Definition Generalised anxiety disorder (GAD) is a psychological disorder. It involves chronic, repeated episodes of anxiety. Anxiety, morbid fear and dread are accompanied by involuntary or autonomic changes.
What is going on in the body? People with chronic anxiety have altered brain activity. Brain-imaging studies have shown this.
What are the signs and symptoms of the condition? Symptoms of GAD include:
excessive anxiety interfering with many areas of life
muscle tension
shortness of breath
excessive sweating
palpitations
stomach and bowel problems
irritability
startled reactions
lightheadedness
diarrhoea
apprehension
impatience
feelings of imminent danger
restlessness
inability to relax
difficulty concentrating
trouble sleeping
lack of enjoyment
difficulty controlling worry
The anxiety disrupts many areas of life. Unlike other anxiety disorders, individuals with generalised anxiety disorder do not avoid situations as a result of the disorder. However, the symptoms can still interfere with routine activities. Individuals with this disorder respond inaccurately to perceived dangers. They tend to pay attention to the negative details in a situation. They have little faith in their own ability to cope with their lives.
What are the causes and risks of the condition? GAD typically begins in childhood or adolescence. It can also begin in adulthood. It is more common among women. Theories consider genetics and social factors to be important in the development of chronic anxiety.
GAD is not the result of a medical condition, medication or a substance use disorder. Psychosocial factors are thought to contribute to GAD.
What can be done to prevent the condition? Preventing GAD involves managing the demands that cause the problems. Increasing the ability to cope with situations can help. This includes a support system and an individual's coping skills. Reducing demands or expectations can help.
Anxiety-reducing techniques can be used. These include:
relaxation exercises, such as meditation, self-hypnosis, breathing exercises.
exercise.
getting adequate sleep.
dietary changes. These changes may include decreasing the use of caffeine, alcohol or other drugs known to produce anxiety.
Counselling for specific problem areas, such as parenting skills, marital, family, career or academic issues may be helpful.
Some individuals may benefit from systematic desensitisation for specific fears, gradually overcoming thier fear.
It is often helpful to increase the persons support systems by providing assistance with childcare, housekeeping and household tasks.
How is the condition diagnosed? Diagnosing an anxiety disorder is usually done by a psychiatrist. Symptoms are reviewed with the individual. A complete mental history and physical examination will be conducted. This will rule out a physical cause. Lifestyle factors will be discussed. These include alcohol or drug use, stresses, recent life changes, medical illnesses, or relationship factors. To be diagnosed with the disorder, a person has to have had symptoms of GAD most days for the past six months.
A thorough evaluation should include questions about the issues and events that increase anxiety. These will include questions about type, quality, timing pattern, aggravating or triggering factors.
What are the long-term effects of the condition? Anxiety is often linked to depression and can cause problems in a person's work and social life. Unlike many other anxiety disorders, the symptoms of generalised anxiety disorder seem to lessen somewhat with age.
What are the risks to others? Relationships may be negatively affected with GAD.
What are the treatments for the condition? The treatments for GAD are similar to the prevention methods listed above. A combination of lifestyle changes, stress reduction, relaxation techniques, counselling or medication may be effective. Cognitive behavioural therapy is useful.
Medications may be used to treat anxiety. Examples of these medications inlcude, antidepressants, such as sertraline, fluoxetine, or citalopram, and beta blockers, such as propranolol or atenolol may be used.
What are the side effects of the treatments? Medication side effects depend on the drug prescribed. Care should be taken with drugs that are psychologically and physically addicting.
What happens after treatment for the condition? Most people are able to return to their daily activities after being treated with therapy and medication. Often, medication is given for a long time.
How is the condition monitored? The person is asked to monitor his or her symptoms and report them to the doctor. A medication may need to be adjusted so that it works better or to decrease side effects.
Author: Ann Reyes, Ph.D. Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
