It’s normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities may be a sign of generalized anxiety disorder. It’s also sometimes known as chronic anxiety neurosis.
Generalized anxiety disorder (GAD) is more than the normal anxiety people experience day to day. It’s chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint.
People with GAD can’t seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants — that it’s irrational. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Or they might feel as though they have a lump in the throat.Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too.
GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It’s more common in women than in men and often occurs in relatives of affected persons. It’s diagnosed when someone spends at least 6 months worried excessively about a number of everyday problems.
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; children do not need to meet as many criteria–only 1 is needed).
- Restlessness or feeling keyed up or on edge
- Being easily fatigued
- Difficulty concentrating or mind going blank
- Muscle tension
- Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
The exact cause of GAD isn’t fully understood, although it’s likely that a combination of several factors plays a role. Research has suggested that these may include:
- overactivity in areas of the brain involved in emotions and behaviour
- an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood
- the genes you inherit from your parents – you’re estimated to be 5 times more likely to develop GAD if you have a close relative with the condition
- having a history of stressful or traumatic experiences, such as domestic violence, child abuse or bullying
- having a painful long-term health condition.
- having a history of drug or alcohol misuse
However, many people develop GAD for no apparent reason.
Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder.
Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you’ve avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.
Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects.
- Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants.
- Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective.
- Benzodiazepines. In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren’t a good choice if you have or had problems with alcohol or drug abuse.
Progressive Muscle Relaxation
Progressive muscle relaxation (PMR) is a non-pharmacological method of deep muscle relaxation, based on the premise that muscle tension is the body’s psychological response to anxiety-provoking thoughts and that muscle relaxation blocks anxiety. Progressive Muscle Relaxation teaches you how to relax your muscles through a two-step process. First, you systematically tense particular muscle groups in your body, such as your neck and shoulders. Next, you release the tension and notice how your muscles feel when you relax them.This tension is then released, as attention is directed towards the differences felt during tension and relaxation. This exercise will help you to lower your overall tension and stress levels, and help you relax when you are feeling anxious. It can also help reduce physical problems such as stomachaches and headaches, as well as improve your sleep.