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Generalized Anxiety Disorder
Anxiety Disorders >> Generalized Anxiety Disorder (GAD)

Everyone gets worried sometimes, but if you have GAD, you stay worried, fear the worst will happen, and cannot relax. Sometimes you aren’t worried about anything special, but feel tense and worried all day long. You also have aches and pains for no reason and feel tired a lot.

Anxiety, the body’s reaction to a perceived, anticipated or imagined danger or threatening situation, is a common occurrence. Most people experience it before or after a stressful event, such as an important presentation or a traumatic loss. A little anxiety isn’t always a bad thing, either: it can help motivate you to do your best and to respond appropriately to danger.

Sometimes, though, anxiety develops spontaneously, even when a stressful or threatening situation isn’t immediately apparent. When worry becomes so excessive and persistent that it limits or inhibits a person’s daily activities, it becomes a disorder that needs to be recognized and treated. UNDERSTANDING GENERALIZED ANXIETY DISORDER
What is generalized anxiety disorder (GAD)? It’s only realistic to be worried about your finances after losing a job or your health if you start having chest pains. And it’s natural to be anxious about a sister who lives in a tough neighborhood or reports of a local flu epidemic or impending SATs. But generalized anxiety disorder isn’t about realistic or natural worries. GAD is about chronic, excessive worry concerning events that are unlikely to occur; it’s minor problems or concerns that wrap around your mind and won’t let go.

Generalized anxiety disorder occurs when normal levels of anxiety become severe, prevent everyday activities, and persist over more than a few months. Normal life becomes difficult for people with GAD because they experience high levels of worry, dreading the immediate future and dwelling on what can go wrong, but feel unable to take action or control events. Generalized anxiety disorder affects 3 to 4 percent of the population at any given time, with women twice as likely to be affected as men.

According to the National Institutes of Mental Health (NIMH), persons with generalized anxiety disorder anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. A co-worker’s careless comment about the economy becomes a constant vision of an imminent pink slip; a spouse’s criticism of a new outfit becomes dread that the marriage is over. People with generalized anxiety disorder usually realize that their anxiety is more intense than the situation calls for, though some convince themselves that their worrying is protective or otherwise helpful. Either way, people with GAD can’t seem to turn off the worry. Sometimes just the thought of getting through the day produces anxiety. Most people with GAD don’t avoid workplace or social situations, but they go about their activities filled with exaggerated worry and tension, even though there is little or nothing to provoke them. For others, the anxiety and physical symptoms of generalized anxiety disorder interfere significantly with work, social interactions, and everyday functioning.


Sound Familiar?
  • “I can’t get my mind to stop…it’s driving me crazy!"
  • “He’s late - he was supposed to be here 20 minutes ago! Oh my God, he must have been in an accident!”
  • “I can’t sleep — I just feel such dread … and I don’t know why!”
Psychological Physical Behavioral
  • chronic worry about events that are unlikely to occur
  • inability to shut off constant anxious thoughts
  • feelings of dread
  • restlessness and inability to relax
  • trouble falling asleep or staying asleep
  • lack of energy
  • twitching or trembling
  • muscular tension, aches or soreness
  • stomach problems (nausea or diarrhea)
  • headaches
  • chest pains
  • grinding of teeth
  • dry mouth
  • sweating or hot flashes
  • dizziness or lightheadedness
  • trouble concentrating
  • irritability
  • easy to startle
  • procrastination

If you have generalized anxiety disorder, your symptoms may fluctuate. You may notice better and worse times of the day, or better and worse days in general.

In children, excessive worrying centers around issues such as future events, past behaviors, social acceptance, family matters, their personal abilities, and school performance. Unlike adults with GAD, children and teens with generalized anxiety disorder often don’t realize that their anxiety is disproportionate to the situation, so adults need to recognize their worries. Along with many of the symptoms that appear in adults with generalized anxiety disorder, some red flags for GAD in children are:
  • “What if” fears about situations far in the future
  • Perfectionism, excessive self-criticism, and fear of making mistakes
  • Feeling that they’re to blame for any disaster, and their worry will keep tragedy from occurring
  • The conviction that misfortune is contagious and will happen to them
  • Need for frequent reassurance and approval
Adults can help children with generalized anxiety disorder by understanding the disorder, listening carefully to a child’s feelings, staying calm in the face of the child’s anxiety, and praising progress, among other interventions.

What are the causes of and risk factors for generalized anxiety disorder (GAD)? A precise cause of generalized anxiety disorder (GAD) is not known, but doctors have identified a variety of experiential, biological, environmental, psychological and cultural factors.

GAD is associated with irregular levels of neurotransmitters in the brain — chemicals that carry signals across nerve endings such as norepinephrine and serotonin. These irregularities can triggered by stressors in people who are predisposed to high levels of anxiety by hereditary factors and environmental influences; often traumatic events in early life can make a person vulnerable to anxiety disorders. Parenting style, family environment and culture may also influence whether a person is susceptible to developing GAD.

Research shows that generalized anxiety disorder tends to run in families, so a genetic link may be involved, but anxiety and fearfulness can also be learned behaviors transmitted to youngsters by adults in their lives. People of certain personality types are more susceptible to anxiety disorders, and, logically, a combination of stressful life situations may trigger excessive anxiety.

Specific medical conditions, such as an overactive thyroid gland, also can produce anxiety and its symptoms, and the stress of coping with a serious illness can lead to excessive worrying. Generalized anxiety disorder also occurs more frequently in people with chronic conditions such as diabetes or high blood pressure.

How is generalized anxiety disorder diagnosed? Generalized anxiety disorder is diagnosed when a person has felt intensely anxious on a day-to-day basis for six months or more. People with GAD often go to their doctors complaining of long-term problems like insomnia or physical symptoms such as stomachaches or headaches.

The doctor will probably perform a physical examination and order tests to rule out physical causes, such as overactive thyroid. Careful questioning and screening by the family doctor or a mental health professional can determine whether someone’s problem is GAD or another anxiety disorder.

Generalized anxiety disorder rarely occurs alone, according to the NIMH, and is often accompanied by depression or substance abuse or by other anxiety disorders. GAD is often difficult to diagnose because it lacks some of the dramatic symptoms of other anxiety disorders, such as panic attacks or the rituals of obsessive compulsive disorder. Conditions occurring with generalized anxiety disorder must also be treated using the appropriate therapies.

What are the treatments for generalized anxiety disorder (GAD)? Psychotherapy, particularly cognitive behavioral therapy (CBT), is a key component of treatment for generalized anxiety disorder. Medication can also be used for generalized anxiety disorder treatment, either on its own or in combination with psychotherapy.

Cognitive Behavioral Therapy
Cognitive-behavioral therapy (CBT) for generalized anxiety disorder can be very effective. CBT examines distortions in our ways of looking at the world and ourselves. Negative thoughts lead to negative emotions, so CBT aims to change those negative thoughts before they trigger psychological difficulties. CBT for generalized anxiety disorder involves retraining the way you think. You therapist will help you identify automatic negative thoughts that contribute to your anxiety. For example, if you catastrophize—always imagining the worst possible outcome in any given situation—you might challenge this tendency through questions such as, “What is the likelihood that this worst-case scenario will actually come true?” and “What are some positive outcomes that are more likely to happen?”

Ellen Jaffe-Gill, M.A. created this article with contributions from Jeanne Segal, Ph.D. Last modified on 12/14/07.

Reprinted with permission from http://www.helpguide.org/. C 2008 Helpguide.org. All rights reserved.

You can find the original article at

SOURCE: www.helpguide.org

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