What Is Generalized Anxiety Disorder?

Do you struggle with anxiety?

If you have generalized anxiety disorder (GAD), you almost always feel worried, fearful or anxious and you’ve felt like this for most of each day, on most days, for longer than 6 months. Sometimes you feel tense for no apparent reason, sometimes you worry about little things, blowing them up way out of proportion and causing yourself unreasonable stress and anxiety. People with generalized anxiety disorder tend to know that they worry too much, but they can’t control their worry – their worry controls them.

Generalized anxiety disorders affect nearly 7 million Americans each year. 

Symptoms of Generalized Anxiety Disorder

We all feel anxious sometimes, but people who suffer from generalized anxiety disorder (GAD) worry with an intensity that disrupts their ability to live a normal, happy and healthy life.

People with GAD tend to feel anxiety or worry without cause, feel worried or tense most of the time, or worry excessively about normal life events. People with this disorder cannot “control” their worrying.

Some common symptoms of this disorder include:

• An often present feeling of worry or dread
• Frequently experienced or ever present tension (feeling “on-edge”)
• A lack of patience and irritability
• Concentration problems – getting easily distracted
• Runaway anxious thoughts
• Being easily startled
• Feeling lightheaded, or breathless
• Fatigue
• Sweatiness
• Insomnia or sleeping problems (waking up frequently throughout the night)
• Physical symptoms of tension, such as muscle tension, stomach pains, diarrhea or nausea or headache
• Trembling or twitching

Children can sadly experience GAD and although they experience much of the same worry, they cannot usually verbalize the way that they feel; it is up to parents or caregivers to recognize the problem – spotting Generalized Anxiety Disorder in Children.

Few people will experience all symptoms and many people experience some variability in the severity of symptoms - feelings of anxiety may retreat to the back-burner at times.

To meet a clinical diagnosis of generalized anxiety disorder, symptoms of anxiety must have occurred:

• Most days, for more than 6 consecutive months
• With a sufficient severity to cause problems in social, professional or family life
• The anxiety cannot be caused by the use of drugs or alcohol, by another medication, by another medical condition and it cannot occur exclusively during an active phase of another mental health disorder

Is it Normal Anxiety, or a Generalized Anxiety Disorder?

There are three primary ways to distinguish normally experienced anxiety from the worry and anxiety experienced by someone with generalized anxiety disorder.

1. Most people can control their worries. While at work, a person without GAD might consciously “put-off” worrying about an anxiety provoking subject, for example, finances or relationships – someone with GAD could not likely delay this anxiety, and would spend much of the day worrying.

2. People with GAD worry more frequently, worry for longer periods and with greater intensity, than people without GAD. People with GAD often get anxious without external triggers and feel very anxious about a wide array of subjects. The more subjects that provoke extreme anxiety, the more likely the anxiety is caused by GAD.

3. People with GAD often experience anxiety caused physical symptoms, such as fatigue, restlessness or irritability – people without GAD do not typically experience these physical consequences of anxiety.

Who Gets Generalized Anxiety Disorder?

Women are twice as men to likely to succumb to generalized anxiety disorder, but the disorder can afflict men and women of any age.

The disorder can begin at any age, although symptoms most commonly begin before 25 years of age; and the symptoms tend to gradually worsen over time. People experiencing the disorder often seek treatment for physical symptoms, such as stomach pain or headache but it often takes doctors a while to put all the pieces together and determine that physical symptoms are in fact caused by a mental health disorder.

Most people with GAD (50% to 90%) experience a co-occurring mental health condition, such as depression or dysthymia, drug or alcohol abuse or panic disorder.

How Long Does Generalized Anxiety Disorder Last?

To meet the diagnostic criteria, symptoms of the disorder must occur for 6 months or longer. Untreated GAD can endure for years – many people entering into treatment for the disorder report feeling an underlying tension and anxiety for as long as they can remember.

Treatment can control the symptoms of GAD and treatment will work for about half of people within a few weeks and for three quarters of people within 9 months.

What Causes Generalized Anxiety Disorder?

There are a number of factors that increase the risks of experiencing general anxiety disorder, such as:

• Genetics - Having a close family relative with GAD may increase your risk.

• Stress – Living with chronic stress may predispose you to an anxiety disorder, especially uncontrollable stress or a history of chronic stress paired with a sudden trauma, such as an assault.

• Serious Illness – The diagnosis of a serious physical illness can cause great stress.

• Personality Traits – certain negative or pessimistic personality traits can cause people to worry excessively, which can lead to a clinical condition, in some instances. Borderline personality disorder is also associated with an increased risk or anxiety disorders.

• Stress or Trauma in Childhood – developmental stress during childhood can lead to altered functioning of the stress response system in the brain, leaving a person susceptible to anxiety disorders.

Treatment for Generalized Anxiety Disorder

The two most common treatments for GAD are medication and psychotherapy, commonly offered together (research has shown that a combination treatment produces a more sustained result).

Medications

The two most commonly used types of medication for GAD are anti-anxiety drugs and anti depressant medications.

Anti-Anxiety Medications

These drugs work quickly and they can relieve symptoms of anxiety very shortly after consumption. They tend to be slightly sedative in nature. Some examples of common anti-anxiety medications include the benzodiazepines, Xanax, Valium or Ativan. These drugs work well, but they are highly addictive, and a tolerance to their effects develops quickly. After a couple of weeks of continual use, you will not be able to stop taking medications of this class without experiencing withdrawal symptoms, unless you gradually taper the dosage down over time.

A newer form of anti-anxiety medication, buspirone, provides symptoms relief without causing a physical dependence and is considered a very safe drug for anxiety. Buspirone takes a few weeks to become fully active and effective, and most people report that buspirone does not remove all (only most) of baseline anxiety.

Anti Depressants

SSRIs, tricyclic anti depressants and selective norepinephrine reuptake inhibitors are all effective types of anti depressants for the treatment of generalized anxiety disorder (New England Journal of Medicine); due to the lower side effect profiles of the SSRIs these medications are often the first line choice. Antidepressants take up to 6 weeks to become effective.

Psychotherapy

Psychotherapy can help people take some control over their symptoms of anxiety and can teach ways to deal with anxiety that does occur.

• Cognitive Behavioral Therapy (CBT) – an evidence based therapy that helps people change unhealthy thinking and behavior patterns in order to produce symptoms improvements, has shown real efficacy in the treatment of GAD. (Read more about cognitive behavioral therapy for anxiety). CBT is the most commonly recommended psychotherapy for the treatment of GAD.

• Relaxation Therapy – Learning relaxation techniques, such as deep breathing, meditation, imagery and visualization can help to reduce the intensity of symptoms.

• Interpersonal Therapy – A therapeutic technique that looks to resolve relationship problems so as to reduce the anxiety and stress.