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What is Generalized Anxiety Disorder?

People with generalized anxiety disorder (GAD) go through the day filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. Sometimes just the thought of getting through the day produces anxiety.

Generalized anxiety usually does not cause people to avoid situations, and there isn’t an element of a "panic attack" involved in the prognosis, either. It’s the inability to shut the mind off that incapacitates the person. Other times, thoughts seem almost non-existent because the anxious feelings are so dominant. Feelings of worry, dread, lack of energy, and a loss of interest in life are common. Many times there is no "trigger" or "cause" for these feelings and the person realizes these feelings are irrational. Nevertheless, the feelings are very real. At this point, there is no "energy" or "zest" in life and no desire to want to do much.

STATISTICS
GAD affects about 6.8 million adult Americans and about twice as many women as men. The disorder comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age. It is diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems. There is evidence that genes play a modest role in GAD.

SYMPTOMS
Physical manifestations of generalized anxiety may include headaches, trembling, twitching, irritability, frustration, and inability to concentrate. Sleep disturbances may also occur. Elements of social phobia and/or panic may sometimes be present, such as high levels of self-consciousness in some situations, and fear of not being able to escape from enclosed spaces.

It is also common, but not universal, for people with generalized anxiety to experience other problems, such as a lack of ability to fully relax and the propensity to be in a state of constant motion. It is difficult for some people with generalized anxiety to settle down enough to have a quiet, reflective time where they can calm down, relax, and feel some peace and tranquility. Strategies to peacefully calm down and relax are one part in overcoming this problem.

DIAGNOSIS
GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months. People with GAD can't seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They can't relax, startle easily, and have difficulty concentrating. Often they have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.

TREATMENT
In general, anxiety disorders are treated with medication, specific types of psychotherapy, or both. Treatment choices depend on the problem and the person's preference. Before treatment begins, a doctor must conduct a careful diagnostic evaluation to determine whether a person's symptoms are caused by an anxiety disorder or a physical problem. If an anxiety disorder is diagnosed, the type of disorder or the combination of disorders that are present must be identified, as well as any coexisting conditions, such as depression or substance abuse. Sometimes alcoholism, depression, or other coexisting conditions have such a strong effect on the individual that treating the anxiety disorder must wait until the coexisting conditions are brought under control.

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