Generalized Anxiety Disorder (GAD)

| May 1, 2012 | 0 Comments

This is a chronic anxiety condition that comes about due to excessive and irrational worry about everyday things. It is much different from a phobia, where a fear is connected to a certain thing, but in GAD, the anxiety and apprehension is far and wide, it is an outlook of dread.

The level of anxiety experienced is less than a panic attack, but because of its chronic nature, relaxation becomes a luxury and a normal life impossible. The things these people worry about are the exact same things everyone worries about, such as health, fiancés, relationships, but these persons take these worries to new levels.

Persons with GAD may also find themselves experiencing sleep difficulties, either unable to get or stay asleep, and are more prone to adrenaline fright attacks. Persons may not even know that they have GAD until multiple doctor visits, since a diagnosis is difficult to make based on a single evaluation. While GAD may be manageable by some, for others it will be debilitating, and although these persons do not generally avoid socially awkward situations, their response to them is poor. It will generally ensue in childhood, but develops slowly, and may only become fully diagnosed as an adult or more commonly in adolescence. It is more prevalent in women and also shows a possible genetic link, since it runs in families.

Symptoms of Generalized Anxiety Disorder

A diagnosis of GAD is made following a continuous six month period of worries, sometimes with associated limitation of ability to work. The diagnosis is based on symptoms present at the time of visit which may include:

Emotional Symptoms

  • Sense of impending disaster
  • Lack of spontaneity- you must plan your every move to feel a bit at rest
  • Constant thought about possible anxiety sources such as what to make for dinner

Behavioural symptoms

  • Overwhelmed feeling so constant put offs and delays
  • Poor concentration or focus on important things
  • Unable to be alone or enjoy quiet time

Physical Symptoms

  • Digestion problems including nausea, constipation or diarrhea
  • Trouble falling asleep or staying asleep because of constant worrying
  • Frequent muscle pains and body aches
  • Headaches
  • Restless, jittery feeling all day long.

Causes of General Anxiety Disorders

Although there are various mechanisms by which anxiety may result, they are not definitive causes. This is because one person may experience the same stimuli, but may react completely different. However, general anxiety disorder seems to develop based upon contribution of various factors, including:

  • Genetics- there appears to be a link between anxiety disorders and certain genes, passed down through families. This would explain why if you have a first degree relative with the disorder, the chances of you developing it are much higher.
  • External Factors- traumatic events or stressful scenarios, such as job difficulties, death of a loved one or abuse and trigger acute anxiety attacks. Over time, these can worsen into chronic anxiety disorders, including GAD. Use of drugs or substances with addictive potential which use withdrawal symptoms can also lead to development or worsening of anxiety disorders.
  • Brain Chemistry- the levels of chemical substances in the brain, called neurotransmitters, are sometimes altered in cases of GAD.         Neurotransmitters are necessary to transmit nerve impulses (including messages and responses) within nerve cells, low levels of which would lead to impairment of this function. This possibly explains why there is an abnormal response to stress and anxiety triggers.

Treatment of Generalized Anxiety Disorders

There are many different treatments available for GAD. Some may involve use of medication, while others may work through behavioural modification.  There are many different classes of drugs used which may include:

  • Benzodiazepines- these are known anti-anxiety drugs sometimes called tranquilizers. They remove the physical symptoms of anxiety such as the tremor, muscle tension, palpitations or restlessness. They leave the patient feeling relaxed and calm. Members of this drug class include lorazepam, alprazolam and diazepam. They are more appropriate for short term treatment as they do possess minor addictive potential.
  • Anti-depressants- these include the new generation SSRIs (selective serotonin reuptake inhibitors) such as sertraline, paroxetine, and older tricyclic anti-depressants such as anafranil.


Generalized Anxiety Disorder

Generalized Anxiety Disorder

This type of treatment may involve something called Cognitive Behavioural Therapy. This involves encouraging the affected to identify their irrational thoughts and attitudes and remedy themselves.

Behavioural Techniques

These include relaxation techniques and methods to gradually increase exposure to a trigger to show that it can be overcome.

A combination of psychotherapy and medication usually yield the best results, within a period of two to three months.

Side-effects of GAD Treatment

Side-effects are a possibility when using treatment for GAD, which may include:

  • SSRIs- nausea, vomiting, urinary retention, insomnia, photosensitivity, diarrhea, bruxism, nightmares, drowsiness.
  • Tricyclic Anti-depressants- dry mouth, blurred vision, bradycardia (slow heart beat), delays in ejaculation, urinary retention, constipation.
  • Benzodiazepines- sedation, decreased alertness, nightmares, decreased libido, tremors, withdrawal symptoms upon cessation.

Prevention of GAD

There are methods you can practice to reduce the chance of you developing GAD, which may include techniques such as yoga, relaxation and breathing exercises. Also, avoid things that make you more anxious or prone to jitters, such as caffeine or high sugar meals. It is also possible that if you avoid situations such as confrontational approaches, limit late night outings and take good care of your body, you greatly decrease your chances of developing GAD

An ounce of prevention is worth more than a pound of cure.

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Category: Anxiety

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