Generalized anxiety disorder (GAD) – causes, symptoms & treatment


Say you’ve got a huge presentation in front
of all your colleagues; you’re nervous, you’ve got quite a bit of stress leading
up to the presentation. That stress is completely normal, and really—probably useful in certain
situations since it can make you more alert and careful. After the presentation’s over
you feel the stress start to fade away, right? Well…for 3% of the population, the stress
doesn’t go away, and maybe that stress isn’t even brought on by a specific event and is
always just sort of always there. Either way, at this point it’s considered to be anxiety.
That anxiety might even get worse over time, and causes things like chest pains or nightmares. Sometimes the anxiety’s so severe that it
causes someone to be anxious about leaving the house or doing everyday things, like going
to work or school. This anxiety may be a sign of Generalized Anxiety Disorder, sometimes
shortened to GAD. GAD’s characterized by excessive, persistent, and unreasonable anxiety
about everyday things, like money, family, work, and relationships; even sometimes the
thought of getting through the day causes anxiety. If the anxiety’s persistent, then
it doesn’t seem to go away, if it’s excessive, it’s usually more than someone else might
feel, and if it’s unreasonable, they probably shouldn’t have a reason to feel anxious
about it. People who have GAD might even understand
that their anxieties are excessive and unreasonable, but they feel it’s out of their control
and don’t quite know how to stop it. People with severe GAD might be completely debilitated
and have trouble with the simplest daily activities, or they might be only mildly affected and
be able to function socially and hold down a job. Sometimes the feelings might worsen
or improve over time. In addition to having feelings of worries
and anxiety, other symptoms include edginess and restlessness, difficulty concentrating
or feeling like the mind just goes blank, and also irritability. These psychological
symptoms can also lead to physical manifestations of symptoms like digestive problems from eating
more or eating less. They might also have muscle aches and soreness from carrying tension
in their muscles. Finally difficulty sleeping is a really common symptom that can have a
serious impact on physical well-being, since the body’s not resting and can lead to issues
of chronic fatigue. Although the decision that someone’s worry
is excessive and unreasonable has a subjective quality, diagnosing GAD is aided by the diagnostic
and statistical manual of mental disorders, or DSM-V, this manual gives a list of criteria
to meet in order to be diagnosed with GAD. First, the excessive worry and anxiety has
to have been present for more days than not over the course of 6 months. In other words,
a person should have the symptoms of excess or unreasonable worry on 90 or more days out
of 180 days. Generally, people can’t quantify or track their feelings in that way, so again,
this is meant to offer a general guideline, right? Okay second—the person finds it hard
to control their anxiety, meaning that they have a hard time calming themselves or “self-soothing”
to help themselves regain control over their feelings. Third, an adult must have three
or more of the symptoms listed previously. In children though, typically defined as “school-age”,
so between 6 and 18 years old, only one symptom is needed for the diagnosis of GAD. Another
criteria is that the anxiety causes impairment in important daily activities like school
or work. For example, they might miss deadlines or find it difficult to even go to work because
of their symptoms. Fifth, the symptoms are not attributable to the physiologic effects
of a drugs or medication, or due to a medical condition like hyperthyroidism which creates
an excess of thyroid hormone, which can sometimes cause symptoms of anxiety and worry. Finally,
their anxiety isn’t better explained by another mental disorder like social phobia
or panic disorder. Just like a lot of mental disorders, it’s
unclear exactly why some individuals develop generalized anxiety disorder, but it’s thought
to be a combination of genetic and environmental factors, as it seems to run in families. It
also has been shown to be twice as prevalent in females than in males. Treating GAD, like many mental disorders,
may involve psychotherapy, medication, or a combination of the two. If it’s psychotherapy,
cognitive behavior therapy has been effective since it teaches the patient to think and
behave in different ways, and react differently to situations that would usually causes anxiety
and worry. Medications like benzodiazepines or antidepressants might be prescribed as
well, benzodiazepines are a type of psychoactive drug that have a relaxing and calming effect.
Antidepressants might also be prescribed, like selective serotonin reuptake inhibitors,
or SSRIs, which regulate the serotonin levels in the brain and help elevate mood. Even though
both medications and cognitive behavior therapy have similar effectiveness in the short-term,
cognitive behavior therapy has major advantages over medication in the long term, due to unwanted
effects of the medications like tolerance, dependence, and withdrawal.