Anxiety and Worry Lasting Over 6 Months: A Sign of Generalized Anxiety Disorder (GAD)

Anxiety is a common experience that affects everyone from time to time. When faced with stress, individuals may experience feelings of confusion, stress, anxiety, worry, and agitation, often accompanied by physical symptoms such as hand tremors, body shakes, frequent urination, stomach upset, chest tightness, and restlessness. To determine whether the stress experienced is abnormal anxiety, consider the following factors:

1. The anxiety is excessive and cannot be explained by the specific stressor.
2. The anxiety is severe.
3. The anxiety persists even after the stressor has subsided.
4. The anxiety disrupts daily routines and work performance.

Generalized Anxiety Disorder (GAD) is a type of anxiety disorder. It affects approximately 4.3-5.9% of the population and is twice as common in women as in men. It is often seen in middle-aged individuals. Key symptoms include:

• Excessive and persistent worry about various matters, typically related to everyday life, such as work, finances, health, and family relationships.
• Possible physical symptoms, such as fatigue, muscle tension, and restlessness.
• Up to 60% of GAD patients also experience comorbid conditions, such as major depressive disorder and other anxiety disorders.

Diagnosing GAD

Physicians diagnose GAD based on the following criteria:

• Excessive worry about multiple issues for at least 6 months
• A feeling of inability to control the worry
• The presence of at least one physical symptom from the following list:
  • Restlessness, feeling jittery, or being on edge
  • Easily fatigued
  • Difficulty concentrating or remembering things
  • Irritability
  • Muscle tension
  • Sleep problems
• The anxiety significantly interferes with daily life

Causes of GAD

GAD is caused by a combination of biological and psychological factors.

• Biological factors: Patients may have abnormalities in brain neurotransmitters.

Psychological factors: It is believed that patients are more attentive to information related to potential threats and perceive ambiguous stimuli as dangerous.

Treatment for GAD

If you experience symptoms of GAD, it is recommended that you consult a psychiatrist. Effective treatment options include medication and psychotherapy.

Medication:

• Antidepressants: These are the primary medications used to treat GAD.
• Anti-anxiety medications: These may be prescribed in combination with antidepressants for short-term relief.
• Treatment duration: If the patient responds well to treatment, medication may be continued for 12 – 18 months before gradually tapering off.

Psychotherapy:

• Cognitive-behavioral therapy (CBT): This is a common approach for GAD.
• Relaxation techniques: These can help manage anxiety symptoms.

Additional Considerations:

• Comorbid conditions: Assess for the presence of comorbid conditions, such as depression.
• Environmental factors: Understand the environmental context that contributes to the patient’s stress and anxiety to identify potential solutions.

Remember: GAD is a treatable condition. With appropriate intervention, individuals with GAD can significantly improve their quality of life and manage their anxiety effectively.

Nattapach Lamliangpon, M.D.
Adult Psychiatrist