Here is a site that talks about GAD (Generalized Anxiety Disorder)
From http://www.helpguide.org/mental/generalized_anxiety_disorder.htm
Please view this site for more information.
Generalized Anxiety Disorder (GAD):
Symptoms, Causes, and Treatment
Everyone gets worried sometimes, but if you have GAD, you stay worried, fear the worst will happen, and cannot relax. Sometimes you aren’t worried about anything special, but feel tense and worried all day long. You also have aches and pains for no reason and feel tired a lot.
Anxiety, the body’s reaction to a perceived, anticipated or imagined danger or threatening situation, is a common occurrence. Most people experience it before or after a stressful event, such as an important presentation or a traumatic loss. A little anxiety isn’t always a bad thing, either: it can help motivate you to do your best and to respond appropriately to danger.
In This Article:
Understanding generalized anxiety disorder (GAD)
Signs and symptoms of GAD
Causes and risk factors for GAD
Diagnosis of GAD
Treatment and help for GAD
Related links for GAD
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Sometimes, though, anxiety develops spontaneously, even when a stressful or threatening situation isn’t immediately apparent. When worry becomes so excessive and persistent that it limits or inhibits a person’s daily activities, it becomes a disorder that needs to be recognized and treated.
Understanding generalized anxiety disorder (GAD)
What is generalized anxiety disorder (GAD)? It’s only realistic to be worried about your finances after losing a job or your health if you start having chest pains. And it’s natural to be anxious about a sister who lives in a tough neighborhood or reports of a local flu epidemic or impending SATs. But generalized anxiety disorder isn’t about realistic or natural worries. GAD is about chronic, excessive worry concerning events that are unlikely to occur; it’s minor problems or concerns that wrap around your mind like kudzu and won’t let go.
Generalized anxiety disorder occurs when normal levels of anxiety become severe, prevent everyday activities, and persist over more than a few months. Normal life becomes difficult for people with GAD because they experience high levels of worry, dreading the immediate future and dwelling on what can go wrong, but feel unable to take action or control events. Generalized anxiety disorder affects 3 to 4 percent of the population at any given time, with women twice as likely to be affected as men.
According to the National Institutes of Mental Health (NIMH), persons with generalized anxiety disorder anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. A co-worker’s careless comment about the economy becomes a constant vision of an imminent pink slip; a spouse’s criticism of a new outfit becomes dread that the marriage is over. People with generalized anxiety disorder usually realize that their anxiety is more intense than the situation calls for, though some convince themselves that their worrying is protective or otherwise helpful. Either way, people with GAD can’t seem to turn off the worry. Sometimes just the thought of getting through the day produces anxiety. Most people with GAD don’t avoid workplace or social situations, but they go about their activities filled with exaggerated worry and tension, even though there is little or nothing to provoke them. For others, the anxiety and physical symptoms of generalized anxiety disorder interfere significantly with work, social interactions, and everyday functioning.
Signs and symptoms of generalized anxiety disorder (GAD)]
Sound Familiar?
“I can’t get my mind to stop…it’s driving me crazy!"
“He’s late - he was supposed to be here 20 minutes ago! Oh my God, he must have been in an accident!”
“I can’t sleep — I just feel such dread … and I don’t know why!”
The mind of a person with generalized anxiety disorder is like a car motor stuck on too high an idle: the person’s thoughts keep running and running, with worrisome thoughts being repeated endlessly. Typical symptoms and behaviors associated with generalized anxiety disorder are:
Typical Symptoms and Behaviors Associated with Generalized Anxiety Disorder
Psychological Physical Behavioral
chronic worry about events that are unlikely to occur
inability to shut off constant anxious thoughts
feelings of dread
restlessness and inability to relax
trouble falling asleep or staying asleep
lack of energy
twitching or trembling
muscular tension, aches or soreness
stomach problems (nausea or diarrhea)
headaches
chest pains
grinding of teeth
dry mouth
sweating or hot flashes
dizziness or lightheadedness
trouble concentrating
irritability
easy to startle
procrastination
If you have generalized anxiety disorder, your symptoms may fluctuate. You may notice better and worse times of the day, or better and worse days in general. Several sites can provide more information about the signs and symptoms of GAD.
Children and generalized anxiety disorder
In children, excessive worrying centers around issues such as future events, past behaviors, social acceptance, family matters, their personal abilities, and school performance. Unlike adults with GAD, children and teens with generalized anxiety disorder often don’t realize that their anxiety is disproportionate to the situation, so adults need to recognize their worries. Along with many of the symptoms that appear in adults with generalized anxiety disorder, some red flags for GAD in children are:
“What if” fears about situations far in the future
Perfectionism, excessive self-criticism, and fear of making mistakes
Feeling that they’re to blame for any disaster, and their worry will keep tragedy from occurring
The conviction that misfortune is contagious and will happen to them
Need for frequent reassurance and approval
Adults can help children with generalized anxiety disorder by understanding the disorder, listening carefully to a child’s feelings, staying calm in the face of the child’s anxiety, and praising progress, among other interventions.
Children’s Hospital in Boston has a detailed Web site discussing generalized anxiety disorder in children and adolescents.
Causes and risk factors for generalized anxiety disorder (GAD)
What are the causes of and risk factors for generalized anxiety disorder (GAD)? A precise cause of generalized anxiety disorder (GAD) is not known, but doctors have identified a variety of experiential, biological, environmental, psychological and cultural factors.
GAD is associated with irregular levels of neurotransmitters in the brain — chemicals that carry signals across nerve endings such as norepinephrine and serotonin. These irregularities can triggered by stressors in people who are predisposed to high levels of anxiety by hereditary factors and environmental influences; often traumatic events in early life can make a person vulnerable to anxiety disorders. Parenting style, family environment and culture may also influence whether a person is susceptible to developing GAD.
Research shows that generalized anxiety disorder tends to run in families, so a genetic link may be involved, but anxiety and fearfulness can also be learned behaviors transmitted to youngsters by adults in their lives. People of certain personality types are more susceptible to anxiety disorders, and, logically, a combination of stressful life situations may trigger excessive anxiety.
Specific medical conditions, such as an overactive thyroid gland, also can produce anxiety and its symptoms, and the stress of coping with a serious illness can lead to excessive worrying. Generalized anxiety disorder also occurs more frequently in people with chronic conditions such as diabetes or high blood pressure.
The Mayo Clinic article on generalized anxiety disorder has sections on the causes and risk factors for GAD.
Diagnosis of generalized anxiety disorder (GAD)
How is generalized anxiety disorder diagnosed? Generalized anxiety disorder is diagnosed when a person has felt intensely anxious on a day-to-day basis for six months or more. People with GAD often go to their doctors complaining of long-term problems like insomnia or physical symptoms such as stomachaches or headaches.
The doctor will probably perform a physical examination and order tests to rule out physical causes, such as overactive thyroid. Careful questioning and screening by the family doctor or a mental health professional can determine whether someone’s problem is GAD or another anxiety disorder.
Generalized anxiety disorder rarely occurs alone, according to the NIMH, and is often accompanied by depression or substance abuse or by other anxiety disorders. GAD is often difficult to diagnose because it lacks some of the dramatic symptoms of other anxiety disorders, such as panic attacks or the rituals of obsessive compulsive disorder. Conditions occurring with generalized anxiety disorder must also be treated using the appropriate therapies.
Treatment and help for generalized anxiety disorder (GAD)
What are the treatments for generalized anxiety disorder (GAD)? Psychotherapy, particularly cognitive behavioral therapy (CBT), is a key component of treatment for generalized anxiety disorder. Medication can also be used for generalized anxiety disorder treatment, either on its own or in combination with psychotherapy.
Cognitive Behavioral Therapy
Cognitive-behavioral therapy (CBT) for generalized anxiety disorder can be very effective. CBT examines distortions in our ways of looking at the world and ourselves. Negative thoughts lead to negative emotions, so CBT aims to change those negative thoughts before they trigger psychological difficulties. CBT for generalized anxiety disorder involves retraining the way you think. You therapist will help you identify automatic negative thoughts that contribute to your anxiety. For example, if you catastrophize—always imagining the worst possible outcome in any given situation—you might challenge this tendency through questions such as, “What is the likelihood that this worst-case scenario will actually come true?” and “What are some positive outcomes that are more likely to happen?”
According to the San Francisco Bay Area Center for Cognitive Therapy, cognitive behavioral therapy for GAD involves five components:
Cognitive Behavioral Therapy
Education
CBT teaches you about the cognitive, physical, and behavioral processes involved in anxiety. It also teaches you how to distinguish between helpful and unhelpful worry. An increased understanding of your anxiety encourages a more accepting and proactive response to it.
Monitoring
Through CBT, you learn to monitor your anxiety, including what triggers it, the specific things you worry about, and the severity and length of a particular episode. This data helps you get perspective, as well as track your progress.
Physical control strategies
Deep breathing and progressive muscle relaxation help decrease the physical over-arousal of the “fight or flight” response that maintains the state of fear and anxiety.
Cognitive control strategies
Through CBT, you are taught to realistically evaluate and alter the thinking patterns that contribute to your anxiety. As you challenge these negative thoughts, your fears will begin to subside. CBT also teaches you to test the beliefs you have about worry itself, such as “Worry is uncontrollable” or “If I worry, bad things are less likely to happen.”
Behavioral strategies
Instead of avoiding situations you fear, CBT teaches you to tackle them head on. You may start by imagining the thing you’re most afraid of. By focusing on your fears without trying to avoid or escape them, you will begin to feel more in control and less anxious. Time management and problem-solving skills are also effective behavioral techniques for GAD.
CBT for generalized anxiety disorder also involves training in relaxation techniques such as guided imagery (visualizing a soothing place), progressive muscle relaxation (systematic tensing and relaxing of the various muscle groups), and controlled breathing. Practice Your Breathing Skills outlines three deep breathing techniques that can counteract anxiety. Biofeedback has also been found to reduce symptoms in GAD.
Medication
Medication can be effective for generalized anxiety disorder. However, it is generally recommended only as a temporary measure to relieve symptoms at the beginning of the treatment process, with psychotherapy the key to long-term success. See Psych Central’s article on treatment for GAD for a discussion of drug therapy vs. alternative non-drug treatments.
There are three types of medication prescribed for generalized anxiety disorder:
Buspirone – This anti-anxiety drug, known by the brand name Buspar, is generally considered to be the safest drug for chronic anxiety. Unlike the benzodiazepines, buspirone isn’t sedating or addictive. Although buspirone will take the edge off, it will not entirely eliminate anxiety. Buspirone typically takes at least two weeks before it has a therapeutic effect.
Benzodiazepines – These anti-anxiety drugs act very quickly (usually within 30 minutes to an hour). The rapid relief the benzodiazepines provide is a major benefit. But there are serious drawbacks as well. Benzodiazepines are addictive, and both physical and psychological dependence are common after more than a few weeks of continuous use. They are generally recommended only for severe, paralyzing episodes of anxiety. Common brand names include Xanax and Valium.
Antidepressants – A number of antidepressants are used in the treatment of GAD. Commonly used brands include Effexor, Paxil, Prozac, Tofranil, and Lexapro. The relief antidepressants provide for anxiety is not immediate, and the full effect isn’t felt for up to six weeks.
For an in-depth look at the medications used for generalized anxiety disorder and the pros and cons of drug treatment, read Helpguide's Anxiety Medications: Benefits and Risks.
Other Generalized Anxiety Disorder Treatments
People with generalized anxiety disorder can adopt a number of effective self-help techniques. Using “self-talk” to intervene in your own anxious thoughts — forcing yourself to stop the cycle of anxiety and replace worried self-dialogue with practical dialogue — can help you learn how not to worry. Tips for learning how to “worry well” include:
Writing down and postponing worrisome matters until your body and mind are better able to handle them.
Challenging the thoughts brought on by anxiety.
Being prepared for stressful situations.
Read Coping Statements for Anxiety, for a helpful list of statements to use when you’re preparing for a stressful situation or feeling overwhelmed.
Improving physical wellness through healthy nutrition and regular exercise is often part of an effective treatment regimen as well. Relaxation skills that can be practiced at home are also important. For more information, read Helpguide's Stress Relief: Yoga, Meditation, and Other Relaxation Techniques.
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