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Generalised anxiety disorder

A person with generalised anxiety disorder, or GAD, finds it hard to control their worries, fears or sense of unease. This long-term condition with a feeling of constant anxiety interferes with daily life.


Other GAD symptoms include irritability, problems concentrating and difficulty sleeping.


Generalised anxiety disorder affects about 1 in 20 adults in Britain. People in their 20s are most likely to have GAD with the condition affecting slightly more women than men.


What are the symptoms of GAD?


GAD affects the way a person thinks, but the anxiety can lead to physical symptoms, as well. Symptoms of GAD can include:

Excessive, ongoing worry and tension

An unrealistic view of problems

Restlessness or a feeling of being "edgy"

Irritability

Muscle tension

Headaches

Sweating

Difficulty concentrating

Nausea

The need to go to the toilet frequently

Tiredness

Trouble falling or staying asleep

Trembling

Being easily startled


In addition, people with GAD often have other anxiety disorders (such as panic disorder, obsessive-compulsive disorder, and phobias), suffer from depression, and/or abuse drugs or alcohol.


What causes GAD?


The exact cause of GAD is not fully known, but a number of factors -- including genetics, brain chemistry, and environmental stresses -- appear to contribute to its development.

Genetics: Some research suggests that family history plays a part in increasing the likelihood that a person will develop GAD. This means that the tendency to develop GAD may be passed on in families.

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 the neurotransmitters are out of balance, messages cannot get through the brain properly. This can alter the way the brain reacts in certain situations, leading to anxiety.

Environmental factors: Trauma and stressful events, such as abuse, the death of a loved one, divorce, changing jobs or schools, may lead to GAD. GAD also may become worse during periods of stress. The use of and withdrawal from addictive substances, including alcohol, caffeine and nicotine, can also worsen anxiety.


How is GAD diagnosed?


If symptoms of GAD are present, your GP will begin an evaluation by asking questions about your medical history and performing a physical examination. Although there are no laboratory tests to specifically diagnose anxiety disorders , the doctor may use various tests to look for physical illness as the cause of the symptoms.


The doctor bases his or her diagnosis of GAD on reports of the intensity and duration of symptoms -- including any problems with functioning caused by the symptoms. The doctor then determines if the symptoms and degree of dysfunction indicate a specific anxiety disorder. GAD is diagnosed if symptoms are present for more days than not during a period of at least six months. The symptoms also must interfere with daily living, such as causing you to miss work or school.


How is GAD treated?


If no physical illness is found, you may be referred to a psychiatrist or psychologist, healthcare professionals who are specially trained to help diagnose and treat mental health disorders like GAD. Treatment for GAD most often includes a combination of medication and cognitive-behavioural therapy.


Cognitive-behavioural therapy: People suffering from anxiety disorders often participate in this type of therapy, in which you learn to recognise and change thought patterns and behaviours that lead to anxious feelings. This type of therapy helps limit distorted thinking by looking at worries more realistically.


Medication: Drugs are available to treat GAD and may be especially helpful for people whose anxiety is interfering with daily functioning.


The medications used to treat GAD in the short-term include benzodiazepines. These medications are sometimes referred to as "tranquillisers", because they leave you feeling calm and relaxed. They work by decreasing the physical symptoms of GAD, such as muscle tension and restlessness.


Long-term treatment is often with antidepressants called selective serotonin reuptake inhibitors (SSRIs). Venlafaxine and pregabalin are also used to treat GAD.


In addition, relaxation techniques, such as deep breathing and biofeedback, may help to control the muscle tension that often accompanies GAD.


Are there side effects of GAD treatment?


Dependency on anti-anxiety medications (benzodiazepines) is a potential complication of treatment. Side effects of antidepressants vary by specific drug and the person taking them. Common side effects can include sleepiness, weight gain, and sexual problems.


What is the outlook for people with GAD?


Although many people with GAD cannot be cured and symptoms can return from time to time, most people gain substantial relief from their symptoms with proper treatment.


Can GAD be prevented?


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

Stop or reduce your consumption of products that contain caffeine, such as coffee, tea, cola and chocolate if you find these make anxiety symptoms worse.

Ask your GP or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.

Exercise daily and eat a healthy, balanced diet.

Seek counselling and support after a traumatic or disturbing experience.

Practise stress management techniques like yoga or meditation.


Source: WebMD

Anxiety