The condition known as generalized anxiety disorder (GAD) causes fear, concern, and a persistent sense of being overwhelmed. It is also described as ongoing, excessive, and irrational concern over ordinary issues. As such, excessive worry is a central feature of GAD.

It affects around one in four teenagers between the ages of 13 and 18 and is twice as common in women as it is in men. GAD often first manifests around the age of 30. Finally, risk factors for generalized anxiety include being female, being single, having poor health, and having low levels of education.

Stress, medical conditions, genetics, environmental factors, and substance abuse are the causes of developing GAD. Additionally, experts have found the involvement of the limbic system, an area of the brain that plays a role in our behavioral and emotional responses.

GAD patients usually present nonspecific reasons for shortness of breath, palpitations, fatigue, headache, dizziness, and restlessness. Symptoms can also include excessive, nonspecific anxiety and worry, unsteady emotions, difficulty concentrating, and insomnia.

GAD patients usually present nonspecific reasons for shortness of breath, palpitations, fatigue, headache, dizziness, and restlessness. Symptoms can also include excessive, nonspecific anxiety and worry, unsteady emotions, difficulty concentrating, and insomnia.

Physicians use the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), to diagnose patients with GAD. A patient must have the following core symptoms:

• Excessive anxiety and worry for at least six months;
• and difficulty controlling the worrying.

Additionally, three or more of the following associated symptoms:

• Restlessness, feeling keyed up or on edge;
• Being easily fatigued;
• Difficulty in concentrating or mind going blank, irritability;
• Muscle tension;
• Sleep disturbance;
• Irritability.

Additionally, anxiety results in significant distress or problems at work or in the community. It is not attributable to any physical cause.

Doctors may also perform other tests such as thyroid function tests, blood glucose levels, and ECG to exclude other causes.

Treatment

There are two main treatments for GAD, cognitive-based therapy (CBT) and medications. Usually, a combination of both treatments is required for the management to work. Cognitive-based therapy includes mental health education, changing maladaptive thought patterns, and gradual exposure to anxiety-provoking situations. The goal of this approach is to increase anxiety tolerance instead of elimination.

On the other hand, possible medications to be given include antidepressants such as selective serotonin reuptake inhibitors, antipsychotics, benzodiazepines, and buspirone.

Anxiety is unpreventable, but medication compliance primarily helps control the symptoms. Additionally, working with a therapist is vital since relapse is common in these cases. Furthermore, many drugs that treat GAD commonly have side effects. Thus, it is necessary to discuss these side effects with your doctor. They can adjust your medication or plan a better treatment strategy to help you stay with your medicine.  

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Munir S, Takov V. Generalized Anxiety Disorder. [Updated 2022 Jan 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441870/