Generalized Anxiety Disorder (GAD): An Overview

It's difficult for people with generalized anxiety disorder to control their worrying. Consider the stories of Steven and Sarah.

Steven
A few days ago, Steven went to his doctor for an annual physical and had routine tests taken. The doctor told him, "The results usually take about two weeks, we'll call you if we need to see you again." Since then, each time Steven's phone rings, he picks it up with apprehension thinking it is his doctor on the other end with bad, even devastating news about his health. He wakes each day with dread about the phone ringing, and he counts the days waiting for the end of the two weeks so he can stop worrying about this. But even when he knows his tests results are fine, Steven's thought and behavior patterns have shown that other events are likely to trigger ongoing fears and worries about his health.

Sarah
Over the last few months, Sarah often only sleeps about three to four hours a night. She wakes with thoughts of her family's financial situation and fears of losing her job. Presently, both situations are relativity stable, but in times of an unsettling economy, the thought of "What if I did lose my job?" is hard for Sarah to ignore. She dwells on the ramifications of losing health insurance, the inability to pay her mortgage, bills, and expenses for children's activities. It's become routine for her to get up in the middle of the night and walk around the house, she seems to feel better when she's not lying down as it eases her queasy stomach.

The prime symptom of generalized anxiety disorder (GAD) is excessive worry.Though physical symptoms of GAD are varied, the central theme of worry remains constant. Individuals affected with GAD trudge through their day unable to cast aside intruding, anxiety inducing thoughts that something bad will happen. Some worry about something, and some worry about anything....everything!

Most mental health professionals diagnose disorders according to the criteria written in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) published by the American Psychiatric Association. For all anxiety disorders, the DSM-IV states that in order to be classified as an anxiety disorder, the condition may not be due to medical conditions, substance abuse, or another mental disorder.

The criteria of GAD in the DSM-IV defines excessive worry as "excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least six months, about a number of events or activities (such as work or school performance)." Very often, the intensity and frequency of the worry is out of balance compared to the actual issue or situation.

In addition to worry, the DSM-IV outlines six symptoms stating that at least three of them are necessary for a GAD diagnosis. As with worry, symptoms must be experienced the majority of days for at least six months. These physical symptoms very often interfere with social activities, job responsibilities, and daily routines. They include:

~ restlessness
~ fatigue,
~ trouble concentrating
~ irritability,
~ muscle tension
~ sleep disturbances or difficulty falling asleep

Other sources such as the Anxiety Disorder Association of America and the Midwest Center for Stress and Anxiety include additional physical manifestations of GAD such as:

~ sweating
~ nausea
~ gastrointestinal discomfort or diarrhea
~ difficulty swallowing
~ trembling
~ dry mouth
~ racing heartbeat
~ numbness in the extremities

If you meet the criteria above, then chances are you're not suffering from some awful disease, you're suffering from GAD. Hopefully, this information helps to ease your mind (but if you're a worrier, it probably hasn't!). You've become accustom to thinking in an unhealthy and irrational way that perpetuates a cycle of worry.

Make the decision to be conscious of your thoughts; be aware how they can lead you in a downward spiral of negativity. Then make the decision to seek help. You'll be glad you did because you'll get relief and learn some healthy personal skills in the process. If you are experiencing physical symptoms, please see your general physician. If you are like many with anxiety, you fear going to the doctor, but push yourself so you can rule out any physical illness. Help squash those fears that keep you on edge.

These next suggestions are just as important. Find a mental health practitioner (therapist, counselor, psychologist, or psychiatrist) in your area who specializes in anxiety disorders. Please be sure they hold the proper licenses or certifications that your state requires. It's best to start by contacting your local or state psychological association affiliated with the American Psychological Association (APA). You can also go to the APA website at www.apa.org and search on their site for professionals dealing in anxiety in your area.

Many seek help for anxiety from their general practitioner; many women also consult their gynecologist. Often in these cases, as a first line of treatment patients are given medication in the form of antidepressants, benzodiazepines, and buspirone. While research has shown that these medications can be effective in treating emotional and physical symptoms, they do not foster thought and behavior modification. While a patient may experience relief after a period of time on medication, many experience gradual relapses after treatment has stopped.

Seeking the help of a mental health professional offers you the most advantageous blend of treatment options. Cognitive behavior therapy (CBT) is a treatment commonly used in helping people with anxiety. The therapist works with you to make you conscious of your thoughts and behaviors and provides methods for healthy change where necessary. CBT has been proven as extremely effective in treating GAD. The therapist may also recommend medication for some gaining the benefits of both pharmacological and organic treatment (CBT occurs naturally from within you!). Many with anxiety fear taking medication. Talk with your therapist to find the right treatment program for you.

Please check back to this lens as I will be updating with the latest information on GAD. I'll also be developing more lenses as part of the Anxiety Ed Program. Thank you for spending some time here. I hope it helps you.

I wish you calm.

Breathe.

Laugh.