Generalized anxiety disorder (GAD) is a mental health condition affecting nearly three percent of the American population. GAD occurs more often in women than men by a 2 to 1 ratio. There are a number of factors that may contribute to the causes of GAD including genetics, brain chemistry, and environmental factors. GAD can affect a person based on their personal risk profile. As a result of GAD, a person can experience a wide range of symptoms both mental and physical. There are a variety of treatments for GAD that involve mental health therapy as well as medications. The impact of GAD can have life-long implications for a person’s long-term health.
GAD is defined as an excessive or irrational worry or anxiety about day to day issues that interfere with daily functioning. Persons with GAD have an outlook on life that is consistently negative and filled with doubt. For the disorder to be diagnosed as GAD, this condition needs to persist for a period of the majority of the days during a six month period continuing for a duration of greater than six months. For a person with GAD, even performing simple everyday tasks may be very difficult. It seems that the disorder can affect one or several aspects of a person’s life including family, work, friends, school, or social activities for example.
Interestingly, GAD affects women to a greater degree than men. This ratio has been determined to be approximately 2 to 1. In a population of 6.8 million American adults that experience GAD, this means that 4.4 million women experience GAD at some point in their lives. Approximately 50 percent of cases for both men and women begin in childhood or adolescence. In children and teens, the condition is called overanxious disorder of childhood. The onset of GAD is usually slow, but can result from a significant life stressor or other life factors in combination with other anxiety disorders.
The exact cause of GAD is not fully understood or known, but it is believed that a number of biological factors may contribute to the disease. Some research suggests that genetic factors may play a role in the development of the disease. This means that the disease may be more prevalent with a family. Biologically, GAD may be associated with abnormal levels of special messenger chemicals, known as neurotransmitters, in the brain. The thought is that if the chemicals are out of balance, that the appropriate chemical messages cannot be processed by the brain properly. This could potentially alter the reaction in the brain and produce anxiety. It is also believed that environmental factors have a significant impact on GAD. Stress inducing events, trauma, job changes or losses, financial stressors, can make GAD worse or initiate symptoms. Finally, there is some research to suggest that GAD may be induced due to substance abuse or dependence. The use of alcohol, benzodiazepines, caffeine, or nicotine can contribute to the worsening of symptoms.
There do appear to be a number of risk factors that increase the risk of developing GAD. These risk factors include: sex (females are at more risk for the disease), childhood adversity (abuse or trauma), illness (chronic or serious health conditions), stress (major events or a buildup of many events), and personality (some personality types are more prone).
The range of GAD symptoms is diverse and can occur singly or in combination. The primary symptom of excessive worry may be accompanied by fatigue, headaches, poor concentration, insomnia, irritability, trembling, sweating, nausea, diarrhea, rapid heartbeat, muscle tension and aches, or shortness of breath. Additional phobias, obsessive-compulsive disorder, or other panic disorders can be attributed to GAD. Because of the variety of symptoms patients are commonly misdiagnosed. While a person may go to their doctor for a single symptom, it is not uncommon for a physician to miss the other contributing factors or symptoms that contribute to GAD.
There are a number of treatments for people with GAD. The first step in the treatment process is to see your doctor to eliminate any other physical problem. The next step would be a referral to a mental health therapist for cognitive behavior therapy. A number of studies indicate that cognitive behavior therapy is more effective than medications. Cognitive behavior therapy (CBT) is a psychological treatment for GAD which involves the analysis of how a person’s thoughts and feelings influence their behavior. The goal of this type of therapy is to have the patient lessen their negative thoughts that contribute to their worry. Adjusting a patient’s expectations to more realistic expectations can help reduce their anxiety-provoking feelings. CBT has a success rate (from mild success to substantial success) of 66 percent, while 33 percent does not respond at all. This approximation of success does not take into account whether patients were taking medications.
Pharmaceutical treatments for GAD include antidepressants, anti-anxiety medications or tranquilizers. Antidepressants are a class of drugs known as SSRIs or selective serotonin reuptake inhibitors. They work by blocking the re-absorption of serotonin in the brain. Serotonin is one of the major neurotransmitters that are thought to play a role in anxiety disorders. Examples of these drugs include Prozac, Paxil, Lexapro, and Zoloft. Another drug class similar to SSRIs is TCAs (tricyclic antidepressants). TCAs are thought to act not only on serotonin, but also norepinephrine and dopamine in the brain, which are also anxiety related neurotransmitters. In limited situations anti-anxiety drugs may be prescribed by your doctor in conjunction with anti-depressants. Tranquilizers are a class of drugs known as benzodiazepines. These are intended for short-term relief of anxiety symptoms and act as a sedative. Examples of these drugs include Klonopin, Ativan, Valium, or Xanax.
There is no specific cure for GAD. Since, GAD may come or go during certain periods in a person’s lifetime, there are some self help steps that a person can take to reduce the risk or symptoms of GAD. Fundamentally, any common sense activities or actions that reduce the level of stress or anxiety can help. For example getting a massage or physical exercise may help. Or, if housework or related activities are causing a person stress, they might consider hiring someone to help with a family’s chores or housekeeping needs. For some people, it may be playing a video game or listening to relaxing music may help. Other lifestyle changes such as getting daily exercise, eating a healthy diet, and avoiding alcohol, nicotine, or other stimulants may help. Alternative therapies may include adopting relaxation techniques, increasing quality sleep, or biofeedback. Finally, a person may seek out an anxiety support group. Fundamentally, the goal to managing GAD is for a person to take action and find the support they need to manage their daily life to make them feel better about themselves.
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