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Generalized anxiety disorder

Generalized anxiety disorder (GAD) is a mental health condition in which a person is often worried or anxious about many things and finds it hard to control this anxiety .

Alternative Names

GAD; Anxiety disorder

Causes, incidence, and risk factors

The cause of GAD is unknown. Genes may play a role. Stress may also contribute to the development of GAD.

Stress and anxiety

GAD is a common condition, affecting about 3% of people. Anyone can develop this disorder, even children. GAD occurs  more often in women than in men.

Symptoms

The main symptom is frequent worry or tension for at least six months, even when there is little or no clear cause. Worries seem to float from one problem to another. Problems may involve family, other relationships, work, school, money, and health.

Generalized anxiety disorder

Even when aware that worries or fears are stronger than appropriate for the situation, a person with GAD still has difficulty controlling them.

Other symptoms of GAD include:

  • Problems concentrating
  • Fatigue
  • Irritability
  • Problems falling or staying asleep, or sleep that is restless and unsatisfying
  • Restlessness when awake
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Other physical symptoms may also be present. These can include muscle tension, upset stomach, sweating, or difficulty breathing.

Signs and tests

There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms, and will likely ask you about other aspects of your mental and physical health. A physical exam or laboratory tests may be done to rule out other conditions that cause similar symptoms.

Treatment

The goal of treatment is to help you feel better and function well in daily life. In less severe cases, talk therapy or medication alone can be helpful. In more severe cases, a combination of these may work best.

Talk Therapy

There are multiple types of talk therapy that may be helpful for GAD. One of the more common and effective talk therapies for GAD is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to:

  • Understand and gain control of distorted views of stressors, such as other people's behavior or life events.
  • Recognize and replace panic-causing thoughts to help you feel more in control.
  • Manage stress and relax when symptoms occur.
  • Avoid thinking that minor problems will develop into terrible ones.

Medicines

Medicines can also be an important part of treatment. Once you start them, do not stop taking them without talking with your health care provider. Commonly prescribed medicines for GAD include antidepressants and benzodiazepines.

Self-care

Other than taking medicine and going to therapy, you can help yourself get better by:

  • Reducing caffeine
  • Not using street drugs
  • Exercising, getting enough rest, and eating healthy foods

Support Groups

You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.

Support groups are usually not a good substitute for talk therapy or medication, but can be a helpful addition.

Expectations (prognosis)

How well a person does depends on how severe the condition is. In some cases, GAD is long-term and is difficult to treat. Most patients, though, get better with medicine and/or talk therapy.

Complications

Depression and substance abuse may occur with an anxiety disorder.

Calling your health care provider

Call your health care provider if you frequently worry or feel anxious, especially if it interferes with your daily activities.

References

Connolly SD, Bernstein GA. Work Group on Quality Issues. Practice parameter for the assessment and treatmetn of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2007;46:267-283.

Hoffmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry. 2008;69:621-632.

Pollack MH, Kinrys G, Delong H, Vasconcelos e Sá D, Simon NM. The pharmacotherapy of anxiety disorders. In: Stern TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby;2008:chap 41.

Taylor CT, Pollack MH,LeBeau RT, Simon NM. Anxiety disorders: panic, social anxiety, and generalizedanxiety. In: Stern TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital ComprehensiveClinical Psychiatry. 1st ed.Philadelphia, PA: Elsevier Mosby; 2008:chap 32.

Updated: 3/25/2013

David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Blackman, Stephanie Slon, and Nissi Wang.


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