Generalised Anxiety Disorder - More Detail
All of us worry about things like health, money, or family problems at one time or another.
But people with GAD are extremely worried about these and many other things, even when there is little or no reason to worry about them. They may be very anxious about just getting through the day. They think things will always go badly.
At times, worrying keeps people with GAD from doing everyday tasks.
GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months.13 People with GAD can’t seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They can’t relax, startle easily, and have difficulty concentrating.
Often they have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.
When their anxiety level is mild, people with GAD can function socially and hold down a job. Although they don’t avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe.
GAD affects about 6.8 million Australian adults,1 including twice as many women as men.2 The disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age.2 GAD sometimes runs in families, but no one knows for sure why some people have it, while others don't. There is evidence that genes play a modest role in GAD.13
Other anxiety disorders, depression, or substance abuse2,4 often accompany GAD, which rarely occurs alone, making it important to use a multi-disorder assessment tool when being assessed by your practitioner.
GAD is commonly treated with medication or cognitive-behavioral therapy, but comorbid conditions must also be treated using the appropriate therapies.
GAD Symptoms
People with GAD:
• worry very much about everyday things for at least six months, even if there is little or no reason to worry about them;
• can't control their constant worries;
• know that they worry much more than they should;
• can't relax;
• have a hard time concentrating;
• are easily startled; and
• have trouble falling asleep or staying asleep.
• common body symptoms are:
- feeling tired for no reason;
- headaches;
- muscle tension and aches;
- having a hard time swallowing;
- trembling or twitching;
- being irritable;
- sweating;
- nausea;
- feeling lightheaded;
- feeling out of breath;
- having to go to the bathroom a lot; and
- hot flashes.
GAD develops slowly. Symptoms often start presenting during the time between childhood and middle age.
Symptoms may get better or worse at different times, and often are worse during times of stress.
People with GAD may visit a practitioner many times before they find out they have this disorder. They ask their practitioners to help them with the signs of GAD, such as headaches or trouble falling asleep, but don't always get the help they need right away. It may take practitioners some time to be sure that a person has GAD instead of something else.
GAD Assessment and Treatment
There is help for people with GAD. The first step is to go to a Family Physician to talk about your symptoms. The practitioner will likely ask you to do a behavioral health assessment and possibly a physical exam to make sure that another physical problem isn't causing the symptoms.
Make sure your practitioner uses a multi-disorder behavioral health assessment tool and not a single disorder tool. It is important your practitioner gets a global overview of your behavioral health and does not limit their assessment to a narrow set of questions as is often found in a basic psychological stress scale.
Once you have completed your assessment, your practitioner should ask you more detailed questions based on the results, arrive at a diagnosis and diskuss with you next steps which may involved psychotherapy, medication or a combination of both.
When chemicals in the brain are not at a certain level it can cause a person to have GAD. That is why medications often help with the symptoms because they help the brain chemicals stay at the correct levels.
Practitioners may prescribe medication to help relieve GAD. It's important to know that some of these medicines may take a few weeks to start working. Only a medical practitioner (a Family Physician or psychiatrist) can prescribe medications.
Practitioners also may refer people with GAD to undertake psychotherapy with a licensed social worker, psychologist, or psychiatrist. This treatment can help people with GAD feel less anxious and fearful.
There is no cure for GAD yet, but treatments can give relief to people who have it and help them live a more normal life. To improve treatment, scientists are studying how well different medicines and therapies work. Click here for more on Anxiety Disorder Research.
If you know someone with signs of GAD, talk to him or her about seeing a practitioner and offer to go along for support.
Who pays for treatment?
In Australia you can receive up to 6 Medicare paid sessions with your psychologist if you are referred by your Family Physician with a Family Physician Mental Health Treatment Plan.
Some insurance plans in Australia cover treatment for anxiety disorders so you should check with your own insurance company to find out about coverage details. For people who don't have insurance, state governments may offer treatment at a clinic or health center.
