>> Generalized Anxiety Disorder
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
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.
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.
SIGNS AND SYMPTOMS OF GENERALIZED
- “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
SYMPTOMS AND BEHAVIORS ASSOCIATED
WITH GENERALIZED ANXIETY DISORDER
- chronic worry about events that are
unlikely to occur
- inability to shut off constant anxious
- 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)
- chest pains
- grinding of teeth
- dry mouth
- sweating or hot flashes
- dizziness or lightheadedness
- trouble concentrating
- easy to startle
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.
CHILDREN AND GENERALIZED ANXIETY
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.
CAUSES AND RISK FACTORS FOR
GENERALIZED ANXIETY DISORDER (GAD)
What are the causes of and risk factors for
generalized anxiety disorder (GAD)?
cause of generalized anxiety disorder (GAD) is not
known, but doctors have identified a variety of experiential,
biological, environmental, psychological and cultural
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
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.
DIAGNOSIS OF GENERALIZED ANXIETY
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.
TREATMENT AND HELP FOR GENERALIZED
ANXIETY DISORDER (GAD)
What are the treatments for generalized anxiety
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
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
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
FOR MORE INFORMATION ON ANY OF THE ABOVE PLEASE VISIT