general anxiety disorder
Generalized Anxiety Disorder is one of the most common anxiety disorders and affects approximately 3.1% of the American adult population. With 6.8 million reported cases among American adults aged 18 and older, the average age of onset is 31 years old. While it can occur at any point of life, the most common points of onset occur between childhood and middle age. If you are a woman, you are twice as likely to suffer from Generalized Anxiety Disorder than men.
Generalized Anxiety Disorder is different than having a phobia about something. People with phobias are fearful of something in particular – for example, spiders, heights, or speaking in public. If you have Generalized Anxiety Disorder, you have an uneasy feeling about life in general. Often associated with feelings of dread or unease, you are in a state of constant worry over everything. If a friend doesn’t call you back within an hour, you may start to worry you did something wrong and the friend is upset with you. If you are waiting for someone to pick you up and he is a few minutes late – you may start to fear the worst – that he was in an accident, instead of thinking something more minor, like he got stuck in traffic. The feelings are not as intense as those that occur during a panic attack episode; however, the feelings are long-lasting. This results in having anxiety toward your life in general and the inability to relax – what some may consider far more debilitating than a specific phobia to a certain thing or situation, which you could possible avoid. There is no “off” switch. If you are suffering from Generalized Anxiety Disorder, you are experiencing a constant state of worry – and you cannot avoid it, because life, in general, is causing you anxiety.
Studies have shown that if you are living with Generalized Anxiety Disorder, you are more likely to also suffer from other mental health issues and ailments. Common conditions that are associated with Generalized Anxiety Disorder include depression, irritable bowel syndrome, stress, attention deficit hyperactivity disorder, and substance abuse.
Occasional anxiety is a normal part of life. You might worry about things like health, money, or family problems. But people with generalized anxiety disorder (GAD) feel extremely worried or feel nervous about these and other things—even when there is little or no reason to worry about them. People with GAD find it difficult to control their anxiety and stay focused on daily tasks.
The good news is that GAD is treatable. Call your doctor to talk about your symptoms so that you can feel better.
Symptoms of GAD
GAD affects the way a person thinks, but the anxiety can lead to physical symptoms, as well. Symptoms of GAD can include:
Excessive, ongoing worry and tension
An unrealistic view of problems
Restlessness or a feeling of being “edgy”
The need to go to the bathroom frequently
Trouble falling or staying asleep
Being easily startled
Children and teens with GAD often worry excessively about:
Their performance, such as in school or in sports
Catastrophes, such as earthquakes or war
Adults with GAD are often highly nervous about everyday circumstances, such as:
Job security or performance
The health and well-being of their children
Completing household chores and other responsibilities
Both children and adults with GAD may experience physical symptoms that make it hard to function and that interfere with daily life.
Diagnosis and Causes
Great questions. Unfortunately, there is usually no clear cut answer – and like many mental health disorders – it is likely caused by a combination of genetic, behavioral, and developmental factors. Anatomically speaking, Generalized Anxiety Disorder is most closely related to a disruption in the functional connectivity of the amygdala – the “emotional control center” of the brain – and how it processes feelings of fear and anxiety. Genetics also play a role in Generalized Anxiety Disorder. If you have a family member that also suffers from this disorder, your chances of suffering from it are increased, especially in the presence of a life stressor. Interestingly, long-term substance abuse also increases your chances of Generalized Anxiety Disorder, as the use of benzodiazepines can worsen your anxiety levels, as can excessive alcohol use. Tobacco use and caffeine are also both associated with increased levels of anxiety.
If you believe you are suffering from Generalized Anxiety Disorder, your doctor will perform a variety of physical exams as well as mental health checks. You might first go to your doctor complaining of constant headaches and trouble sleeping. After he or she rules out any underlying medical conditions that are causing your physical symptoms, s/he may refer you to a mental health specialist for further diagnosis. Your mental health specialist will ask you a series of psychological questions to get a better understanding of your condition. To be clinically diagnosed with Generalized Anxiety Disorder, your doctor and/or mental health provider will assess the length of time you have been suffering from excessive worry and anxiety, your difficulty in controlling your anxiety, how your anxiety interferes with your daily life, and if you are experiencing fatigue, restlessness, irritability, muscle tension, sleep problems, and difficulty concentrating.
GAD sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain, as well as biological processes, play a key role in fear and anxiety. By learning more about how the brain and body function in people with anxiety disorders, researchers may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors play a role.
If no other medical condition is found, you may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses like GAD. Treatment for GAD most often includes a combination of medication and cognitive-behavioral therapy.
Medication: Drugs are available to treat GAD and may be especially helpful for people whose anxiety is interfering with daily functioning. The drugs most often used to treat GAD in the short-term (since they can be addictive, are sedating, and can interfere with memory and attention) are from a class of drugs called benzodiazepines. These medications are sometimes also referred to as sedative-hypnotics or “minor tranquilizers” because they can remove intense feelings of acute anxiety. They work by decreasing the physical symptoms of anxiety, such as muscle tension and restlessness. Common benzodiazepines include Xanax, Librium, Valium, and Ativan. These drugs can exaggerate sedation effects when combined with many other medicines, and they are also dangerous if mixed with alcohol. Certain antidepressants, such as Paxil, Effexor, Prozac, Lexapro, Zoloft, and Cymbalta are also used to treat GAD for longer periods of time. These antidepressants may take a few weeks to start working, but they’re safer and more appropriate for long-term treatment of GAD.
Cognitive-behavioral therapy: People suffering from anxiety disorders often participate in this type of therapy, in which you learn to recognize and change thought patterns and behaviors that lead to anxious feelings. This type of therapy helps limit distorted thinking by looking at worries more realistically.
In addition, relaxation techniques, such as deep breathing and biofeedback, may help control the muscle tension that often accompanies GAD.
Anxiety disorders like GAD cannot be prevented. However, there are some things that you can do to control or lessen symptoms, including:
Stop or reduce your consumption of products that contain caffeine, such as coffee, tea, cola, and chocolate.
Ask your doctor or pharmacist before taking any over-the-counter drugs or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
Exercise daily and eat a healthy, balanced diet.
Seek counseling and support after a traumatic or disturbing experience.
Practice stress management techniques like yoga or meditation.