Doctor.org website. Available at: http://familydoctor.org/online/famdocen/home/common/mentalhealth/anxiety/013.html . Updated September 2006. Accessed October 29, 2008.
Ballenger JC, Davidson JR, Lecrubier Y, et al. Consensus statement on generalized anxiety disorder from the International consensus Group on Depression and Anxiety. J Clin Psychiatry.2001;62:53-58
Flint AJ. Generalised anxiety disorder in elderly patients: epidemiology, diagnosis and treatment options. Drugs Aging.2005;22:101-14
Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier Mosby; 2004.
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Diagnosis of generalized anxiety disorder (GAD) can be difficult, since the distinction between normal anxiety and GAD is not always apparent. Diagnosis is based on a physical exam, psychological evaluation, and the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders(DSM-IV). The symptoms of GAD must be present for at least six months and cause impairment in your ability to function.
After obtaining your medical history, you may be asked about worries, anxiety, “nerves,” stress, and other symptoms. Your doctor may ask whether your anxiety is acute (brief or intermittent) or chronic (persistent).
Acute anxiety lasts from hours to weeks and usually occurs in response to a particular stressor. Persistent anxiety lasts from months to years and may be considered a part of your temperament. Persistent anxiety does not normally occur in response to stress. In susceptible people, though, stress may increase levels of persistent anxiety.
Before generalized anxiety disorder can be diagnosed, your doctor will look for and rule out other medical disorders that could cause your symptoms. Medical conditions commonly associated with anxiety include:
Your doctor should also ask what medications, herbal supplements , and vitamins you take. You may be asked to stop taking certain medications or supplements so that your doctor can more accurately pinpoint the cause of your symptoms. Medications that can contribute to or worsen anxiety include:
Use or withdrawal from addictive substances can cause anxiety. Your healthcare provider may ask about your use of alcohol, caffeine, nicotine, addictive medications (particularly sedatives), illegal drugs, and other substances.
You may be tested for:
When testing the effectiveness of a given treatment for Generalized Anxiety Disorder, certain evaluation tools are used to measure if/how much anxiety has been reduced after an intervention with the treatment. Among these are:
References:
Generalized anxiety disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated September 2008. Accessed October 30, 2008.
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med.2006;166:1092-1097.
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
There are questionnaires, such as the GAD-7, that doctors use for screening and assessing the severity of GAD.
References
Generalized anxiety disorder (GAD). Anxiety Disorders Association of America website. Available at: http://www.adaa.org/GettingHelp/AnxietyDisorders/GAD.asp . Accessed October 29, 2008.
Generalized anxiety disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/anxiety-disorders/generalized-anxiety-disorder-gad.shtml . Update June 2008. Accessed October 29, 2008.
Hahn RK, Reist C, Albers LJ. Psychiatry. Laguna Hills, CA: Current Clinical Strategies Publishing; 2006.
You have a unique medical history. Therefore, it is essential to talk with your doctor about your personal risk factors and/or experience with generalized anxiety disorder (GAD). By talking openly and regularly with your doctor, you can take an active role in your care.
Here are some tips that will make it easier for you to talk to your doctor:
Ask your doctor or counselor about lifestyle changes that could help you reduce your anxiety and stress symptoms. Examples may include:
