Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is an anxiety disorder characterized by a syndrome of psychological and physiological symptoms that the individual experiences most of the time, rather than just sporadically. These symptoms include anxiety–fear or tension, excessive worry about a variety of issues/situations, becoming fatigued easily, concentration difficulty, irritability, muscle tension, and insomnia. Moreover, these symptoms are present continually for at least 6 months.

Many of these symptoms overlap with other types of psychiatric disorders, so it is important to distinguish them from other anxiety and mood disorders in particular. Further, there are many medical illnesses which can cause some or all of these symptoms. Therefore, a comprehensive evaluation will look for these other illnesses, such as thyroid problems, vitamin deficiencies, and others.

Treatment can be highly effective and may include either medicine and/or psychotherapy. Medicines commonly used include the so-called antidepressants, particularly the SSRI’s (selective serotonin reuptake inhibitors), and the SNRI’s (serotonin and norepinephrine reuptake inhibitors). Unfortunately, many people are prescribed benzodiazepines for GAD, but they are not the treatment of choice since the antianxiety effect probably does not continue after a few months, but the individual develops physical dependence by that time.

Cognitive-behavioral psychotherapy has been shown to be as effective as medicine for some people. It involves learning about one’s automatic thought patterns and how these patterns inadvertently maintain the anxiety. The behavioral component may include learning about progressive muscle relaxation and breathing techniques which can have a powerful benefit.