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Generalized Anxiety Disorder

Generalized anxiety disorder (or GAD) is characterized by excessive, exaggerated anxiety and worry about everyday life events with no obvious reasons for worry. People with symptoms of generalized anxiety disorder tend to always expect disaster and can't stop worrying about health, money, family, work, or school. In people with GAD, the worry is often unrealistic or out of proportion for the situation. Daily life becomes a constant state of worry, fear, and dread. Eventually, the anxiety so dominates the person's thinking that it interferes with daily functioning, including work, school, social activities, and relationships.

What Are the Symptoms of GAD?

GAD affects the way a person thinks, but the anxiety can lead to physical symptoms, as well. Symptoms of GAD can include:

  • Excessive, ongoing worry and tension
  • An unrealistic view of problems
  • Restlessness or a feeling of being "edgy"
  • Irritability
  • Muscle tension
  • Headaches
  • Sweating
  • Difficulty concentrating
  • Nausea
  • The need to go to the bathroom frequently
  • Tiredness
  • Trouble falling or staying asleep
  • Trembling
  • Being easily startled

In addition, people with GAD often have other anxiety disorders (such as panic disorder or phobias), obsessive-compulsive disorder, clinical depression, or additional problems with drug or alcohol misuse.  

What Causes GAD?

The exact cause of GAD is not fully known, but a number of factors -- including genetics, brain chemistry, and environmental stresses -- appear to contribute to its development.

  • Genetics: Some research suggests that family history plays a part in increasing the likelihood that a person will develop GAD. This means that the tendency to develop GAD may be passed on in families.
  • Brain chemistry: GAD has been associated with abnormal functioning of certain nerve cell pathways that connect particular brain regions involved in thinking and emotion.  These nerve cell connections depend on chemicals called neurotransmitters that transmit information from one nerve cell to the next.  If the pathways that connect particular brain regions do not run efficiently, problems related to mood or anxiety may result.  Medicines, psychotherapies, or other treatments that are thought to "tweak" these neurotransmitters may improve the signaling between circuits and help to improve symptoms related to anxiety or depression. 
  • Environmental factors: Trauma and stressful events, such as abuse, the death of a loved one, divorce, changing jobs or schools, may lead to GAD. GAD also may become worse during periods of stress. The use of and withdrawal from addictive substances, including alcohol, caffeine, and nicotine, can also worsen anxiety.

How Common Is GAD?

About 4 million adult Americans suffer from GAD during the course of a year. It most often begins in childhood or adolescence, but can begin in adulthood. It is more common in women than in men.

How Is GAD Diagnosed?

If symptoms of GAD are present, the doctor will begin an evaluation by asking questions about your medical and psychiatric history and perform a physical exam. Although there are no lab tests to specifically diagnose anxiety disorders, the doctor may use various tests to look for physical illness as the cause of symptoms.

The doctor bases his or her diagnosis of GAD on reports of the intensity and duration of symptoms -- including any problems with functioning caused by the symptoms. The doctor then determines if the symptoms and degree of dysfunction indicate a specific anxiety disorder. GAD is diagnosed if symptoms are present for more days than not during a period of at least six months. The symptoms also must interfere with daily living, such as causing you to miss work or school.

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