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Generalized Anxiety Disorder

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Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is a chronic and often disabling condition that is associated with uncontrollable worry and tension. The vicious cycle of anxiety and worry interferes with relationships, careers, and education, and often leads to depression. This disorder is much more than the normal anxiety that everyone experiences from time to time, and can be crippling in its severity. GAD is unlikely to disappear without proper treatment, and often worsens over time.

Physical manifestations of GAD often include headaches, trembling, twitching, fatigue, irritability, frustration, muscle tension, and inability to concentrate. Sleep disturbances may also occur. Individuals suffering from this disorder may appear to be always tense and unable to relax, or may startle more easily than others. Often they might seem to be constantly moving or fidgeting, unable to sit comfortably through a movie without worrying about something else that needs to be done.

Some research suggests that GAD may run in families, and it Generalized Anxiety Disorder

may grow worse during times of stress. Symptoms can begin at any age, but the risk is highest between childhood and middle age. GAD affects about 4 million adult Americans. Women are twice as likely to be affected than men. The disorder usually comes on gradually, although it can be suddenly triggered by a childhood psychological trauma, the death of a loved one, divorce, and losing or changing a job.

DSM-IV Diagnostic Criteria:

1. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

2. The person finds it difficult to control the worry.

3. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children.

- restlessness or feeling keyed up or on edge

- being easily fatigued

- difficulty concentrating or mind going blank

- irritability

- muscle tension

- sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

4. The focus of the anxiety and worry is not confined to features of an Axis I disorder, e.g., the anxiety

or worry is not about having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder.

5. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in

social, occupational, or other important areas of functioning.

6. The disturbances is not due to the direct physiological effects of a substance (e.g. a drug of abuse, a

medication) or a general medical condition (e.g. hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.

Treatment of GAD:


Benzodiazepines- Medications such as Klonopin, Ativan, Valium, and Xanax often bring quick relief from the symptoms of anxiety. They are generally used while waiting for other medications to begin working, as addiction and tolerance is possible.

Antidepressants- Antidepressants can be useful in managing anxiety and in treating the depression that often accompanies it. The SSRIs are the most common antidepressants used to treat generalized anxiety disorder.

Buspirone (BuSpar)- Buspirone is an anti-anxiety drug that can be effective for generalized anxiety disorder. Some individuals respond very well to this medication, although many do not find it effective in treating all the symptoms of their disorder. Unlike the benzodiazepines, buspirone must be taken consistently for at least two weeks to achieve relief of symptoms.



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