About generalized anxiety disorder (gad)

What is generalized anxiety disorder (gad)?

Generalized anxiety disorder (GAD) is a mood disorder that is characterized by multiple and/or nonspecific worries that interfere with the person's life in some way.

  • The most common anxiety disorders are specific phobias. Besides generalized anxiety disorder, other anxiety disorders include separation anxiety disorder in children, social anxiety disorder, selective mutism, panic disorder, and agoraphobia.
  • While obsessive compulsive disorder (OCD) used to be classified as an anxiety disorder, it is now grouped with other compulsive disorders. Posttraumatic stress disorder (PTSD) has been reclassified such that it is considered a trauma-related disorder instead of an anxiety disorder.
  • GAD is quite common, affecting millions of people.
  • While there is no single cause of GAD, there are many factors that increase the risk of developing this disorder.
  • Signs and symptoms of anxiety can include those that are emotional or behavioral and ways of thinking that are responses to feeling as if one is in danger.
  • The similarities and differences in symptoms of anxiety in adults compared to children and adolescents depend on the specific diagnosis.
  • There seem to be gender differences in the expression of anxiety.
  • If a medical or mental-health professional suspects that you have GAD, you will likely undergo an extensive medical interview and physical examination.
  • Treatment of GAD usually involves some combination of lifestyle changes, psychotherapy, and/or medication.
  • As anything that is ingested carries the risk of side effects, it is important for the anxiety disorder sufferer to work closely with the prescribing doctor to decide whether treatment with medications is an appropriate intervention, and if so, which medication should be administered.
  • There are many possible complications associated with anxiety.
  • Various lifestyle choices and family interventions can help prevent and decrease anxiety.
  • GAD usually requires treatment for it to resolve.
  • There are many support groups for people who suffer from generalized anxiety disorder.

What is generalized anxiety disorder (GAD)?

Generalized anxiety disorder (GAD) is a mood disorder that is characterized by multiple and/or nonspecific worries. The fear associated with GAD interferes with the person's ability to sleep, think, or function in some other way. Symptoms of anxiety are even described in the word itself. Specifically, the word anxiety comes from the Latin word anxietas, which means to choke or upset. The symptoms therefore include emotional or behavioral symptoms as well as ways of thinking that are responses to feeling as if one is in danger.

What are the different types of anxiety?

Anxiety can range from the constructive kind that elevates performance as with mild performance anxiety, to disorders of anxiety, in that the individual suffers from a level of fear, angst, or dread that interferes with his or her ability to function. The most common anxiety disorders are specific phobias. Other anxiety disorders include separation anxiety disorder in children, selective mutism, agoraphobia, social anxiety disorder, panic disorder, and generalized anxiety disorder. While obsessive compulsive disorder (OCD) used to be classified as an anxiety disorder, it is now grouped with other compulsive disorders, like hoarding and trichotillomania (hair pulling). Posttraumatic stress disorder (PTSD) has been reclassified such that it is considered a trauma-related disorder instead of an anxiety disorder.

How common is generalized anxiety disorder?

GAD is quite common. In fact, it is the most common anxiety disorder seen by most primary-care doctors. About 5% of people will develop GAD over the course of their lifetime. That translates to millions of GAD sufferers. This illness usually begins when individuals are in their early 20s. Panic and generalized anxiety occur in about 0.7% of children in any one-year period and up to 20% over the course of childhood.



What are the symptoms for generalized anxiety disorder (gad)?

Trembling symptom was found in the generalized anxiety disorder (gad) condition

Physical signs and symptoms may include:

  • Fatigue
  • Trouble sleeping
  • Muscle tension or muscle aches
  • Trembling, feeling twitchy
  • Nervousness or being easily startled
  • Sweating
  • Nausea, Diarrhea or irritable bowel syndrome
  • Irritability

There may be times when your worries don't completely consume you, but you still feel anxious even when there's no apparent reason. For example, you may feel intense worry about your safety or that of your loved ones, or you may have a general sense that something bad is about to happen.

Your anxiety, worry or physical symptoms cause you significant distress in social, work or other areas of your life. Worries can shift from one concern to another and may change with time and age.

Symptoms in children and teenagers

Children and teenagers may have similar worries to adults, but also may have excessive worries about:

  • Performance at school or sporting events
  • Family members' safety
  • Being on time (punctuality)
  • Earthquakes, nuclear war or other catastrophic events

A child or teen with excessive worry may:

  • Feel overly anxious to fit in
  • Be a perfectionist
  • Redo tasks because they aren't perfect the first time
  • Spend excessive time doing homework
  • Lack confidence
  • Strive for approval
  • Require a lot of reassurance about performance
  • Have frequent stomachaches or other physical complaints
  • Avoid going to school or avoid social situations



What are the causes for generalized anxiety disorder (gad)?

As with many mental health conditions, the cause of generalized anxiety disorder likely arises from a complex interaction of biological and environmental factors, which may include:

  • Differences in brain chemistry and function
  • Genetics
  • Differences in the way threats are perceived
  • Development and personality



What are the treatments for generalized anxiety disorder (gad)?

There are a variety of treatments available for controlling anxiety, including several effective anti-anxiety medications and specific forms of psychotherapy. In terms of medications, buspirone (Buspar) is known to be quite effective for treating GAD. However, it seems to be less effective in managing many other disorders that often co-occur (are comorbid) with GAD. Therefore, specific members of the selective serotonin reuptake inhibitor (SSRI) and the selective serotonin and norepinephrine reuptake inhibitor (SSNRI) classes of drugs, which are also approved by the U.S. Food and Drug Administration (FDA) for effective treatment of GAD, are prescribed more often. Examples of SSRI medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro). Examples of SNRI medications are duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq). Although buproprion (Wellbutrin) is known primarily as an antidepressant, preliminary research suggests that it may also be helpful in the treatment of anxiety.

Benzodiazepine medications like clonazepam (Klonopin) and lorazepam (Ativan) are sedatives and are therefore more useful in stopping severe anxiety symptoms, like those that occur in panic disorder or in posttraumatic stress disorder, rather than the ongoing worry that is usually associated with GAD. Although alprazolam (Xanax) is often used to treat panic attacks, its short duration of action can sometimes result in having to take it several times per day. Another benzodiazepine, diazepam (Valium), tends to be used less often due to concerns about its length of action and addiction potential. Medications from the beta-blocker family (for example, propranolol [Inderal]) are sometimes used to provide rapid relief of the physical symptoms associated with a panic attack. Some individuals who suffer from severe panic attacks may benefit from treatment with neurontin (Gabapentin), which was initially developed to treat seizures, or may benefit from a neuroleptic medication like risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify), or lurasidone (Latuda). Zolpidem (Ambien) has been found helpful in treating the insomnia that can often be a symptom of anxiety.

Before SSRIs and SSNRIs became available, medications from the group known as the tricyclic antidepressants (TCAs) were often used to address panic disorder. Although TCAs have been found to be equally effective in treating panic attacks, SSRIs and SSNRIs have been proven to be safer and better tolerated. Therefore TCAs are used much less often than they used to be. When used in the appropriate person with close monitoring, these medications can be quite effective as part of treatment for panic disorder.

For individuals who may be wondering how to avoid panic attacks using treatment without prescribed medications, natural remedies may be an option. While treatment like hypnosis and herbal supplements that contain kava have been found to be helpful for some people with some anxiety disorders, the research data are still considered to be too limited for many physicians to recommend treatment with other natural remedies like valerian or passionflower. Also, care should be taken when taking any dietary supplements, since dietary supplements and "natural" remedies are not regulated in terms of quality, content, or effectiveness.

The psychotherapy component of treatment for anxiety disorders is at least as important as the medication treatment. In fact, research shows that counseling alone or the combination of medication and psychotherapy treatment are more effective than medication alone in overcoming anxiety for both adults and children. It has also been found to be potentially effective for people with autism in addition to anxiety. The most common type of therapy used to treat anxiety is cognitive behavioral therapy (CBT). This form of therapy seeks to help those with an anxiety disorder identify and decrease the irrational thoughts and behaviors that reinforce anxiety symptoms and can be administered either individually, in group therapy, and even in partner-assisted therapy. CBT that seeks to help the anxiety sufferer decrease the tendency to pay excessive attention to potential threats has also been found to be helpful.

Behavioral techniques that are often used to decrease anxiety include relaxation techniques and gradually increasing exposure to situations that may have previously precipitated anxiety in the individual. Helping the anxiety sufferer to understand and how to handle the emotional forces that may have contributed to developing symptoms (anxiety-focused psychodynamic psychotherapy) has also been found to be effective in teaching an individual with panic disorder how to prevent an anxiety attack or to decrease or stop a panic attack once it starts.

Often, a combination of psychotherapy and medications produces good results. Improvement is usually noticed in a fairly short period of time, about two to three months. Thus, appropriate treatment for anxiety can prevent symptoms or at least substantially reduce their severity and frequency, bringing significant relief to many people with anxiety. There are also self-care measures that people with anxiety can do to help make treatment more effective. Since substances like caffeine, alcohol, and illicit drugs can worsen anxiety, those things should be avoided. Other tips to prevent or manage anxiety symptoms include engaging in aerobic exercise and stress-management techniques like deep breathing, massage therapy, and yoga, since these self-help activities have also been found to help decrease the frequency and severity of symptoms. Although many people breathe into a paper bag when afflicted by the hyperventilation that can be associated with panic, the benefit received may be the result of the individual believing it will remedy the symptoms (placebo effect). Also, breathing into a paper bag when one is having trouble breathing can make matters worse when the hyperventilation is the result of conditions of oxygen deprivation, as occurs with an asthma attack or a heart attack.

People with an anxiety disorder may also need treatment for other emotional problems. Depression has often been associated with anxiety, as have alcohol and drug abuse. Recent research also suggests that suicide attempts are more frequent in people with an anxiety disorder. Fortunately, these problems associated with panic disorder can be overcome effectively, just like panic disorder itself. Sadly, many people with anxiety do not seek or receive treatment.



What are the risk factors for generalized anxiety disorder (gad)?

Women are diagnosed with generalized anxiety disorder somewhat more often than men are. The following factors may increase the risk of developing generalized anxiety disorder:

  • Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are.
  • Genetics. Generalized anxiety disorder may run in families.
  • Experiences. People with generalized anxiety disorder may have a history of significant life changes, traumatic or negative experiences during childhood, or a recent traumatic or negative event. Chronic medical illnesses or other mental health disorders may increase risk.



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