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How Is Generalized Anxiety Disorder Diagnosed?

Although everyone uses the term anxiety to describe feelings of trepidation and nervousness about uncertain situations, generalized anxiety disorder (GAD) is a much more severe condition. One of the more common anxiety disorders, GAD affects about 3.1% of the adult US population—over 6 million people.

What is Generalized Anxiety Disorder?

GAD is a psychological disorder in which excessive, persistent, and intrusive feelings of worry take over a person’s life. People with GAD may worry about events that might occur, but they have no real reason to worry. GAD was once called “free-floating anxiety,” and that’s still a good description. A person with GAD experiences worry and fear that are not attached to any stressor.

What Causes GAD?

As is common with most mental illnesses, the precise cause of GAD is unknown. Some major contributors to the development of GAD include genetics, traumatic experiences, long-term stress, and negative early life experiences. Some research studies have shown minute abnormalities in the brains of people with GAD, particularly in the amygdala, a group of brain tissues that affect the management of emotions.

Risk Factors for GAD

These are the most commonly identified risk factors for GAD:

  • Gender. GAD affects twice as many women as men.
  • Prior stressful life events. People who have suffered trauma, abuse, neglect, or deprivation also are at an elevated risk of GAD. Other events that may contribute to GAD include the illness or death of a loved one, divorce, and so forth.
  • Unmanaged stress. Ongoing stressful situations can prompt GAD, lowering a person’s coping ability.
  • Illness. Those with chronic illnesses are at an increased risk of GAD, as are those taking care of people with a chronic illness.
  • Substance abuse. People who experience substance or alcohol use disorder may also have GAD.
  • Concurrent or past mental health diagnoses. People with depression and bipolar disorder can also have GAD.
  • Inadequate coping skills. People who feel unequipped to cope with life events often have persistent feelings of dread and worry.

What Are the Signs and Symptoms of GAD?

GAD has physical and psychological symptoms, as anxiety is a mental and biological response to a threat or a likely threat. In GAD, there is neither an impending nor a likely threat, but a person’s body responds as if danger were present.

The typical signs and symptoms of GAD include:

  • Persistent feelings of impending doom or danger (the hallmark symptom of GAD)
  • Feeling on edge, jittery, nervous, or irritable
  • Persistent, repetitive, and intrusive feelings of dread and worry
  • Problems concentrating
  • Elevated heart rate
  • Occasional hyperventilation, sweats, trembling
  • Feeling tired, weak
  • Muscles, aches, and pains not explained by a physical condition
  • Twitches or involuntary movement in the hands or feet
  • Headaches
  • Trouble sleeping—either going to sleep, staying asleep, or waking up too early
  • Aggravated gastrointestinal disorders (nausea, vomiting, stomach cramps, diarrhea, constipation, acid reflux)

Unlike other anxiety disorders, people with GAD do not suffer from panic attacks.

How is GAD Diagnosed?

When a person finds it difficult or impossible to control worry on more days than not for at least 6 months, has at least 3 of the hallmark symptoms, and is experiencing negative consequences of their worry, GAD is diagnosed. GAD is most often diagnosed during a standard anxiety screening, which includes measures like the Generalized Anxiety Disorder Scale.

Distinguishing GAD From Other Mental Health Issues

In addition to the symptoms we’ve discussed, GAD can be recognized by the broad, general scope of the issues sufferers worry about and the low likelihood of these events happening. The degree of dread, worry, and fear that these situations might come to pass is far more than what would normally be experienced.

People often confuse panic disorder and GAD. GAD sufferers endure high levels of anxiety most of the day, more days than not. People with panic disorder experience brief but profoundly intense feelings of anxiety “out of the blue.”

How Can GAD Affect Someone’s Life?

By its definition as a mental illness, GAD’s effects on a person’s life are severe. A person may experience social, financial, interpersonal, and health problems because of GAD. Consider that a person with GAD feels irritable, fatigue, distracted, and maybe in pain most of the time. This tremendously affects a person’s ability to work, socialize, and relax.

What Treatment Options Are Available For GAD?

Only 20% of people with GAD seek therapy, which is unfortunate because GAD responds well to mental health treatment, including medication, psychotherapy, or both.

Medications for GAD

One family of medications, the benzodiazepines, are notably effective for the short-term treatment of the symptoms of GAD and provide temporary relief. However, benzodiazepines carry a significant risk of dependence and addiction. Therefore, doctors recommend using them for no more than 4 weeks continuously.  Common benzodiazepines prescribed for GAD include alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan).

Another class of medications, Selective Serotonin Reuptake Inhibitors (SSRIs), have no potential for abuse or addiction and help promote feelings of happiness, well-being, and emotional stability. They include fluoxetine (Prozac), escitalopram (Lexapro), and sertraline (Zoloft).

Psychotherapy

Psychotherapy helps people manage and reduce anxiety by:

  • Challenging and changing harmful habitual thought patterns
  • Teaching effective anxiety management and stress coping skills
  • Building confidence
  • Teaching relaxation and self-soothing techniques
  • Providing education about anxiety and anxiety reduction techniques

At Absolute Awakenings, we treat anxiety disorders and other co-occurring mental health disorders by taking an individualized and multi-pronged approach. In addition to medical treatment, our patients can access multiple psychotherapy types, stress management workshops, goal-setting activities, and life-planning support.

References

  1. Facts & Statistics | Anxiety and Depression. Accessed January 15, 2023. https://adaa.org/understanding-anxiety/facts-statistics
  2. Carey E. Generalized Anxiety Disorder (GAD): Symptoms and More. Healthline. Published September 15, 2022. Accessed January 15, 2023. https://www.healthline.com/health/anxiety/generalized-anxiety-disorder
  3. Hettema JM, Prescott CA, Kendler KS. A population-based twin study of generalized anxiety disorder in men and women. J Nerv Ment Dis. 2001;189(7):413-420. doi:10.1097/00005053-200107000-00001
  4. Monk CS, Telzer EH, Mogg K, et al. Amygdala and Ventrolateral Prefrontal Cortex Activation to Masked Angry Faces in Children and Adolescents with Generalized Anxiety Disorder. Arch Gen Psychiatry. 2008;65(5):568-576. doi:10.1001/archpsyc.65.5.568
  5. Vesga-LĂłpez O, Schneier F, Wang S, et al. Gender differences in Generalized Anxiety Disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). J Clin Psychiatry. 2008;69(10):1606-1616.
  6. Generalized Anxiety Disorder (Symptoms) | Center for the Treatment and Study of Anxiety | Perelman School of Medicine at the University of Pennsylvania. Accessed January 15, 2023. https://www.med.upenn.edu/ctsa/general_anxiety_symptoms.html
  7. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Archives of Internal Medicine. 2006;166(10):1092-1097. doi:10.1001/archinte.166.10.1092
  8. Glasofer DR. How Is Generalized Anxiety Disorder Diagnosed Using the DSM-5-TR? Verywell Mind. Published July 25, 2022. Accessed January 15, 2023. https://www.verywellmind.com/dsm-5-criteria-for-generalized-anxiety-disorder-1393147
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