Anxiety & Panic Disorders Health Center

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, too much or too little calcium, low blood sugar, and certain heart problems. A thorough evaluation by your doctor will determine if any of these conditions are the cause.

If no organic culprit can be found and the symptoms seem out of proportion to any situation you are facing, the condition may be classified as an anxiety disorder.

What Are the Treatments for Generalized Anxiety Disorder?

Medication is useful for alleviating the symptoms of generalized anxiety disorder (or GAD) and is often prescribed in conjunction with other therapies. Some types of these drugs can be addictive 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 curative in purpose.

Antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), are now also widely used for a variety of anxiety disorders and for the long-term management of anxiety problems. Examples of SSRIs that are sometimes used to treat chronic anxiety include Prozac, Zoloft, Celexa, Paxil, and Lexapro. The antidepressants Effexor and Cymbalta, which act on serotonin and norephinephrine, and some of the tricyclic antidepressants, like imipramine (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.

Drugs like Prozac, Zoloft, and Paxil are mostly preventive in nature. They:

• Need to be taken daily whether you have anxiety on that particular day or not
• Mostly prevent or minimize the next anxiety attack (preventive in nature)
• Are least helpful in immediately relieving an anxiety attack if you are in the middle of an attack (not curative)

Another antianxiety drug is Buspar (buspirone). It has fewer side effects than the benzodiazepines (mentioned below) 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.

The most prominent of antianxiety drugs for the purpose of immediate relief are those known as benzodiazepines; among them are lorazepam, diazepam, alprazolam, and clonazepam. 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.

Psychotherapy, with or without medication, is often considered a fundamental aspect of treatment for generalized anxiety disorder. Exercise and relaxation techniques can help with an anxiety episode, but a person with GAD needs professional help.