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Alternative Names Return to topGAD; Anxiety disorder
Definition Return to top
Generalized anxiety disorder (GAD) is a pattern of frequent, constant worry and anxiety over many different activities and events.
Causes Return to top
Generalized anxiety disorder (GAD) is a common condition. The cause of GAD is not known, but biological and psychological factors play a role. Stressful life situations or behavior developed through learning may also contribute to GAD.
The disorder may start at any time in life, including childhood. Most people with the disorder report that they have been anxious for as long as they can remember. GAD occurs somewhat more often in women than in men.
Symptoms Return to top
Generalized anxiety disorder has the following symptoms:
Depression and substance abuse may occur with an anxiety disorder.
Exams and Tests Return to top
A physical examination and psychological evaluation can rule out other causes of anxiety. The health care provider should rule out physical disorders that may mimic anxiety, as well as symptoms caused by drugs. This process may include different tests.
Treatment Return to top
The goal of treatment is to help the person function well. The success of treatment usually depends on the severity of the generalized anxiety disorder.
Cognitive-behavioral therapy (CBT) and medications are the mainstays of treatment.
Selective serotonin reuptake inhibitors (SSRIs) are usually the first choice in medications. Serotonin-norepinephrine reuptake inhibitors (SNRIs) are another choice. Other antidepressants and some antiseizure drugs may be used for severe cases.
Other anti-anxiety medications may also be prescribed. Benzodiazepines may be recommended if antidepressants don't help.
Behavioral therapies that may be used with drug therapy include:
Other counseling and therapy techniques may help people gain an understanding of the illness and the factors that protect against or trigger it.
A healthy lifestyle that includes exercise, enough rest, and good nutrition can help reduce the impact of anxiety.
Support Groups Return to top
Support groups may be helpful for some patients with GAD. Patients have the opportunity to learn that they are not unique in experiencing excessive worry and anxiety.
Support groups are not a substitute for effective treatment, but can be a helpful addition to it.
Outlook (Prognosis) Return to top
The disorder may continue and be difficult to treat, but most patients see great improvement with medications or behavioral therapy.
Possible Complications Return to top
People with GAD may develop other psychiatric disorders, such as panic disorder or depression. Substance abuse or dependence may become a problem if you try to self-medicate with drugs or alcohol to relieve anxiety.
When to Contact a Medical Professional Return to top
Call your health care provider if:
References Return to top
Ebell MH. Diagnosis of anxiety disorders in primary care. Am Fam Physician. 2008;78:501-502.
Gale C, Davidson O. Generalised anxiety disorder. BMJ. 2007;334:579-581.
Schneier FR. Clinical practice: social anxiety disorder. New Engl J Med. 2006;355:1029-1036.
Katon WJ. Clinical practice: panic disorder. New Engl J Med. 2006;354:2360-2367.
Connolly SD, Bernstein GA, Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2007;46:267-283.Update Date: 1/15/2009 Updated by: Christos Ballas, MD, Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.