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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Generalized Anxiety Disorder

What is it?

Anxiety can be a natural, beneficial reaction to stress or danger. Under normal circumstances, anxiety diminishes when the stressful situation ends. But for some people, anxiety persists and serves no constructive purpose. In generalized anxiety disorder (GAD), a person experiences excessive, prolonged worry over everyday concerns, such as job responsibilities, health or family well-being, or even minor matters, such as household chores or personal appearance. Along with worry itself , GAD may produce such physical symptoms as heart palpitations, sweating, headaches, and nausea. In addition, perpetual anxiety may impair concentration, memory, decision-making ability, and social functioning, such as maintaining intimate relationships or working. GAD is the most common anxiety disorder, affecting 2 to 3 percent of the population (also see Panic Disorder, Obsessive-Compulsive Disorder, Phobic Disorders, and Post-Traumatic Stress Disorder). Most people with GAD first have symptoms during young adulthood, though it may start at any age, and the disorder is slightly more prevalent among women.

What Causes It?

  • The cause of GAD is unknown but a neurotransmitter (brain chemical) called gamma-aminobutyric acid (GABA) may play a role. Environmental factors may also be involved.
  • Various drugs or chemical substances can trigger anxiety; these include caffeine, nonprescription decongestants and cold remedies, thyroid hormones and inhaled asthma drugs. Anxiety also accompanies withdrawal from caffeine, alcohol, tobacco, sedatives, narcotics, and other addictive drugs.

Prevention

  • Treatment of GAD may help prevent future episodes.

Diagnosis

  • A thorough psychological evaluation is used to identify the type of anxiety.
  • A physical examination, including certain blood tests, may help rule out underlying causes of anxiety or other disorders, such as a asthma, heart attack, overactive thyroid, or certain vitamin deficiencies, that mimic its symptoms.

How to Treat It

  • Antidepressant medications, which include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, and tricyclics are used for long-term treatment; the antianxiety drug buspirone is also used for long-term management.
  • Short-term treatment involves the use of benzodiazepines; long-term use of benzodiazepines is not recommended as it can lead to dependence.
  • Psychotherapy may be recommended, either alone or in combination with medication.
  • Relaxation techniques, such as deep breathing exercises or meditation, may help relieve anxiety.
  • Substances that trigger anxiety, such as caffeine, should be limited or discontinued.

When to Call a Doctor

  • Consult a doctor if symptoms of anxiety interfere with daily functioning, or if you've experienced symptoms of GAD for longer than 3 months.