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Generalized Anxiety Disorder
Generalized anxiety disorder is a condition characterized by chronic anxiety, worry, and tension, even when there is little or nothing to provoke it. Symptoms include trembling, headaches, and irritability. Treatment includes medications and cognitive behavioral therapy. In many cases, this disorder is accompanied by other problems, such as depression or substance abuse, so treatment is needed for these conditions as well.
"I always thought I was just a worrier. I'd feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days. I'd worry about what I was going to fix for a dinner party or what would be a great present for somebody. I just couldn't let something go.
"I'd have terrible sleeping problems. There were times I'd wake up wired in the middle of the night. I had trouble concentrating, even reading the newspaper or a novel. Sometimes I'd feel a little lightheaded. My heart would race or pound. And that would make me worry more. I was always imagining things were worse than they really were: When I got a stomachache, I'd think it was an ulcer.
"When my problems were at their worst, I'd miss work and feel just terrible about it. Then I worried that I'd lose my job. My life was miserable until I got treatment."
Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It's chronic and fills one's day with exaggerated worry and tension, even though there is little or nothing to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, however, the source of the worry is hard to pinpoint. Simply the thought of getting through the day provokes anxiety.
People with generalized anxiety disorder can't seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. Their worries are accompanied by physical symptoms, especially:
- Fatigue
- Headaches
- Muscle tension
- Muscle aches
- Difficulty swallowing
- Trembling
- Twitching
- Irritability
- Sweating
- Hot flashes.
People with generalized anxiety disorder may feel lightheaded or out of breath. They also may feel nauseated or have to go to the bathroom frequently.
Individuals with generalized anxiety disorder are often unable to relax, and they may startle more easily than other people. They tend to have difficulty concentrating, too. Often, they have trouble falling or staying asleep.
Unlike people with several other anxiety disorders, people with generalized anxiety disorder don't characteristically avoid certain situations as a result of their condition. When impairment associated with this disorder is mild, people may be able to function in social settings or on the job. If severe, however, generalized anxiety disorder can be debilitating, making it difficult to carry out even the most ordinary daily activities.
Some research suggests that generalized anxiety disorder may run in families, and it may also grow worse during times of stress. The condition usually begins at an earlier age, and symptoms may manifest themselves more slowly than in most other anxiety disorders.
Treatments for generalized anxiety disorder include medications and cognitive behavioral therapy (CBT).
Research shows that generalized anxiety disorder often coexists with depression, substance abuse, or other anxiety disorders. Other conditions associated with stress, such as irritable bowel syndrome (IBS), often accompany generalized anxiety disorder. People with physical symptoms, such as insomnia or headaches, should also tell their doctors about their feelings of worry and tension. This will help the healthcare provider recognize that the person may be suffering from generalized anxiety disorder.
Generalized anxiety disorder affects about 4 million adult Americans and about twice as many women as men.
Generalized anxiety disorder comes on gradually and can begin at any time in life, although the risk is highest between childhood and middle age.
The disorder is diagnosed when someone spends at least six months worrying excessively about a number of everyday problems. There is evidence that genes play a modest role in the development of generalized anxiety disorder.
The condition is commonly treated with medications. However, generalized anxiety disorder rarely occurs alone -- it is usually accompanied by another anxiety disorder, depression, or substance abuse. So these other conditions must be treated along with the generalized anxiety disorder.
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD
