Generalized Anxiety Disorder: When Worry Gets Out of Control
Are you extremely worried about everything in your life, even if there is little or no reason to worry? Are you very anxious about just getting through the day? Are you afraid that everything will always go badly?
If so, you may have an anxiety disorder called generalized anxiety disorder (GAD).
What is GAD?
All of us worry about things like health, money, or family problems. But people with GAD are extremely worried about these or other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks.
GAD develops slowly. It often starts during the teen years or young adulthood. Symptoms may get better or worse at different times, and often are worse during times of stress.
People with GAD may visit a doctor many times before they find out they have this disorder. They ask their doctors to help them with headaches or trouble falling asleep, which can accompany GAD but they don’t always get the help they need right away. It may take doctors some time to be sure that a person has GAD instead of something else.
What causes GAD?
GAD sometimes runs in families, but no one knows for sure why some people have it, while others don’t. Researchers have found that several parts of the brain are involved in fear and anxiety. Research suggests that the extreme worries of GAD may be a way for a person to avoid or ignore some deeper concern. If the person deals with this concern, then the worries of GAD would also disappear. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
What are the signs and symptoms of GAD?
A person with GAD may:
Worry very much about everyday things
Have trouble controlling their constant worries
Know that they worry much more than they should
Have trouble relaxing
Have a hard time concentrating
Be easily startled
Have trouble falling asleep or staying asleep
Feel tired all the time
Have headaches, muscle aches, stomach aches, or unexplained pains
Have a hard time swallowing
Tremble or twitch
Be irritable, sweat a lot, and feel light-headed or out of breath
Have to go to the bathroom a lot.
How is GAD treated?
First, talk to your doctor about your symptoms. Your doctor should do an exam to make sure that an unrelated physical problem isn’t causing the symptoms. The doctor may refer you to a mental health specialist.
GAD is generally treated with psychotherapy, medication, or both.
Psychotherapy. A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful for treating GAD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and worried.
Medication. Doctors also may prescribe medication to help treat GAD. Two types of medications are commonly used to treat GAD—anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time.
Antidepressants are used to treat depression, but they also are helpful for GAD. They may take several weeks to start working. These medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.
It's important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults. A "black box"—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts. Anyone taking antidepressants should be monitored closely, especially when they first start treatment.
Some people do better with CBT, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you.
What is it like to have GAD?
"I was worried all the time about everything. It didn't matter that there were no signs of problems, I just got upset. I was having trouble falling asleep at night, and I couldn't keep my mind focused at work. I felt angry at my family all the time.
"I saw my doctor and explained my constant worries. My doctor sent me to someone who knows about GAD. Now I am taking medicine and working with a counselor to cope better with my worries. I had to work hard, but I feel better. I'm glad I made that first call to my doctor."
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