Generalized anxiety disorder (GAD)

Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It's chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting through the day provokes anxiety.

People with GAD can't seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They may have the following symptoms:

• frequent worry
• inability to relax
• difficulty falling or staying asleep
• trembling, twitching, muscle tension
• headaches,
• irritability
• sweating
• hot flashes
• lightheadedness or shortness of breath
• nausea
• frequent urination
• lump in the throat
• fatigue
• difficulty concentrating
• being easily startled

Some individuals with GAD suffer from ]]>depression]]> .

Usually the impairment associated with GAD is mild. People with the disorder don't feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don't characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.

GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It's more common in women than in men and often occurs in relatives of affected persons. It's diagnosed when someone spends at least six months worried excessively about a number of everyday problems. In general, the symptoms of GAD seem to diminish with age.

How common is GAD?

About 3 to 4% of the U.S. population has GAD during the course of a year. GAD most often strikes people in childhood or adolescence, but can begin in adulthood, too. It affects women more often than men.

What causes GAD?

Some research suggests that GAD may run in families, and it may also grow worse during stress. GAD usually begins at an earlier age and symptoms may manifest themselves more slowly than in most other anxiety disorders.

What treatments are available for GAD?

Successful treatment for GAD may include a medication called buspirone . Research into the effectiveness of other medications, such as benzodiazepines and antidepressants , is ongoing. Also useful are cognitive-behavioral therapy , relaxation techniques, and biofeedback to control muscle tension.

What other physical and emotional illnesses can accompany GAD?

Research shows that GAD often coexists with ]]>depression]]> , substance abuse , or other anxiety disorders. Other conditions associated with stress , such as irritable bowel syndrome , often accompany GAD. Patients with physical symptoms such as ]]>insomnia]]> or headaches should also tell their doctors about their feelings of worry and tension. This will help the patient's health care provider to recognize that the person is suffering from GAD.