Generalized Anxiety: Diagnosis, Treatment, and Support

Worried about an upcoming work project or a job interview? Feeling nervous about a first date you have planned? From time to time, we all experience these telltale signs of anxiety, especially when we’re dealing with issues related to our health, money, and relationships. In fact, anxiety in small amounts can actually be beneficial—anxiety can help us notice dangerous situations and focus our attention, which helps to ensure our safety in dangerous situations. 

But if your feelings of anxiety are extreme and long-lasting, you may be suffering from an anxiety disorder. If this sounds familiar, you’re not alone—anxiety disorders are the most common of mental disorders and affect nearly 30% of adults at some point in their lives. 

What is generalized anxiety disorder? 

Generalized anxiety disorder, or GAD, is a mental disorder characterized by frequent and extreme worry and nervousness—even when there is no obvious reason to be worried. These feelings are different from occasionally worrying about things or experiencing anxiety due to stressful life events, and these feelings can be so extreme as to interfere with daily life. Those living with GAD may experience frequent anxiety for months or even years. 

While GAD can develop in childhood, it mostly commonly develops around age 30, and is more common in women than in men. 

What are some signs and symptoms of generalized anxiety disorder? 

Generalized anxiety disorder symptoms can vary from person to person, and can include both mental and physical symptoms. 

Mental symptoms include: 

• Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events
• Overthinking plans and solutions to all possible worst-case outcomes
• Perceiving situations and events as threatening, even when they aren’t
• Difficulty handling uncertainty
• Indecisiveness and fear of making the wrong decision
• Inability to set aside or let go of a worry
• Inability to relax, feeling restless, and feeling keyed up or on edge
• Difficulty concentrating, or the feeling that your mind “goes blank” 

Physical symptoms include: 

• Fatigue
• Trouble sleeping
• Muscle tension or muscle aches
• Trembling, feeling twitchy
• Nervousness or being easily startled
• Sweating
• Nausea, diarrhea or irritable bowel syndrome
• Irritability

How is generalized anxiety disorder diagnosed? 

Before diagnosing you with GAD, your doctor will perform a mental health screening, which involves asking you questions about your symptoms and how long you’ve had them. If necessary, they may refer you to a mental health professional such as a psychologist or psychiatrist.

Sometimes, generalized anxiety disorder is caused by an underlying illness or substance abuse problem. To see if your anxiety is linked to medications or an underlying medical condition, your doctor may also perform a number of medical tests. These tests may include: 

• blood tests, to check hormone levels that may indicate a thyroid disorder
• urine tests, to check for substance abuse
• gastric reflux tests, such as an X-ray of your digestive system or an endoscopy procedure to look at your esophagus to check for GERD
• X-rays and stress tests, to check for heart conditions

How is generalized anxiety disorder treated? 

Treatments will vary for each individual based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for GAD involve either psychotherapy or medication; most patients benefit from a combination of the two treatments.  

Psychotherapy

Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy, a common type of talk therapy, has been shown to be the most effective for treating generalized anxiety disorder.

During cognitive behavioral therapy, or CBT, patients learn specific skills to directly manage their worries and anxiety over the short-term, while also helping patients gradually return to the activities they’ve avoided because of anxiety. ​​This approach has been associated with lower anxiety symptoms within 12 months after treatment.

Medication

Along with psychotherapy, doctors may also prescribe medication. 

Antidepressants 

For those dealing with symptoms of GAD, antidepressants are the first line of medication treatment. They are usually prescribed for long-term treatment. These medications usually need to be taken for 1-2 weeks, without skipping a dose, before you start to feel the benefits. Some common antidepressants are: 

• escitalopram (Lexapro)
• duloxetine (Cymbalta)
• venlafaxine (Effexor XR)
• paroxetine (Paxil, Pexeva) 

Buspirone

Buspirone is an anti-anxiety medication that may be used on an ongoing basis. Like antidepressants, buspirone usually take a few weeks to start working. 

Benzodiazepines 

Benzodiazepines are also prescribed for relief from anxiety symptoms. These medications are recommended for short-term use only, as they have a high risk for dependency and abuse. 

Home Remedies 

Most people with anxiety disorders require treatment with medication and therapy. However, there are also a number of lifestyle changes that can make a difference. 

Get Regular Exercise 

A regular exercise routine can help with anxiety symptoms and relieve stress. Start out slowly and gradually increase your exercise activities until you can develop a regular exercise routine. 

Get Enough Sleep 

Sleep deprivation can worse anxiety, so it’s important to get enough sleep that you feel rested. Speak with your doctor if you’re having trouble sleeping. 

Try Relaxation Techniques 

Techniques like meditation, yoga, and mindfulness are examples of relaxation techniques that can help with anxiety symptoms. 

Avoid Alcohol 

Alcohol and other recreational drugs can worsen symptoms of anxiety, and alcohol also has the potential to interfere with the medications that are used to treat anxiety. Talk to your doctor if you feel that your drinking is interfering with your ability to do daily activities. 

While it’s normal to experience a certain amount of anxiety from time to time, those with generalized anxiety disorder worry uncontrollably about common occurrences and situations. If you think you are experiencing symptoms of GAD, talk to your doctor so that you can figure out a treatment plan to provide you with relief from anxiety and its symptoms. 

Sources:

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