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Understanding Generalized Anxiety Disorder

Thursday 23 April 2020
Mental Health
6 minute(s) read
Dr..Nick Ho

Medically reviewed by

Dr. Nick Ho, MD

on 2 September 2020

Table of Contents

I. Symptoms

II. Risk Factors

III. Diagnosis

IV. Treatment

Everyone has experienced feelings of worry and stress in their life. Anxiety is a universal human emotion, but generalized anxiety disorder (GAD) is more than the occasional bout of worrying. Those with GAD have a hard time coping with concerns about health, family, work, and money. They tend to anticipate disaster and expect the worst. These feelings of doom can stick around for several months and often impact everyday life. Luckily, there are medications like Lexapro (escitalopram) and Effexor XR (venlafaxine) to help combat these symptoms.

GAD affects close to 7 million adults in the United States, which is around 3-4 percent of the population. Women are twice as likely to be affected. Anxiety can be a crippling condition to deal with because it typically comes on gradually and can begin at a young age. The exact cause of GAD is unknown, and people don’t often seek treatment until it becomes difficult to get through a day without constant worry.  [1]

Symptoms of Generalized Anxiety Disorderr

Every person with GAD deals with their anxiety differently, but some common symptoms of GAD can include:

  • Persistent worrying that is out of proportion with the actual impact of events
  • Difficulty handling uncertainty
  • An inability to relax and feelings of restlessness
  • Difficulty concentrating
  • Perceiving situations and events as threatening
  • Overthinking plans or solutions
  • Thinking in terms of worst-case scenarios

a woman shaking her hair

Anxiety begins in the mind, but it can start to impact your physicality as well. Those with anxiety may experience:

  • Trouble sleeping
  • Fatigue
  • Nervousness
  • Sweating
  • Irritability
  • Nausea
  • Diarrhea
  • Muscle tension or muscle aches

Once your anxiety begins to take over your mind and body, then it can cause a lot of stress on your personal and work relationships. These worries can start to compound on top of each other, and people can find themselves in an endless cycle of stress and fear.

a. Different symptoms in children and teenagers

Different stressors accompany every stage of life. Adolescents can have an especially hard time adjusting to schools and relationships, which can lead to feelings of anxiety. Parents should look out for excessive worry in their younger kids. A child or teen with excessive worry may have symptoms that include:

  • A lack of confidence
  • Perfectionist tendencies
  • Spending excessive time doing homework
  • Striving for approval
  • Requiring a lot of reassurance about performance
  • Avoiding going to school
  • Avoiding social situations
  • Redoing tasks over and over if they aren’t “perfect”

Young children or teens may also have excessive worries about things that are out of control, which can include:

  • Family member’s safety
  • Being on time
  • Natural disasters (earthquakes, nuclear war, catastrophic events)
  • Performance at school or sporting events

What puts me at risk for Generalized Anxiety?

It is possible to develop anxiety without any risk factors, but there are often conditions that contribute to feelings of anxiousness. Some contributing factors to anxiety can include:

Substance abuse: Using drugs, smoking cigarettes or marijuana, or drinking excessively can increase a person’s risk of GAD.

Cultural factors: Since the 1950s, there has been a sharp increase in the rate of anxiety in young people and adolescents. Some studies suggest this is due to a lack of social connections as well as increasing worry about the state of the environment.

a funeral

Stressful events: If a person experiences a traumatic event it can trigger the beginning of anxious thoughts. Some of these events can include the loss of a job, being a victim of a crime, or the loss of an important relationship.

Medical conditions: If a person has a chronic illness, they are at a higher risk of developing GAD.

Family history: Anxiety disorders sometimes run in families, and people are more likely to develop anxiety if someone in their immediate family also has it. This is often due to family dynamics and whatever behaviors or coping skills a person learns as a kid.

History of self-harm: Young people who engage in self-harm before the age of 16 are at a higher risk of developing anxiety in adulthood. [2]

How is Generalized Anxiety Diagnosed?

Anxiety can be hard to diagnose, so a doctor or mental health professional may perform several tests or examinations to determine your condition. If you think that you are experiencing a generalized anxiety disorder, then your doctor may perform a physical exam to look for any physical signs of anxiety disorder or symptoms of an underlying medical condition.

If your doctor suspects GAD, then they may give you a detailed psychological questionnaire to help determine your diagnosis. The doctor will then go over your answers to determine if you are experiencing GAD. This questionnaire will ask you several questions, like how often you experience excessive worry.

The Best Treatment for Generalized Anxiety Disorder

The treatment for generalized anxiety disorder is different for every person. You and your doctor will determine how much your anxiety disorder is affecting your everyday function. If you have moderate to severe anxiety disorder, then the two main treatments often include a combination of psychotherapy and medications.

a. Therapy

Psychotherapy is an in-depth process in which you and your therapist work together to reduce your anxiety symptoms. Therapy will be tailored to your specific symptoms and diagnosis. Cognitive-behavioral therapy (CBT) is thought to be the most effective form of psychotherapy. CBT works to address negative patterns in your life and the distorted way you may view yourself and the world.

The cognitive part examines negative cognitions that contribute to anxiety while behavior therapy examines how you behave and react in particular situations. A CBT therapist will help you discover how those behaviors trigger your anxiety. With successful CBT, an anxious person can learn coping practices and obtain new ways of thinking. This new perspective can help battle anxious thoughts and create healthy coping mechanisms. [3]

encouraging signs

b. Medications

There are three types of drugs that are often used for anxiety disorders. Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and norepinephrine reuptake inhibitors (SNRIs) are usually prescribed first. These antidepressants typically prevent the absorption of serotonin in the brain, which contributes to feelings of happiness. Some common antidepressants include Lexapro (escitalopram) and Effexor XR (venlafaxine).

Buspirone and benzodiazepines are also commonly used. Buspirone is an anti-anxiety medication that is used on an ongoing basis. Buspirone affects the neurotransmitters in the brain and increases the action of serotonin. These drugs usually take several weeks to become effective. Benzodiazepines are used less frequently for the relief of anxiety symptoms. These drugs are sedatives that relieve acute anxiety on a short-term basis. They are less used because they can be habit-forming, especially for those with problems of alcohol or drug abuse.

c. Alternative treatments 

Anxiety can be helped with medication and therapy, but an anxious person has to maintain a healthy lifestyle in order to fully keep their anxiety at bay. It is important to stay physically active and avoid harmful substances that may increase feelings of anxiety. Using relaxation techniques like meditation and yoga can also be beneficial.

The content provided in this article is based on thorough research and in some cases, reviewed by a medical professional. Our goal for the information is to provide helpful, general health informational. It is not intended as a substitute for professional medical advice.