Symptoms | Causes | Diagnostic Criteria | Treatments

Generalized anxiety disorder is a very debilitating mental illness characterized by intense irrational fear and worry that is not appropriate for the given situation. It is not uncommon for someone with this disorder to feel “on edge” most of the time and to even experience full blown panic attacks as a result of their anxiety.

Someone with generalized anxiety disorder may find it very difficult to do something as simple as making small talk with a cashier or even being in the presence of other people. They will usually isolate themselves from others or avoid the particular thing that gives them anxiety in order to help them feel “safe” and to help minimize the intense fear that the aforementioned stimuli would give them.

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The essential feature of this anxiety disorder is excessive anxiety and worry (apprehensive expectation) about a number of events or activities. The intensity, duration, or frequency of the anxiety and worry is out of proportion to the actual likelihood or impact of the anticipated event.

According to the DSM-5, adults with generalized anxiety disorder often worry about everyday, routine life circumstances, such as possible job responsibilities, health and finances, the health of family members, misfortune to their children, or minor matters.

Symptoms of Generalized Anxiety Disorder

Excessive worrying impairs the individual’s capacity to do things quickly and efficiently, whether at home or at work. The worrying takes time and energy; the associated symptoms of muscle tension and feeling keyed up or on edge, tiredness, difficulty concentrating, and disturbed sleep contribute to the impairment. While symptoms can vary, here are some of the most common ones:

• Excessive worrying
• Unable to control worrying
• Easily startled
• Irritable or “on edge”
• Feeling weak or tired
• Excessive sweating
• Difficulty concentrating
• Increased heart rate
• Muscle tension, trembling
• Trouble sleeping
• Unable to relax, restless
• Difficulty making decisions
• Feeling nauseous
• Extreme nervousness

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Causes of Generalized Anxiety Disorder

Temperamental, environmental, and genetic factors may play a significant role in the development of this mental disorder. In fact, one-third of the risk of experiencing this condition is genetic.

The median age at onset for generalized anxiety disorder is 30 years; however, age at onset is spread over a very broad range. Many individuals with this disorder report that they have felt anxious and nervous all of their lives.

Children and adolescents tend to worry more about school and sporting performance, whereas older adults report greater concern about the well-being of family or their own physical health. Thus, the content of an individual’s worry tends to be age appropriate.

The earlier in life individuals have symptoms that meet criteria for generalized anxiety disorder, the more comorbidity they tend to have and the more impaired they are likely to be.

In children and adolescents with generalized anxiety disorder, the anxieties and worries often concern the quality of their performance or competence at school or in sporting events, even when their performance is not being evaluated by others.

Although childhood adversities and parental overprotection have been associated with this condition, there are no environmental factors that have been identified as specific to this anxiety disorder or necessary or sufficient for making the diagnosis.

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Diagnostic Criteria

To get diagnosed with generalized anxiety disorder, one must undergo a psychiatric evaluation by a licensed mental health professional. This will often entail asking the patient numerous questions to better understand their family history, current symptoms, as well as the severity of those symptoms.

Another vital component of getting diagnosed with this mental illness is the length of time the symptoms have occurred for and how impactful they are in the patient’s daily life. In fact, according to the DSM-5, one of the diagnostic criteria for developing this disorder is that their symptoms of excessive anxiety and worry must occur more days than not for at least 6 months.

It is also important to note that the individual’s symptoms cannot be attributed due to a substance (i.e. drug abuse) or another medical condition.

For example, although someone may have a specific phobia or have social anxiety disorder, this does not mean that they also have generalized anxiety disorder, too. While there are many similarities between anxiety disorders, each condition that is accredited in the DSM-5 is distinct enough to garner its own diagnosis.

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Treatments for Generalized Anxiety Disorder

Cognitive behavioral therapy (CBT) and/or psychiatric medication may be very effective at helping to reduce symptoms of this disorder. Essentially, CBT helps to teach people different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and worried. Oftentimes, CBT is used in conjunction with a low dose of an antidepressant or an anti-anxiety drug.

Mindfulness meditation has been shown to help reduce stress levels and can help to relieve acute and chronic anxiety when practiced consistently. Essentially, it can help with redirecting one’s attention away from their fears and excessive worry thoughts to something that does not have any emotional baggage attached to it, such as focusing on the sensations of breathing.

Exercise, especially aerobic exercises like jogging or swimming have also been shown to help reduce anxiety. While weight lifting or anaerobic exercise can still produce advantageous results with regards to reducing one’s anxiety, most experts agree that aerobic exercise tends to be more beneficial.

Dialectical behavior therapy (DBT) may also be effective at treating some of the symptoms of this condition, especially with regards to regulating the emotion of fear. Although DBT is often used to treat people with emotion regulation issues, such as those seen in borderline personality disorder, DBT can also be beneficial for someone with general anxiety disorder too.

Some common drugs that may help treat this condition are SSRIs like Lexapro, Zoloft, and Prozac, among several others. Benzodiazepines like Valium, Xanax, and Ativan may also be prescribed to help with short term anxiety relief. Talk to your doctor or therapist to see what the best course of action is for you with regards to psychiatric medication.

If you think you may be suffering from some of the symptoms of this condition, then you may benefit from therapy. Feel free to reach out to your doctor or local mental health clinic to see what your available options are and to see if there is any sort of discount or promo code available to help you with the costs of treatment, as well as if your health insurance will cover treatment costs.

References:

• https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad/

• https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803

• https://medlineplus.gov/ency/article/000917.htm

• https://www.health.harvard.edu/anxiety/generalized-anxiety-disorder

• https://www.helpguide.org/articles/anxiety/generalized-anxiety-disorder-gad.htm

• https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad

• Diagnostic and Statistical Manual of Mental Disorders (DSM-5) https://www.psychiatry.org/psychiatrists/practice/dsm

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