Generalized Anxiety Disorder | What Is It ?
Generalized Anxiety
The term I’ve heard used for generalized anxiety disorder is “worrywart.” They are also called “worriers,” or “neurotic.” I don’t like using these terms, but they are out there. These individuals simply worry about everything. They worry about the bills, they worry about their job, the weather, the fate of the earth. Things that they have no control over to things they have some ability to affect, they worry about. It simply drives their families and others around them batty.
Be aware that many of the physical symptoms of generalized anxiety disorder are similar to the other anxiety disorders. Common among the anxiety disorders of gastrointestinal problems such as stomach aches, nausea, and diarrhea. Others will have hand tremors, a shaky voice, sweating, and a lot of other physical complaints that don’t have a specific cause. Some will show facial tics : think of Inspector Clouseau’s boss from the Pink Panther (video).
Generalized Anxiety Disorder | What You Need To Be Concerned About
- Anxiety disorders are the most common “mental illness” in the United States: A lot of people are not getting help.
- The main medical concern of generalized anxiety disorder is with patient seeking unnecessary medical treatments. They frequently go to the doctor with numerous medical complaints and can easily end up with a number of medications and other treatments that end up hurting them. Oftentimes, it takes time for a doctor to zero in on the fact the problem is generalized anxiety and not a medical problem.
- Isolation : Others may avoid the person
- The person with generalized anxiety disorder may not agree it a problem and won’t seek help
- Risk of Depression and Suicide
- Without treatment, it can be a lifelong illness
Generalized Anxiety Disorder | How Many People Have It?
About 5% of People will have generalized anxiety disorder in their life and 3% of the population at any time
If it is in your family, you have about 50% chance of getting it. The other anxiety disorders run in families too.
Generalized Anxiety Disorder | What Causes It?
The below generally hold true for all the anxiety disorders.
- Genetic Link: Those with relatives that have it have a have a higher chance of getting it.
- Stress: People have a greater chance of getting GAD if the conditions in their environment are right.
- Learning From Others: We learn to cope with problems by following the lead of our parents and important figures while growing up. If they have GAD, we may pick up their coping mechanisms.
- Biological: The Amygdala in the brain is part of a circuit in the brain that is involved in reinforcement of fear and anxiety. Medications act on these systems to calm them. Therapy and cognitive restructuring can also calm the circuit without medications.
- Stressful Events: A series of stressful events that resulted in severe anxiety could trigger generalized anxiety. For most, this would have happened in the childhood and teen years.
- Our Beliefs: How we view a stress. Why does one person find a situation stressful and another find the same situation fun (i.e. jumping out of a plane)? You can apply this to any situation. Much anxiety is in our believe we can actually control the events around us and worrying about them is a way to do it.
- Our Actions: We can feed the worry in generalized anxiety disorder by doing things that worsen it. For some, watching the news causes more worry. Perhaps it is not such a good idea to go through the bills every day. What about spending hours and hours planning an event so it will be “perfect” (which is impossible anyway).
Generalized Anxiety Disorder | Do I Have It?
The symptoms of generalized anxiety disorder are below. I also have a link to the exact definition of generalized anxiety disorder from the DSM-IV-TR by the American Psychiatric Association.
At least 6 months of symptoms in different places
Excess,uncontrollable worry most days
Three or more of the following:
- restlessness or feeling keyed up or on edge
- being easily fatigued
- difficulty concentrating or mind going blank
- irritability
- muscle tension
- sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
The anxiety is not caused by another mental disorder or physical problem or drugs
The worrying has to cause you problems. This can be tricky because the person may not always see the problems it is causing them at work or home. Input from family and friends if very helpful.
Things That Can Cause or Mimic Generalized Anxiety Disorder
Other Psychiatric Disorders
- Panic disorder
- obsessive-Compulsive Disorder
- Anorexia Nervosa
- Hypochondriasis
- Somatization Disorder
- Separation Anxiety Disorder
- Post Traumatic Stress Disorder
- Adjustment Disorder
Here is a list of some of the major contributors to generalized anxiety and other anxiety disorders that I have seen with patients and that you may need to discuss with your doctor.
1. Other Mental Disorders
- Underlying depression
- Underlying PTSD
- Underlying Panic Disorder
- Obsessive Compulsive Disorder
- Acute Stress Disorder
- Specific Phobia
- Psychotic Disorders
2. Underlying Substance Use Disorder
- Drinking too much
- Methamphetamine or Cocaine use
- Too much caffeine
- Opioid withdrawal (Prescription pain medications, heroin, other narcotics)
- Sedatives and Sedative Withdrawal (including barbituates)
- Marijuana
- Theophylline
- Amyl Nitrite
- Anticholinergics
- Antihistamines
- Hallucinogens
3. Non-Medical
- Poor sleep
- High stress
- Too many recent changes
- Lack of social supports
- Asthma
4. Medical
- Heart Arrhythmias (supraventricular tachycardia)
- Underlying Heart Condition (angina or Heart attack, heart failure)
- Hyperthyroidism
- Blood Electrolyte Imbalance
- Hyperventillation
- High Blood Pressure
- Anemia
- Cancer
- Stroke or Transient Ischemic Attacks
- Menopause
- B12 Deficiency
5. Medical: Less Common or Rare
- Pulmonary Embolism
- Multiple Sclerosis
- Vestibular Disorders (balance problems)
- Cushing’s Syndrome
- Hypoparathyroid
- Addison’s Disease
- Seizure Disorder
- Parkinson’s Disease
- Huntington’s Disease
- Wilson’s Disease
- Lupus
- Uremia
- Pheochromocytoma
- Mastocytosis
- Carcenoid Syndrome
- Heavy Metal Poisoning
- Temporal Arteritis
- Sepsis
- Systemic Allergic Reaction
6. Medications That Can Cause Anxiety
- Thyroid Medication
- Medications for Asthma
- Theophylline
- Hormones (Contraceptives)
- Steroids
- Serotonin Reuptake Inhibitors (many of the antidepressants)
- Methyldopa
- Amphetamines (for ADHD, e.g. Ritalin)
- Medications/products with Caffeine (Many over the counter medications have caffeine: Excedrin)
- Decongestants : Sudafed
Generalized Anxiety Disorder | GAD | Generalized Anxiety Resources
GAD : American Family Physician
GAD: World Federation for Mental Health (pdf)
GAD Chapter: Clinical Handbook of Psychological Disorders (pdf)
Treating Generalized Anxiety Disorder (pdf)
Dr.Rich is a psychiatrist who writes about mental health related topics focusing on anxiety disorders and substance abuse on various blogs as he realizes anxiety and substance abuse occur together. You can find information about opioid dependence and Methadone Vs Suboxone. Skip to our other sections:
Anxiety Information | Panic Attacks| Social Anxiety| Generalized Anxiety| Stress Management
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