الثلاثاء، 7 يونيو 2011

GAD - Generalized Anxiety Disorder


Overview, Causes, & Risk Factors

Generalized anxiety disorder is also called GAD. With this condition, the individual has chronic, repeated episodes of severe emotional and physical distress. People with this disorder have vague feelings of fear, impending danger, and dread for unknown reasons. In turn, these strong feelings result in physical changes in the body.
What is going on in the body?
People who have chronic anxiety have altered brain activity, which can be seen in brain X-rays, scans, or other studies.
What are the causes and risks of the condition?
GAD typically begins in childhood or during the teen years. It can also begin in adulthood. It is more common among women. GAD is not the result of a medical condition, medicine, or a substance use disorder. Experts believe that GAD runs in families. It may also be related to personality factors such as low self-esteem and poor coping skills. Life experiences can play a role too. For example, abuse, violence, and poverty might make someone more prone to developing GAD.

Symptoms & Signs

What are the signs and symptoms of the condition?
GAD causes constant, exaggerated worry that interferes with many areas of the person's life. Symptoms include:
  • diarrhea

  • difficulty concentrating

  • difficulty controlling worry

  • excessive sweating

  • feeling nervous

  • feelings of impending danger

  • impatience

  • inability to relax

  • irritability

  • lack of enjoyment

  • lightheadedness

  • muscle tension

  • palpitations, which make it feel as if the heart is pounding or racing

  • restlessness

  • shortness of breath

  • startled reactions

  • stomach and bowel problems

  • trouble sleeping


    • Unlike other, more acute anxiety disorders, people who have GAD do not avoid the situations that make them anxious. However, the symptoms can still interfere with their routine activities. They may overreact to what they see as dangers. They tend to pay attention to the negative details in a situation. And they may have little faith in their own ability to cope with their lives.

    Diagnosis & Tests

    How is the condition diagnosed?
    Physicians or mental healthcare providers usually diagnose an anxiety disorder. They will review the person's symptoms and conduct a complete mental health history and physical exam. This will help them rule out a physical cause. The doctor will also discuss lifestyle factors such as alcohol or drug use, stresses, recent life changes, medical illnesses, or relationship factors. To be diagnosed with the disorder, a person must have had symptoms of GAD most days for the past 6 months.
    A thorough exam should include questions about the issues and events that increase the individual's anxiety. For example, the doctor may ask questions such as these:
  • What does the anxiety feel like?

  • How intense is it?

  • When and how often do feelings of anxiety occur?

  • What triggers the anxiety or aggravates it?

    • Prevention & Expectations

    What can be done to prevent the condition?
    To prevent GAD, people must manage the demands that cause the problems. Learning how to cope better with the things that trigger anxiety can help. A good support system can also be helpful. Setting realistic demands and expectations is also key.
    Take these actions to reduce anxiety:
  • Try relaxation techniques, such as meditation, self-hypnosis, and breathing exercises.

  • Get 30 minutes of exercise per day.

  • Get at least 8 hours of sleep each night.

  • Adopt healthy eating habits such as drinking less caffeine and alcohol.

  • Avoid taking drugs known to cause anxiety.

  • Get counseling for specific problem areas, such as parenting skills and marital, family, career, or school issues.

  • Talk with a doctor about whether there might be benefits from systematically desensitizing specific fears. This therapy can help someone gradually overcome a fear.

  • Build support systems. Find people who can help with child care, housekeeping, and household tasks.


    • What are the long-term effects of the condition?
    Anxiety is often linked to depression and can cause problems in a person's work and social life. Unlike many other anxiety disorders, the symptoms of generalized anxiety disorder seem to lessen somewhat with age.
    What are the risks to others?
    GAD may have a negative effect on the individual's relationships with friends and family.

    Treatment & Monitoring

    What are the treatments for the condition?
    The treatments for GAD are similar to the prevention methods listed above. A combination of lifestyle changes, stress reduction, relaxation techniques, counseling, or medicine may be effective. Cognitive behavioral therapy is useful.
    Medicines may be used to treat anxiety. Examples of these include antidepressants, such as sertraline, fluoxetine, or citalopram; and beta-blockers such as propranolol or atenolol may be used.
    What are the side effects of the treatments?
    Medicine side effects depend on the drug prescribed. Drugs that cause psychological and physical addiction should be used with care.
    What happens after treatment for the condition?
    Most people are able to return to their daily activities after being treated with therapy and medicine. Often, medicine is given for a long time.
    How is the condition monitored?
    Keep track of symptoms and report any that are new or worsening to the healthcare provider. He or she may need to adjust the medicine so that it works better or so there are fewer side effects.

    Attribution

    Author:Ann Reyes, Ph.D.
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:12/16/01
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:01/16/02
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