Understanding Generalized Anxiety Disorder -- Diagnosis and Treatment
How Do I Know If I Have Generalized Anxiety Disorder?
The first step is to rule out the possibility that your symptoms are being caused by a medical condition that is not psychiatric. Among the conditions that produce symptoms similar to those of anxiety are hyperthyroidism or other endocrine problems, too much or too little calcium, low blood sugar, and certain heart problems. A thorough evaluation by your health care provider will determine if any of these conditions are the cause of your symptoms.
If no other medical culprit can be found and the symptoms seem out of proportion to any situation you are facing, you may be diagnosed with an anxiety disorder.
What Are the Treatments for Generalized Anxiety Disorder?
Medication for Anxiety
Medication is useful for alleviating the symptoms of generalized anxiety disorder and is often prescribed in conjunction with other therapies. Some types of anxiety drugs can be habit-forming and are usually prescribed on a short-term or as-needed basis.
Different anxiety disorders have different medication regimens. Some are preventive and some are designed to cure the problem.
Antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), are widely used to treat and prevent a variety of anxiety disorders. Examples of SSRIs that are commonly used to treat chronic anxiety include Prozac, Zoloft, Celexa, Paxil, and Lexapro. The antidepressants Effexor and Cymbalta, which act on the brain chemicals serotonin and norephinephrine, and some of the tricyclic antidepressants, like Tofranil, may also help. Finally, antihistamines (such as hydroxyzine) and beta-blockers (such as propranolol) can help mild cases of anxiety as well as performance anxiety, a type of social anxiety disorder. These medicines need to be taken daily whether you have anxiety on that particular day or not, as prescribed by your health care provider.
If you have acute anxiety (panic attack), you will likely need to take an anti-anxiety medicine as well. The most prominent of anti-anxiety drugs for the purpose of immediate relief are those known as benzodiazepines; among them are Ativan, Valium, Librium, Xanax, and Klonopin. They have drawbacks: Benzodiazepines sometimes cause drowsiness, irritability, dizziness, memory and attention problems, and physical dependence. Nonetheless, in recent decades they have largely replaced barbiturates because they tend to be safer if taken in large doses.
Another anti-anxiety drug is Buspar. It has fewer side effects than the benzodiazepines and is not associated with dependence. Buspar has its own side effects and may not always be as effective when a person has taken benzodiazepines in the past.
Several specific forms of psychotherapy have been described in research studies as helpful for alleviating the symptoms of GAD. Two -- psychodynamic psychotherapy and supportive-expressive therapy -- focus on anxiety as an outgrowth of feelings about important relationships. Another form of psychotherapy, called cognitive-behavioral therapy, involves learning behavioral relaxation techniques as well as restructuring patterns of thinking that foster anxiety.