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  • Writer's pictureJen Ozarow, MHC-LP

General Anxiety Disorder: Symptoms, Causes, and Treatment

Edited by: Dr. Gabrielle Schreyer-Hoffman, Ph.D.


General Statistics and Information on GAD


General anxiety disorder (GAD) is a common mental health disorder that affects millions of people worldwide. The main characteristic of GAD is a pattern of excessive and persistent chronic worrying that is difficult to control. The estimated prevalence of generalized anxiety disorder in the general population of the United States is 3.1% in a one-year span (Stein & Sareen, 2015). Women and adolescent girls experience generalized anxiety disorder at a rate of at least twice as often as men and adolescent boys (American Psychiatric Association [APA], 2022). People of European descent tend to have symptoms that meet the criteria for generalized anxiety disorder more often than individuals of African and Asian descent (APA, 2022). The prevalence rate of GAD for Seniors aged 75 ranges from 2.8% to 3.1% in the United States, Israel, and European countries (APA, 2022). For Seniors, the onset of chronic physical disease or chronic pain can trigger excessive worry. In addition, those who are physically frail, have safety concerns about falling and need to limit their activities in response to this, tend to feel more distressed and anxious. (APA, 2022).


GAD sufferers are also susceptible to a high rate of secondary co-occurring anxiety disorders such as social -anxiety and panic disorders (Borza, 2017). Notably, Stein & Sareen (2015) found that alcohol and drug-use-related problems can develop in individuals with generalized anxiety disorder who use drugs and alcohol as a means to relieve symptoms of anxiety associated with GAD.


What is GAD?


Generalized Anxiety Disorder (GAD) is characterized by excessive and persistent anxiety and worry, to the extent that this worry is disproportionate to the actual situation anticipated or actual event. Individuals with generalized anxiety disorder find it difficult to control their worry and to keep worrisome thoughts from interfering with overall functioning and the tasks they are trying to accomplish (American Psychiatric Association [APA], 2013). A core feature of GAD is excessive and persistent worrying, even if the focus of worry may shift from one topic to another (Stein & Sareen, 2015). Adults who have generalized anxiety disorder may worry excessively about circumstances in their daily lives, such as job responsibilities, their finances, their own health, and/or their family member’s well-being to the point where it negatively impacts their own functioning. Whether the source of the person’s worry is day-to-day ordinary life circumstances or includes situations or events that are more complex, it is the pervasive, chronic and relentless nature of their worrying that causes significant distress for individuals with GAD (APA, 2013). Adults may worry excessively, for instance, about being late or about completing routine household chores, and may simultaneously experience feelings of helplessness and/or physical symptoms associated with stress, such as sweating, muscle tension, dizziness or difficulty sleeping. Children and adolescents with generalized anxiety disorder are prone to excessive worry about their own capabilities and performance and may be anxious about their peer relationships [APA], 2022). Additionally, symptoms of GAD in children can appear as physical symptoms such as recurrent abdominal pain that may cause disruption in school attendance (Stein and Sareen, 2015).


The symptoms of Generalized Anxiety Disorder can affect individuals physically, cognitively and emotionally and vary from person to person. Some of the physical symptoms of GAD include those associated with stress such as headaches, muscle tension, nausea and gastrointestinal issues. In addition to excessive worry and anxiety, other emotional and cognitive symptoms of GAD may include feeling keyed up or on edge, difficulty concentrating, irritability and a sense of helplessness in the face of the symptom (Stein & Sareen, 2015; Cuijpers et al.,2014, APA,2022).


Here are common symptoms associated with GAD:


● Excessive worry

● Chronic anxiety

● Difficulty concentrating

● Mind going blank

● Sleep problems

● Irritability

● Easily fatigued

● Feeling keyed up or on edge

● Muscle tension

● Muscle aches or soreness

● Sweating

● Nausea

● Diarrhea

● An exaggerated startle response

● Difficulty in tolerating uncertainty


Causes Of GAD


The causes of GAD are variable and no one circumstance can predict the onset. Research shows that it is likely a combination of genetics, environmental factors and life events that create the circumstances for GAD to develop (Stein & Sareen, 2015; APA, 2022). Some of the factors contributing to the increased risk of developing GAD include exposure to childhood trauma and adversity, such as physical or sexual abuse or neglect (Stein & Sareen, 2015; APA, 2022). Other documented contributing factors of increased risk are low socioeconomic status and being born female (Stein and Sareen, 2015).

Treatments for GAD


There are many effective treatments for GAD, including therapy, psychotropic medication and lifestyle changes. Research has shown that the use of psychotropic medication by itself to treat GAD can be effective, though efficacy increases when combined with therapy. Therapy has been documented as a preferred treatment by both clinicians and patients in treating GAD (Stein & Sareen, 2015; Cujipers,et al., 2014).


Cognitive Behavioral Therapy (CBT) has empirical support for treating GAD. CBT is a structured and collaboratively therapy that utilizes a variety of techniques like cognitive restructuring, exposure and step-wise problem-solving. Additional therapeutic approaches proven to be beneficial in treating GAD are Acceptance and Commitment Therapy (ACT), relaxation techniques, Mindfulness training and meditation (Cujipers, et al., 2014).


Lifestyle changes can also offer potential benefits for managing the symptoms of GAD. Research has shown that exercise and avoiding or reducing alcohol use can reduce anxiety symptoms (Stein & Sareen, 2015). Good sleep hygiene habits including maintaining a regular sleep schedule and not using devices such as smartphones or iPads at night have been shown to improve sleep which helps mitigate anxiety (Stein and Sareen, 2015).


If GAD goes untreated it can lead to an increased risk of developing other physical health conditions or can exacerbate physical symptoms like chronic pain, asthma and inflammatory bowel disease (Stein & Sareen, 2015.) Additionally, untreated symptoms of GAD increased one’s risk of developing other co-occurring mental health conditions (Borza, 2017).


Having generalized anxiety is challenging and you shouldn’t have to go through it alone. If you are struggling with GAD, it is important to seek professional help and to get treatment as soon as possible.


References

American Psychiatric Association. (2013). Anxiety disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).


American Psychiatric Association. ( 2022). Anxiety Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.,

text rev.)


Bomyea, Ramsawh, H., Ball, T., Taylor, C. , Paulus, M. , Lang, A. , & Stein, M. (2015). Intolerance of uncertainty as a mediator of

reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder. Journal of Anxiety Disorders, 33, 90–94. https://doi.org/10.1016/j.janxdis.2015.05.004


Borza. (2017). Cognitive-behavioral therapy for generalized anxiety. Dialogues in Clinical Neuroscience, 19(2), 203–208.


Cuijpers, Sijbrandij, M., Koole, S., Huibers, M., Berking, M., & Andersson, G. (2014). Psychological treatment of generalized

anxiety disorder: A meta-analysis. Clinical Psychology Review, 34(2), 130–140. https://doi.org/10.1016/j.cpr.2014.01.002

If you're a constant worrier, you may have an anxiety disorder: generalized anxiety disorder can cause health problems if not treated properly. Don't ignore the symptoms. (2009, May). Women's Health Advisor, 13(5), 4. https://link-gale-com.proxy.wexler.hunter.cuny.edu/apps/doc/A200408466/AONE?u=cuny_hunter&sid=bookmark-AONE&xid=da3ff197


McLean, Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011). Gender differences in anxiety disorders: Prevalence, course of illness,

comorbidity and burden of illness. Journal of Psychiatric Research, 45(8), 1027–1035. https://doi.org/10.1016/j.jpsychires.2011.03.006


Stein, & Sareen, J. (2015). Generalized Anxiety Disorder. The New England Journal of Medicine, 373(21), 2059–2068.

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