Generalized Anxiety Disorder

GAD

What is Generalized Anxiety Disorder?

This disorder is characterized by chronic, excessive worry and fear about many aspects of life, including competence at work or school, finances, house repairs, etc. Worry may extend to family members' health or life difficulties. The individual often notices anxiety immediately upon awakening. The anxiety is so severe that it impairs the person's ability to function in social relationships or at work. Physical symptoms such as muscle tension are commonly a part of this disorder.

This diagnosis is made if other more specific diagnoses are eliminated, such as panic disorder, excessive caffeine intake, or a medical condition such as an overactive thyroid gland (hyper-thyroidism). The disorder is not caused by substance abuse; if drug or alcohol abuse is present, it is usually an attempt by the individual to self-treat the anxiety. Generalized anxiety disorder is not diagnosed if symptoms are seen only during another mood disorder or a psychotic episode. This disorder is seen approximately twice as often in females as in males. Onset in half of cases is in childhood or adolescence (overanxious disorder of childhood). It also commonly arises after age twenty. Many individuals state they have felt nervous all their lives.

How is it diagnosed?

History is of a high level of apprehension and fear that has been present most of the time for at least six months. The individual seems unable to control his or her worrying. In addition to anxiety, at least three of the following are reported: restlessness, becoming easily fatigued, difficulty with con-centration, irritability, muscle tension, and disturbed sleep. The symptoms result in significant impairment of occupational functioning or personal relationships.

Physical exam could reveal trembling, cold and sweaty hands, or an elevated heart rate and/or blood pressure.

Tests are not helpful in establishing this diagnosis.

Generalized Anxiety Disorder Treatment

Treatment can include psychotherapy, relaxation training, biofeedback, and drug therapy (usually a benzodiazepine).

Medications

Information Brand Generic Label Rating
Sertraline Zoloft Sertraline Off-Label
order Amitriptyline Elavil Amitriptyline On-Label
Buy Paroxetine Paxil Paroxetine On-Label
Neurontin online Neurontin Gabapentin Off-Label
Buy Generic Effexor Effexor Venlafaxine On-Label
Lexapro 20mg Lexapro Escitalopram On-Label

Luvox (Fluvoxamine), Pamelor (Nortriptyline), Prozac (Fluoxetine), BuSpar (Buspirone), Klonopin (Clonazepam), Xanax (Alprazolam), Valium (Diazepam), Ativan (Lorazepam

What might complicate it?

Depression can result from emotional exhaustion. Stress-related illnesses such as headaches or irritable bowel syndrome can occur. There may be abuse or dependence on anti-anxiety drugs, sleep medicines, or alcohol.

Predicted outcome

This is a chronic illness, with the focus of anxiety changing from one concern to another. It frequently becomes worse when an acute life stress arises. The disease becomes less intense as the person ages.

Alternatives

Other anxiety disorders share similarities with this condition but have a more specific focus on the anxiety. They are panic disorder, social phobia, obsessive-compulsive disorder, anorexia nervosa, hypochondriasis or somatization disorder, posttraumatic stress disorder, anxiety caused by a prescription medicine, substance abuse, or medical condition (hyperthyroidism, pheochromocytoma), or anxiety occurring only during a mood or psychotic disorder.

Appropriate specialists

Psychiatrist, psychologist, or other mental health professionals.

Last updated 20 December 2011


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