Generalized Anxiety Disorder

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AnxietyIn an anxiety disorder, there is an excessive amount of anxiety which is troublesome to the sufferer. There are various types of anxiety disorders, and Generalized Anxiety Disorder (GAD) is one type.

If you have GAD, you may have a persistent worry and anxiety about many things, usually pertaining to finances, family, work, studies and other aspects of daily life. There is little or no specific stressor that can obviously provoke it and the worries are usually excessive. You may find it difficult to control the anxiety and there may be also other symptoms such as muscle tension, headaches, difficulty concentrating and sleep difficulties. These symptoms can last for many years and affect your work, relationship with family and general quality of life.

Normal Worry vs Generalized Anxiety Disorder

"Normal" Worry

• Your worrying doesn’t impair your daily activities and responsibilities. You’re able to control your worrying.

• You are not significantly distressed by the worries.

• Your worries are limited to a specific, small number of realistic concerns.

• Your worries only last for a limited period of time.

Generalized Anxiety Disorder

• Your worrying significantly impairs your job, activities, or social life. You can't control your worries.

• Your worries cause significant distress.

• You worry about all sorts of things, even though you know that there is no real need for such worries.

• You’ve been worrying almost daily for at least a few months.


How is GAD diagnosed? What happens in a psychiatric consultation?

If you have the above symptoms and they are causing distress and affecting your life, it is time to consult a doctor. A psychiatrist will ask you about your symptoms, background history and medical history. He may also ask you about your premorbid personality, as some patients with GAD are anxious by nature. Further investigations such as blood tests may be done if needed. After the diagnosis is made, the psychiatrist decides on the individualized treatment for you.

How is Generalized Anxiety Disorder (GAD) treated?

This can be in the form of medications and/or psychological therapy. Medications are effective and help to reduce anxiety. Medications that act on the serotonin receptors in the brain will reduce the level of anxiety and these do not result in addiction.

There are many examples of such anti-anxiety medicines available and your psychiatrist will choose one that is most suitable for you. For example, a class of medicine known as Selective Serotonin Reuptake Inhibitor (SSRI) is useful in treating GAD. Examples of SSRIs include escitalopram, sertraline, fluvoxamine, fluoxetine and paroxetine. Other medications such as duloxetine and mirtazapine act on additional brain receptors and are also useful in treating GAD. The older class of medication known as tricyclics (TCA) can also effective in treating anxiety but are dangerous when overdosed. It is important to note that, after starting the above medications, it will take a few weeks to produce an improvement in symptoms.

Other short-term medicines such as sedatives and sleeping pills are also given if requested to improve sleep and allow you to relax. These are given temporarily so as to allow anti-anxiety medicines to work. They are very effective in reducing anxiety and work almost immediately. For non-medicinal approaches, cognitive behaviorial therapy (CBT) techniques and relaxation therapy are also useful in the treatment of GAD.

Remember: GAD can be treated and you can feel better. Do not postpone treatment and suffer needlessly.

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Expert Author:
Dr Thong Jiunn Yew, Nobel Psychological Wellness Clinic

Further Reading

The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.