Generalised Anxiety

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. 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.

People with the disorder, which is also referred to as GAD, experience exaggerated worry and tension, often expecting the worst, even when there is no apparent reason for concern. They anticipate disaster and are overly concerned about money, health, family, work, or other issues. GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months.

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, up to 20% over the course of childhood.

The disorder comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age. 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.

When their anxiety level is mild, people with GAD can function socially and be gainfully employed. Although they may avoid some situations because they have the disorder, some people can have difficulty carrying out the simplest daily activities when their anxiety is severe.

The exact cause of GAD is not known. In most people, it probably results from some combination of inherited factors, personality traits, previous life experiences, general health, and the environment. Your risk of getting GAD is higher if you have a family member with anxiety or depression.

While there is no single cause of GAD, women tend to develop this condition and most other anxiety disorders more often than men, and individuals with a family history of anxiety and depression are more at risk for having GAD. Younger adults are more likely to have GAD or social anxiety disorder compared to older adults.

Generalized anxiety disorder (GAD) is a common condition. Genes may play a role. Stress may also contribute to the development of GAD. Anyone can develop this disorder, even kids. Most people with the disorder report that they have been anxious for as long as they can remember. GAD occurs somewhat more often in women than in men.

Inhibited temperament, parental anxiety, and having family and friends who somehow support avoidant coping mechanisms are risk factors for developing an anxiety disorder. Adolescents who smoke have been found to be at risk for developing anxiety. In children, girls, particularly those who begin puberty early, seem to be more likely to develop anxiety than their age peers of both genders.

The main symptom is the almost constant presence of worry or tension, even when there is little or no cause. Worries seem to float from one problem to another, such as family or relationship problems, work issues, money, health, and other problems. Even when aware that their worries or fears are stronger than needed, a person with GAD still has difficulty controlling them.

People with GAD have mental and physical symptoms of anxiety. Symptoms often buil>d up little by little.

Mental symptoms include:

1. Excessive and persistent worries about several things
2. Having trouble controlling the worries
3. Irritability
4. Difficulty concentrating, feeling the mind go “blank”

Physical symptoms include:

1. Fatigue
2. Muscle tension
3. Headaches
4. Feeling restless, keyed up, or on edge
5. Difficulty sleeping
6. People with GAD often have additional anxiety disorders or depression. Often they set very high standards for themselves.

Many health care professionals may help individuals with GAD: licensed mental health therapists, family physicians, or other primary care professionals, specialists whom you see for a medical condition, emergency physicians, psychiatrists, psychologists, psychiatric nurses, and social workers. If one of these professionals suspects that you have GAD, you will likely undergo an extensive medical interview and physical examination. As part of this examination, you may be asked a series of questions from a standardized questionnaire or self-test to help assess your risk of anxiety.

Anxiety may be associated with a number of other medical conditions or can be a side effect of various medications. For this reason, routine laboratory tests are often performed during the initial evaluation to rule out other causes of your symptoms. Occasionally, an X-ray, scan, or other imaging study may be needed. Well-recognized diagnostic criteria for generalized anxiety disorder are as follows:

Excessive anxiety and worry that occurs more days than not for at least six months. The worries are either generalized or are about a number of events or activities (such as work or school performance).

The person finds it difficult to control the worry.

The anxiety and worry are associated with three (or more) of the previously described symptoms (with at least some symptoms present for more days than not for the past six months).

The focus of the anxiety and worry is not confined to features of other mood or to a thought disorder (such as social phobia, OCD, PTSD, schizophrenia, etc.).

The anxiety, worry, or physical symptoms cause clinically significant distress or impairment an important area of functioning, like work, school, or socially.

The illness is not due to the direct physical effects of a substance (like a drug of abuse or a medication) or a general medical condition (like hyperthyroidism) and does not only occur during a mood disorder, psychotic disorder, or a pervasive developmental disorder

Like other anxiety disorders, GAD is treatable. Cognitive-behavioral therapy is effective for many people, helping them to identify, understand, and modify faulty thinking and behavior patterns. This enables people with GAD learn to control their worry. Some people with GAD also take medication.

Relaxation techniques, meditation, yoga, exercise, and other alternative treatments may also become part of a treatment plan.

Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone; co-occurring conditions must also be treated with appropriate therapies.

Specific treatments may include the following:

Cognitive behavioral therapy: A therapist will work with you to change your patterns of thinking. This will help you see how you react to situations that cause you anxiety. You will then learn skills that will help change patterns of thinking that cause anxiety.

Behavioral therapy: A therapist will help you face what you fear by gradually helping you deal with things that you have been avoiding. Your therapist also may teach you relaxation techniques to learn to calm your body. Learning ways to relax can help you gain more control over anxiety. Instead of reacting with worry and tension, you can learn to stay calm.

Medicine: Medicine can be prescribed for severe symptoms that make daily functioning difficult. Medicines can help ease symptoms so you can focus on getting better.