Alternate Names: GAD

Causes and Risks:

A generalized anxiety disorder is one of the most common types of anxiety disorder. It is characterized by excessive anxiety and worry about two or more life circumstances for a period of six months or longer. The exact cause of this disorder may be unknown but biological and genetic factors play a role. Stressful life situations or nonadaptive behavior acquired through learning may also contribute to GAD. The disorder may start at any time, including childhood, and a history of excessive worry is common. GAD occurs somewhat more often among women than among men.

No prevention is known.

Symptoms:

• typical symptoms of anxiety:
• irritability or restlessness
• fatigue
• trembling or feeling shaky
• muscle tension, aches or soreness
• sweating, clammy skin
• a dry mouth
• difficulty swallowing or lump in the throat
• sleep disturbances
• nightmares
• poor concentration
• excessive worry
• muscle tension
• restlessness
• fatigue
• shortness of breath or breathing difficulty, especially lying down
• palpitations
• dizziness
• nausea, diarrhea
• flushing or chills
• fainting
• an exaggerated startle response
• difficulty with concentrating, confusion
• feeling keyed up
• complaining of urinary frequency or urgency

Signs and Tests:

A physical examination and a psychological evaluation should be completed in order to rule out other causes of anxiety. Physical disorders that may mimic an anxiety state are ruled out, as well as drug-induced symptoms. Various diagnostic tests may be done in this process.

Treatment:

Medications used to treat anxiety disorders include antidepressants and antianxiety agents. Treatment may also involve sedative (sleep-inducing) drugs, antihistamines, and/or minor tranquilizers. These medications act on the central nervous system to reduce the feelings of anxiety and associated symptoms. A common class of antianxiety medications, the benzodiazepines, are usually used with caution due to potential for dependence. Behavioral therapies, which have been effective with GAD, include relaxation training (a systematic relaxation of the major muscle groups in the body) and cognitive behavioral therapy (treatment that identifies cognitions or thoughts that contribute to anxiety). Caffeine and other stimulants should be reduced or eliminated.

Prognosis:

The disorder may be long-standing and difficult to treat. Although many with this disorder may not be cured with treatment, all can expect substantial improvement with drug or behavioral therapy.

Complications:

Persons with GAD are at risk for development of substance abuse or dependence, sometimes due to self-medication of anxiety symptoms. GAD is frequently complicated by co-existing depression.

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 six months or longer or interferes with your daily functioning.