“I always thought I was just a worrier. I’d feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days. I’d worry about what I was going to fix for a dinner party, or what would be a great present for somebody. I just couldn’t let something go.”
“When my problems were at their worst, I’d miss work and feel just terrible about it. Then I worried that I’d lose my job. My life was miserable until I got treatment.”
“I’d have terrible sleeping problems. There were times I’d wake up wired in the middle of the night. I had trouble concentrating, even reading the newspaper or a novel. Sometimes I’d feel a little lightheaded. My heart would race or pound. And that would make me worry more. I was always imagining things were worse than they really were. When I got a stomachache, I’d think it was an ulcer.”
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.
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.
When their anxiety level is mild, people with GAD can function socially and hold down a job. Although they don’t avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe.
GAD affects about 6.8 million American adults, including twice as many women as men. The disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age. There is evidence that genes play a modest role in GAD.
Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone. GAD is commonly treated with medication or cognitive-behavioral therapy, but co-occurring conditions must also be treated using the appropriate therapies.
When to Seek Medical Advice
Both adults and children with Generalized Anxiety Disorder are constantly plagued by worries.
They may feel anxious and worried about things both large and small, such as:
- Sports performance
- Car repairs
- Household chores
- Airplane flights
- Their own and others’ health
Those with GAD may find it impossible to banish fears and worries, even when trying to relax or unwind. This anxiety can go on for months and months. They may feel as if they’ve lost control over managing it. And it may interfere with their ability to carry out daily routines.
Their worries are unlikely to simply go away on their own, and they may actually get worse over time. It’s best to seek professional help even before the anxiety becomes severe — it may be easier to treat.
Signs & symptoms of Generalized Anxiety Disorder can vary in combination or severity.
Symptoms may include:
- Feeling of being keyed up or on edge
- Feeling a lump in your throat
- Difficulty concentrating
- Being easily distracted
- Muscle tension
- Trouble falling or staying asleep
- Excessive sweating
- Shortness of breath
- Difficulty swallowing
If an individual has GAD they may feel on edge about many or all aspects of life. For example, they may feel intense worry about their safety or that of loved ones, or have a general sense that something bad is about to happen, even when there’s no apparent danger.
GAD often begins at an early age, and the signs and symptoms may develop more slowly than in other anxiety disorders. Many people with GAD can’t recall when they last felt relaxed or at ease.
The two main treatments for Generalized Anxiety Disorder are psychotherapy and medications, either alone or in combination.
Also known as talk therapy or counseling, psychotherapy involves receiving help from a mental health provider through a combination of talking and listening. Evidence shows that cognitive behavior therapy in particular can help improve symptoms of GAD.
Cognitive behavior therapy helps identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. It’s based on the idea that our own thoughts — not other people or situations — determine how we behave. Even if an unwanted situation doesn’t change, we can change the way we think and behave in a positive way. Generally a short-term treatment, cognitive behavior therapy emphasizes learning to develop a sense of mastery and control over thoughts and feelings.
Treatment for GAD or any mental illness is tailored to each person. No single treatment regimen works for everyone. Most treatment occurs on an outpatient basis, but some people may need care in a hospital setting.
Several different types of medications are used to relieve Generalized Anxiety Disorder symptoms:
Anti-anxiety medications. Benzodiazepines are sedatives that have the advantage of easing anxiety within 30 to 90 minutes. On the downside, they can be habit-forming if taken for more than a few weeks. For this reason, the doctor may prescribe them for only a short time to help get through a particularly rough period. The most commonly prescribed sedatives include alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium) and lorazepam (Ativan).
These medications may cause unsteadiness, drowsiness, reduced muscle coordination and problems with balance. Higher doses and long-term use can cause memory problems.
A different type of anti-anxiety medication often prescribed for GAD is buspirone (BuSpar). While this medication typically takes several weeks to improve symptoms, it doesn’t pose a risk of dependence. A common side effect of buspirone is a brief feeling of lightheadedness shortly after taking it. Less common side effects include headaches, nausea, nervousness and insomnia.
Anti-depressants. These medications influence the activity of certain neurotransmitters that are thought to play a role in anxiety disorders. Examples of antidepressants used to treat GAD include fluoxetine (Prozac), paroxetine (Paxil), imipramine (Tofranil), venlafaxine (Effexor), escitalopram (Lexapro) and duloxetine (Cymbalta).
Coping & Support
- Joining an anxiety support group. Here, individuals with GAD can find compassion, understanding and shared experiences.
- Taking action. Working with a mental health provider to figure out what’s making the person anxious and address it.
- Letting it go. Don’t dwell on past concerns. Change what can be changed and let the rest take its course. Repeat as needed.
- Breaking the cycle. When feeling anxious, take a brisk walk or delve into a hobby to refocus the mind away from worries.
- Self care. Get enough rest, eat a balanced diet, exercise and take time to relax. Avoid caffeine and nicotine, which can worsen anxiety. Don’t turn to alcohol or un-prescribed drugs for relief.
- Sticking to a treatment plan. Take medications as directed. Keep therapy appointments. Consistency can help keep treatment plans on track.
- Don’t let worries isolate them from loved ones or enjoyable activities. Touching base with others offers a healthy diversion.
- Allow their faith in God to help through the daily activities and responsibilities. Focus on the good things in life and be grateful for them.
- Bourne, Edmund J., and Lorna Garano. Coping with Anxiety. Oakland, CA: New Harbinger Publications, 2003.
- Brantley, Jeffrey. Calming Your Anxious Mind. Oakland, CA: New Harbinger Publications, 2003.
- Copeland, Mary Ellen. The Worry Control Workbook. Oakland, CA: New Harbinger Publications, 1998.
- White, John. Overcoming Generalized Anxiety Disorder: Therapist Protocol and Client Manual. Oakland, CA: New Harbinger Publications, 1999.
Written by: Maureen Vogt, MA, LPC
As a Licensed Professional Counselor, Maureen has dedicated her career to working with Generalized Anxiety, OCD, panic and phobias, depression, low self-esteem, eating problems, interpersonal relationships, trauma, abuse, personality challenges, adoption issues, and ADHD.