Generalized anxiety disorder (GAD) is characterized by excessive, exaggerated anxiety and worry for no obvious reasons. People with this disorder often expect disaster and constantly worry about such things as health, money, family, work or school. This worry is often unrealistic or out of proportion with the situation, and daily life becomes consumed with feelings of worry, fear and dread. Eventually, the anxiety dominates the person’s thinking and interferes with daily tasks, work, school, social activities and relationships.

People with GAD also tend to suffer from depression and such anxiety disorders as panic disorder, obsessive-compulsive disorder and phobias, and sometimes abuse drugs or alcohol.

What causes GAD?

The exact cause of GAD is unknown, but a number of factors including genetics, brain chemistry and environmental stresses appear to contribute to its development.


Some research suggests that the likelihood of developing GAD may be genetically inherited.

Brain Chemistry

GAD has been associated with abnormal levels of certain neurotransmitters in the brain. Neurotransmitters are special chemical messengers that help move information from nerve cell to nerve cell. If they are out of balance, messages cannot properly move through the brain. This can alter the way the brain reacts in certain situations, leading to anxiety.


Trauma and stressful events such as abuse, the death of a loved one, divorce, or changing jobs or schools may lead to GAD. Stress and the use of or withdrawal from such addictive substances as alcohol, caffeine and nicotine may worsen the anxiety.

How common is GAD?

About 4 million adult Americans suffer from GAD during the course of a year. It most often begins in childhood or adolescence, but can begin in adulthood. It is more common in women than in men.

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How is GAD treated?

If no physical illness is found, you may be referred to a psychiatrist or psychologist trained to diagnose and treat mental illness. Treatment for GAD most often includes a combination of medication and cognitive-behavioral therapy. Although there is no cure for GAD and symptoms can periodically return, proper treatment can alleviate symptoms.


A number of drugs may be helpful for people whose anxiety interferes with daily functioning. Benzodiazepines, often called tranquilizers because they decrease muscle tension and restlessness, leaving patients feeling calm and relaxed, are typically used to treat GAD in the short-term. Common benzodiazepines include Xanax, Librium, Valium and Ativan. Antidepressants, including Paxil, Effexor, Prozac, Lexapro and Zoloft, take a few weeks to start working, but can be helpful in the long-term treatment of GAD.

However, these types of treatment do have risks and side effects. Patients can develop a dependency on anti-anxiety medications (benzodiazepines) or suffer from the side effects of antidepressants, which commonly include sleepiness, weight gain and sexual problems.

Cognitive Behavioral Therapy

Therapy can help people who suffer from anxiety disorders learn to recognize and change the thought patterns and behaviors that lead to anxious feelings. Relaxation techniques, such as deep breathing and biofeedback, may help to control the muscle tension that often accompanies GAD.

Can GAD be prevented?

Anxiety disorders cannot be prevented. However, there are things you can do to control or lessen symptoms:

  • Reduce or stop consumption of such caffeinated products as coffee, tea, cola and chocolate.
  • Ask your doctor or pharmacist before taking over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
  • Exercise daily and eat a healthy, balanced diet.
  • Seek counseling and support after a traumatic or disturbing experience.
  • Practice stress management techniques, such as yoga or meditation.

What are the symptoms of GAD?

Although GAD affects the way a person thinks, the anxiety can cause physical symptoms. GAD symptoms include:

  • Excessive, ongoing worry and tension
  • An unrealistic view of problems
  • Restlessness or feeling ‘edgy’
  • Irritability
  • Muscle tension
  • Headaches
  • Sweating
  • Difficulty concentrating
  • Nausea
  • The need to go to the bathroom frequently
  • Tiredness
  • Trouble falling or staying asleep
  • Trembling
  • Being easily startled

Is GAD diagnosed?

If you exhibit symptoms of GAD, your doctor will first ask questions about your medical history and perform a physical examination. There are no lab tests designed to diagnose anxiety disorders, so your doctor may first run tests to determine whether a physical illness could have caused your symptoms.

The doctor will make a diagnosis based on the intensity and duration of the symptoms including any problems caused by the symptoms and the degree of dysfunction. GAD may be diagnosed if symptoms are present for more days than not during a six-month period and interfere with your daily living, such as causing you to miss work or school.

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