- Genetics: GAD tends to run in families, suggesting a genetic predisposition.
- Brain Chemistry and Function: Differences in brain chemistry and the function of certain brain circuits involved in fear and emotion (e.g., amygdala, prefrontal cortex) are thought to play a role. Neurotransmitters like serotonin, norepinephrine, and gamma-aminobutyric acid (GABA) may be imbalanced.
- Personality: Certain personality traits, such as shyness or negativity, may increase susceptibility.
- Environmental Factors:
- Stressful life events: Major life changes, trauma, chronic stress, or significant life challenges can trigger GAD in susceptible individuals.
- Childhood experiences: Adverse childhood experiences, such as abuse or neglect, may increase the risk.
- Substance use: Long-term use or withdrawal from certain substances (e.g., caffeine, nicotine, alcohol, recreational drugs) can exacerbate anxiety.
- Excessive and persistent worry: Worry about a variety of things (e.g., health, money, family, work, school) that is out of proportion to the actual likelihood or impact of the feared event.
- Restlessness or feeling on edge: A sense of being keyed up or unable to relax.
- Fatigue: Feeling tired easily, even without physical exertion.
- Difficulty concentrating: Problems focusing or feeling like your mind goes blank.
- Irritability: Feeling easily annoyed or short-tempered.
- Muscle tension: Aches, stiffness, or soreness in muscles.
- Sleep disturbances: Difficulty falling or staying asleep, or restless, unsatisfying sleep.
- Physical symptoms:
- Sweating
- Nausea or stomach upset
- Diarrhea
- Trembling or shaking
- Shortness of breath or feeling smothered
- Heart palpitations or a pounding heart
- Headaches
- Detailed interview: The healthcare professional will ask about your symptoms, their duration, intensity, and impact on your daily life. They will also inquire about your personal and family medical and psychiatric history.
- Symptom checklists and rating scales: Standardized questionnaires (e.g., GAD-7) may be used to assess the severity of anxiety symptoms.
- Physical exam and lab tests: To rule out other medical conditions (e.g., thyroid problems, heart conditions, substance use) that can cause anxiety-like symptoms.
- Diagnostic criteria: Symptoms must meet specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including excessive worry for at least six months, difficulty controlling the worry, and association with at least three of the physical/cognitive symptoms (in children, only one symptom is required).
- Psychotherapy:
- Cognitive Behavioral Therapy (CBT): This is the most effective form of therapy for GAD. It helps individuals identify and challenge negative thought patterns and develop more effective coping mechanisms for worry.
- Applied Relaxation: Teaches progressive muscle relaxation techniques to manage physical tension.
- Medication:
- Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are often the first-line medication treatment for GAD (e.g., escitalopram, sertraline, duloxetine, venlafaxine). They can take several weeks to become fully effective.
- Buspirone: An anti-anxiety medication that is not a benzodiazepine and can be used for long-term treatment.
- Benzodiazepines: (e.g., alprazolam, lorazepam) may be prescribed for short-term use to quickly alleviate severe anxiety symptoms, but are generally not recommended for long-term use due to the risk of dependence.
- Lifestyle Management:
- Stress reduction techniques: Mindfulness, meditation, yoga, deep breathing exercises.
- Regular exercise: Can help reduce anxiety and improve mood.
- Adequate sleep: Establishing a consistent sleep schedule and practicing good sleep hygiene.
- Healthy diet: Limiting caffeine, alcohol, and sugary foods.
- Avoiding recreational drugs.
- Support groups: Connecting with others who have similar experiences.