Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about a number of different things. People with GAD may anticipate disaster and may be overly concerned about money, health, family, work, or other issues.
Overview
Individuals with GAD find it difficult to control their worry. They may worry more than seems warranted about actual events or may expect the worst even when there is no apparent reason for concern. GAD affects 6.8 million adults, or 3.1% of the U.S. population, in any given year. Women are twice as likely to be affected. The disorder comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age.
Symptoms
Sometimes just the thought of getting through the day produces anxiety. People with GAD don’t know how to stop the worry cycle and feel it is beyond their control, even though they usually realize that their anxiety is more intense than the situation warrants. All anxiety disorders may relate to a difficulty tolerating uncertainty and therefore many people with GAD try to plan or control situations. Many people believe worry prevents bad things from happening so they view it is risky to give up worry. At times, people can struggle with physical symptoms such as stomachaches and headaches.
Feeling nervous, irritable, or on edge
Having a sense of impending danger, panic or doom
Having an increased heart rate
Breathing rapidly (hyperventilation), sweating, and/or trembling
Feeling weak or tired
Difficulty concentrating
Having trouble sleeping
Experiencing gastrointestinal (GI) problems
Types of This Disorder
Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone; co-occurring conditions must also be treated with appropriate therapies.
Causes
Although the exact cause of GAD is unknown, there is evidence that biological factors, family background, and life experiences, particularly stressful ones, play a role.
Diagnosis
GAD is diagnosed when a person finds it difficult to control worry on more days than not for at least six months and has three or more symptoms. This differentiates GAD from worry that may be specific to a set stressor or for a more limited period of time.
Treatments
A number of types of treatment can help with GAD. Supportive and interpersonal therapy can help. Cognitive behavioral treatment (CBT) has been more researched and specifically targets thoughts, physical symptoms and behaviors including the over-preparation, planning and avoidance that characterizes GAD. Mindfulness based approaches and Acceptance Commitment Therapy have also been investigated with positive outcome. All therapies (sometimes in different ways) help people change their relationship to their symptoms. They help people to understand the nature of anxiety itself, to be less afraid of the presence of anxiety, and to help people make choices independent of the presence of anxiety. The adult CBT treatments for GAD have been modified for children and teens and show positive outcomes.
There are a number of medication choices for GAD, usually the SSRIs either alone or in combination with therapy.
Relaxation techniques, meditation, yoga, exercise, and other alternative treatments may also become part of a treatment plan.
Coping Strategies
Try these when you’re feeling anxious or stressed:
Take a time-out. Practice yoga, listen to music, meditate, get a massage, or learn relaxation techniques. Stepping back from the problem helps clear your head.
Eat well-balanced meals. Do not skip any meals. Do keep healthful, energy-boosting snacks on hand.
Limit alcohol and caffeine, which can aggravate anxiety and trigger panic attacks.
Get enough sleep. When stressed, your body needs additional sleep and rest.
Exercise daily to help you feel good and maintain your health. Check out the fitness tips below.
Take deep breaths. Inhale and exhale slowly.
Count to 10 slowly. Repeat, and count to 20 if necessary.
Do your best. Instead of aiming for perfection, which isn’t possible, be proud of however close you get.
Accept that you cannot control everything. Put your stress in perspective: Is it really as bad as you think?
Welcome humor. A good laugh goes a long way.
Maintain a positive attitude. Make an effort to replace negative thoughts with positive ones.
Get involved. Volunteer or find another way to be active in your community, which creates a support network and gives you a break from everyday stress.
Learn what triggers your anxiety. Is it work, family, school, or something else you can identify? Write in a journal when you’re feeling stressed or anxious, and look for a pattern.
Talk to someone. Tell friends and family you’re feeling overwhelmed, and let them know how they can help you. Talk to a physician or therapist for professional help.