Anxiety

Generalized Anxiety Disorder

Approximately 6.8 million American adults, or about 3.1 percent of people age 18 and over, have generalized anxiety disorder (GAD) in a given year. Frequent and persistent worry about many different activities and events is a defining characteristic of GAD or simply anxiety disorder. GAD is characterized by excessive anxiety and worry that is out of proportion to the impact of the event or circumstance that is the focus of the worry.

For example, while college students often worry about tests, a student who constantly worries about failure -- despite getting consistently good grades -- has a typical pattern of worry among patients with this disorder. An individual who suffers from GAD finds it difficult to control their worry and anxiety.

What causes Anxiety and who is at risk?

The cause of GAD is not known, but biological and psychological factors play a role. Stressful life situations or learned maladaptive behavior may also contribute to GAD.

GAD is a common condition that occurs somewhat more frequently in women than in men. The disorder may start at any time in life, including in childhood. However, the median age of onset is 31. Most patients with the disorder report that they have been anxious for as long as they can remember.

Symptoms of Anxiety

Anxiety and worry are often associated with the following symptoms:

  • Restlessness or feeling keyed up or "on edge"
  • Being easily fatigued
  • Difficulty concentrating
  • Irritability
  • Muscle tension -- shakiness, headaches
  • Sleep disturbance (difficulty falling or staying asleep; or restless, unsatisfying sleep)
  • Excessive sweating, palpitations, shortness of breath, and various gastrointestinal symptoms

Diagnosis

Your physician will conduct a physical examination and a psychological evaluation in order to rule out other causes of anxiety. Neurologic and endocrine diseases, such as hyperthyroidism and Cushing's disease, are the most common medical causes of anxiety; anxiety may also be a drug-induced symptom.

Once the physical causes of anxiety are ruled out, your physician will then attempt to rule out other psychological causes of anxiety, such as depression or panic disorder.

GAD is often a comorbid disorder, that is, one that occurs in conjunction with another disorder such as social phobia.

Call your doctor if:

Call your health-care provider if you are experiencing the signs and symptoms of generalized anxiety disorder, especially if this has been going on for a period of 6 months or longer or it interferes with your daily functioning.

Treatment Options

Treatment for GAD may involve specific medications that provide a sedative (sleep-inducing) or calming effect.

Anxiolytics

Generic Name Brand Name(s)
buspirone BuSpar

Benzodiazepines

Generic Name Brand Name(s)
alprazolam Xanax, Niravam
chlordiazepoxide Librium
clorazepate Tranxene SD, Tranxene T-Tab
diazepam Valium
lorazepam Ativan
oxazepam Serax

Benzodiazepines, a common class of anti-anxiety medications, should be used with caution because they can cause judgment problems and can be addictive.

Antidepressants

Generic Name Brand Name(s)
escitalopram Lexapro
paroxetine Paxil, Pexeva
venlafaxine Effexor XR

Several antidepressant medicines are approved for generalized anxiety disorder.

Antihistamines

Generic Name Brand Name(s)
hydroxyzine Vistaril

Other drugs such as antihistamines, which have the favorable side effect of reducing anxiety, may also be used.

Therapy

Two types of therapy are used to treat GAD:

  • Relaxation training -- a systematic relaxation of the major muscle groups in the body
  • Cognitive behavioral therapy -- helps patients identify thoughts that contribute to anxiety

Caffeine and other stimulants that can make anxiety worse should be reduced or eliminated.

Patient support groups may be helpful for some patients suffering from GAD. Patients have the opportunity to learn that they are not unique in experiencing excessive worry and anxiety. Support groups are not a substitute for effective treatment, but they can be a helpful addition to it.

See Also:

Last updated: 2012-05-20

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