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Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is characterized by six months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. People with this disorder usually expect the worst. They worry excessively about money, health, family or work, even when there are no signs of trouble. They are unable to relax and often suffer from insomnia. Many people with GAD also have physical symptoms, such as fatigue, trembling, muscle tension, headaches, irritability or hot flashes.

Fortunately, through research supported by the National Institute of Mental Health (NIMH), effective treatments have been developed to help people with GAD.

Causes

Some research suggests that GAD may run in families, and that it may grow worse during stress. GAD usually begins at an earlier age and symptoms may manifest themselves more slowly than in most other anxiety disorders.

Treatments

Treatments for GAD include medications and behavioral or cognitive-behavioral therapy.

  • Medication: Successful treatment may include antianxiety medications, such as buspirone and the benzodiazepines or antidepressants.
  • Behavioral therapy: Behavioral therapy focuses on using specific relaxation techniques to change anxiety-causing behaviors. For example, one technique trains patients in a special breathing exercise involving slow, deep breaths to reduce anxiety. This is necessary because people who are anxious often hyperventilate, taking rapid, shallow breaths that can trigger rapid heartbeat, lightheadedness, and other symptoms. Another technique—exposure therapy—gradually exposes patients to what frightens them and helps them cope with their fears.
  • Cognitive-behavioral therapy: Like behavioral therapy, cognitive-behavioral therapy teaches patients to react differently to the situations and bodily sensations that trigger anxiety symptoms. However, patients also learn to understand how their thinking patterns contribute to their symptoms and how to change their thoughts so that symptoms are less likely to occur. This awareness of thinking patterns is combined with behavioral techniques to help people confront their feared situations.

Co-occurring Illnesses

Research shows that GAD often coexists with depression, substance abuse, or other anxiety disorders. Other conditions associated with stress, such as irritable bowel syndrome, often accompany GAD. Patients with physical symptoms, such as insomnia or headaches, should also tell their doctors about their feelings of worry and tension. This will help the patient's health care provider to recognize that the person is suffering from GAD.

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