Generalized Anxiety Disorder

What is generalized anxiety disorder?

Generalized anxiety disorder (GAD) is a condition in which a person worries excessively and unrealistically. They may also be jittery, restless, or dizzy. When these symptoms last for at least 6 months, a diagnosis of GAD may be made.

GAD may exist by itself, or with both anxiety and depression. It is estimated that almost 5% of people have had this disorder during their lives.

How does it occur?

The cause of GAD is unknown. Genetic and environmental factors play a role. Women have GAD about twice as often as men.

The worry in GAD is not about panic attacks or being afraid in public places. It is typically "free-floating" anxiety out of proportion to any real life situation. The worrying can interfere with normal day-to-day activities and work or school.

What are the symptoms?

Symptoms include excessive, unrealistic, and uncontrollable worrying about many things such as:

• the state of the world
• the economy
• violence in society
• your job
• the bills
• chores
• family members.

Physical symptoms such as muscle tension, sleep problems, or feeling on edge usually go along with anxiety. A person may be short-tempered and unable to focus or concentrate because of the worrying. People with GAD may be uneasy in a group or in a waiting room.

How is it diagnosed?

There is no lab test for GAD. Your healthcare provider or therapist will ask about your symptoms. He or she will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms.

If you have had the symptoms for at least 6 months, if you have had to cut back on your activities, and if you find it difficult to get things done, you may be diagnosed with generalized anxiety disorder.

How is it treated?

Different types of approaches have proven helpful in treating GAD. These include medication, behavior therapy, relaxation therapy, cognitive therapy, and stress management techniques. Which treatments your healthcare provider or therapist uses may depend upon how much the disorder interferes with your day-to-day life.

Antianxiety and antidepressant medicines are helpful. Some medicines are:

• buspirone (BuSpar)
• selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), paroxetine (Paxil), escitalopram (Lexapro), and citalopram (Celexa)
• benzodiazepines such as lorazepam (Ativan), clonazepam (Klonopin) and alprazolam (Xanax)
• venlafaxine (Effexor) or mirtazapine (Remeron).

How long will the effects last?

GAD can last many years and sometimes an entire lifetime. Research is expected to continue in an effort to learn more about this disorder.

What can I do for myself?

• Discuss your concerns with your healthcare provider or therapist.
• Discuss any physical symptoms or medicine you may be taking with your provider.
• Realize that you are not alone and that your anxiety can be overcome.
• Do not use alcohol or other drugs to overcome your anxiety.
• Exercise regularly.
• Avoid caffeine.
• Get 7 to 9 hours of sleep per night.
• Eat a healthy diet.
• Go to a stress management class in your local community.

For further information, see:

You may also want to contact the National Mental Health Association (NMHA). NMHA's toll-free Information Center number is 1-800-969-NMHA. Its web site address is http://www.NMHA.org.