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Symptoms and Treatment of Anxiety (GAD)
By peace | May 3, 2006
Generalized anxiety disorder (GAD) is a common condition. It is characterized by excessive anxiety and worry, which is out of proportion to the impact of the event or circumstance that is the focus of the worry.
For example, while college students often worry about tests, a student who constantly worries about failure — despite getting consistently good grades — has the pattern of worry typical of this disorder.
The person finds it difficult to control the worry. The cause of GAD is not known, but biological and psychological factors play a role. Stressful life situations or maladaptive behavior, acquired through learning, may also contribute to GAD.
The disorder may start at any time in life, including childhood. Most patients with the disorder report that they have been anxious for as long as they can remember. GAD occurs somewhat more often in women than in men.
Anxiety and worry are often associated with the following symptoms:
- Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
- The person finds it difficult to control the worry.
- The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months; children don’t need to meet as many criteria).
* restlessness or feeling keyed up or on edge
* being easily fatigued
* difficulty concentrating or mind going blank
* irritability
* muscle tension
* sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
Additionally, the anxiety or worry is not about having a Panic Attack, being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder (PTSD).
The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.
A physical examination and a psychological evaluation should be completed in order to rule out other causes of anxiety. Physical disorders that may mimic an anxiety state should be ruled out, as well as drug-induced symptoms. Various diagnostic tests may be done in this process.
Treatment may involve specific medications that provide a sedative (sleep-inducing) or calming effect. Other drugs that have the favorable side effect of reducing anxiety may be used, such as antihistamines. A common class of anti-anxiety medications, benzodiazepines, are used with caution because they can impair judgment and have a high potential for addiction.
Two kinds of therapy have been effective in treating GAD. Behavioral therapy uses relaxation training (a systematic relaxation of the major muscle groups in the body). Cognitive behavioral therapy helps patients identify cognitions — thoughts — that contribute to anxiety.
Caffeine and other stimulants that can make anxiety worse should be reduced or eliminated.
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