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What is Generalized Anxiety Disorder (GAD)?

Everyone feels anxious from time to time, and more so when going through periods of increased stress. However, Generalized Anxiety Disorder (GAD) is different from these normal feelings of anxiety. People who have GAD experience persistent and excessive worry, more days than not for months on end (6 months or more). They are often overly concerned with health, work, family, finances and other issues, and tend to worry about these situations even where there is no reason to worry. Although they usually realize their anxiety is more intense than the situation warrants, they cannot stop themselves from worrying. The topics a person worries about may shift and change with time or age. Sometimes the worry isn’t about something specific, but rather a general feeling of foreboding and worrying that something bad is going to happen. People with GAD have difficulty controlling this worry to the point it interferes with their day-to-day functioning.

GAD develops gradually, most often starting in the teen years or as a young adult, although onset can occur at any age. Although the exact cause of GAD is unknown, like most mental health disorders, the cause of GAD is likely an interaction between biological and environmental factors. Biological factors include a person’s genetics and differences in brain chemistry and function. Environmental factors include family background and life experiences, particularly significantly stressful or traumatic ones. These factors can influence how a person’s personality develops and how threats are perceived.

Symptoms of Generalized Anxiety Disorder:

There are many symptoms associated with GAD and these can vary from person to person. Common symptoms include:

  • Persistent worrying
  • Feelings of anxiety/nervousness about everyday things
  • Trouble controlling and stopping the worry
  • Perceiving situations as threatening when they are not
  • Difficulty handling uncertainty
  • Having a sense of impending danger or doom
  • Feeling irritable or on edge
  • Feeling restless, on edge, or keyed-up
  • Having difficulty relaxing
  • Being easily startled
  • Feeling fatigued or tired
  • Having difficulty concentrating
  • Trouble sleeping

A person with GAD may also experience a number of somatic or bodily symptoms that are commonly associated with anxiety. These include:

  • Increased heart rate
  • Breathing rapidly
  • Sweating
  • Feeling shaky, twitchy, or trembling
  • Muscle tension, muscle aches
  • Headaches
  • Gastrointestinal (GI) problems (nausea, diarrhea)

How Generalized Anxiety Disorder Can Affect Your Life

The excessive and persistent worry characterized by GAD is not only frightening and emotionally exhausting, it can significantly interfere with a person’s daily activities and functioning, including work, school, and social relationships. Unfortunately, individuals with GAD may miss fulfilling life experiences and opportunities, such as job promotions or travel, when they avoid these situations due to their anxiety and fear. When a person’s anxiety level is mild, or if they are participating in treatment, they are usually able to function meaningfully at work, home, and socially. If untreated, or if anxiety levels are more severe, even everyday activities can become difficult.

Generalized Anxiety Treatment Options

GAD is treated with psychotherapy, medication, or both.

Psychotherapy

Psychotherapy, also known as counseling or talk therapy, involves working with a licensed psychologist or other licensed mental health provider to reduce GAD symptoms. A number of treatment modalities and interventions are used to treat GAD. Cognitive behavioral therapy (CBT) is the most commonly used evidenced based treatment for GAD and targets the thoughts, physical symptoms, and behaviors (e.g. avoidance) that characterize GAD. Goals of CBT include teaching the client skills to manage unhelpful anxious thoughts, coping skills to reduce worry and improve one’s ability to relax and calm, and behavioral interventions to increase engagement in pleasant activities or meaningful events that may have been previously avoided. As self-efficacy beliefs and use of new coping skills improve, symptoms of GAD continue to reduce over treatment. Therapists may also utilize a variety of other psychotherapy treatment modalities and interventions, such as: Acceptance Commitment Therapy (ACT), mindfulness based interventions, relaxation techniques, meditation, etc.

Medications

Several types of medications are used to treat generalized anxiety disorder, most commonly selective serotonin reuptake inhibitors (SSRIs), which are in the antidepressant category. SSRIs are often used in combination with psychotherapy. It typically takes up to several weeks for SSRIs to become fully effective. Buspirone, is an antianxiety medication that may be prescribed for GAD. Finally, benzodiazepines may also be prescribed in limited circumstances for anxiety symptom relief. Because they are habit-forming, benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Medications should always be discussed, prescribed, and monitored by your treating medical provider.

How Teletherapy can help with Generalized Anxiety Disorder

If you feel you are worrying too much and it is interfering with important aspects of your life such as work or your relationships, you are not alone. Many people experience GAD and the good news is that GAD is treatable. Working with a licensed therapist will help you learn the coping skills you need to reduce your anxiety, control your worry, and increase your engagement in activities that are meaningful to you. Telehealth makes accessing a licensed therapist easy and convenient from your own home.

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