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Generalized Anxiety Disorder

anxiety cooccurring disorder general anxious mental healthGeneralized anxiety disorder, also known as GAD, is a disorder that includes chronic anxiety, exaggerated worry and tension, even when there is nothing specific provoking the symptoms.

The Anxiety and Depression Association of America estimates that GAD impacts 6.8 million adults. This is about 3.1% of the U.S. population. The condition is known to impact twice as many females as males. Plus, the disorder often occurs in conjunction with major depression. Unfortunately, only 43.2% of those with GAD receive treatment.


What Is Generalized Anxiety Disorder (GAD)?

An individual who is experiencing generalized anxiety disorder worries more than someone who is not experiencing the disorder. They tend to expect the worst outcome in most situations. When the amount of worry cannot be controlled within a six-month period, it’s best to seek the help of a qualified medical professional.

Everyone worries about stressful situations. In fact, there are many life events when worry is to be expected. This includes moving, getting a new job or becoming a parent for the first time. These are worries that are tied to events. Once the event passes, so does the worry. When the worry does not pass with the event, however, the problem could be GAD.

GAD is a crippling condition. In many cases, an individual experiencing generalized anxiety will find it difficult to get through their day on an almost daily basis. As the day progresses, there is a high level of anxiety. What makes the condition more difficult for an individual is that they do not know how to regain control of themselves. The severity of the anxiety can cause physical symptoms, including stomach aches and headaches. Many people living with GAD also find it hard to complete everyday tasks.


Difference Between Normal Worry and GAD

As mentioned, experiencing worry and anxiety at certain junctures of a person’s life is to be expected. Losing a job suddenly, preparing for a big test or raising children are circumstances that are almost certain to cause stress, worry or anxiety. This is considered normal. Experiencing excessive worry that never lets up, however, is not normal. Some things that individuals with GAD worry about include:

  • Job security or performance
  • Health
  • Finances
  • Children
  • Being late
  • Completing household chores and other responsibilities


Signs and Symptoms

The National Institute on Mental Health has found that generalized anxiety disorder develops slowly. Many cases develop during the teen years. Others develop during young adulthood. Some symptoms of GAD are:

  • Excessive worry about daily things
  • An inability to control worry
  • An inability to relax or concentrate
  • Being easily startled
  • Sleeping difficulties
  • Feeling tired
  • Headaches, muscle aches and stomach aches as well as other unexplained pains
  • Feeling unable to swallow
  • Experiencing trembles or twitches
  • Feeling on edge
  • Sweating
  • Feeling lightheaded or out of breath
  • Feeling a frequent need to go the bathroom


GAD Symptoms in Children

Children are not immune to generalized anxiety disorder. Children and young adults are actually the more at-risk groups for certain mental health disorders for several reasons. The impulse control portion of the brain, for example, does not fully form until the age of 25 years old. This is often why substance use issues develop at a younger age. Genetic, neurobiological and temperamental factors in a child can determine if they are more predisposed and susceptible to developing a disorder such as GAD.

GAD symptoms in children include:

  • “What if” fears
  • Perfectionism
  • Feeling that they are to blame for any disaster
  • Needing frequent reassurance and approval

Children and especially teens undergo several changes until they get into their 20s. This is why it can be difficult to diagnose something like generalized anxiety disorder. The teen years, for example, tend to be filled with angst, so it is hard to determine when a mood is just that angst or something more serious. Children living with undiagnosed and untreated GAD symptoms are common.


Risk Factors

Researchers are finding that both genetic and environmental factors contribute to the risk of developing an anxiety disorder. Although the risk factors for each type of anxiety disorder can vary, some general risk factors for all types of anxiety disorders include:

  • Temperamental traits of shyness or behavioral inhibition
  • Exposure to stressful and negative life or environmental events in early childhood or adulthood
  • Biological history of anxiety or other mental illnesses
  • Physical health conditions such as thyroid problems or heart arrhythmia
  • Existing medication that contains caffeine, which can produce or aggravate anxiety symptoms


GAD and Substance Use Disorder

The Anxiety and Depression Association of America estimates that anxiety disorders are the most common mental illness affecting Americans. At least 40 million adults aged 18 and older, or 18.1% of the population, experience an anxiety disorder on an annual basis. Anxiety disorders are treatable, but only an estimated 36.9% of those needing it receive treatment. Individuals with an anxiety disorder tend to visit their doctor up to five times more than a person who does not, and they are six times more likely to be hospitalized for psychiatric issues.

As mentioned, children are not immune to the effects of anxiety. In fact, over 25% of young people between the ages of 13 and 18 years old are living with anxiety. Signs that a child is being left untreated for an anxiety disorder include performing poorly in school, missing out on important social experiences and engaging in substance use.

It should also be noted that anxiety disorders in both children and adults can co-occur with other disorders. The most common are depression, eating disorders and ADHD, which can also co-occur with addiction issues.


Co-Occurring Disorders

Individuals who have a mental health disorder often also have a substance use disorder. In terms of adolescents, 60% of those who are admitted to a community-based substance use disorder treatment program also meet the diagnostic criteria for mental illness. Individuals diagnosed with depression, anxiety disorders, schizophrenia and personality disorders are more likely to develop a substance use disorder. The rates of alcohol use also go up when someone is dealing with anxiety. Studies have shown that approximately 20% of Americans living with anxiety or a mood disorder such as depression have issues with alcohol or drug use.

When comorbidity exists, doctors have to be extra careful with their diagnosis and treatment. Essentially, they have to peel away the layers to figure out what symptoms belong to the correct condition. If the substance use disorder came first, a doctor may not be able to prescribe medication because the patient has a higher risk of not using it as prescribed.

For psychiatrists, anxiety and substance use disorders are the most common conditions in patients. One treatment option for these cases is pharmacotherapy. The recommendation has become that a patient who exhibits both disorders should have their disorders treated simultaneously. Researchers agree that there is still a long way to go in developing the best treatment practices for co-occurring disorders.


Treatment for Generalized Anxiety Disorder

For the person who is experiencing generalized anxiety disorder, it may seem as if it is impossible to get over the condition. However, there are several treatment options, including:

Cognitive behavioral therapy (CBT) uses education, monitoring and physical control strategies as well as cognitive control strategies and behavioral strategies. The therapy targets the connection between thoughts, physical symptoms and behaviors, namely the negative ones that lead to the disorder. The intent is to change how the patient is relating to their symptoms. By educating the patient on what GAD actually is, they may understand why it happened and how to prevent its control over them. In a sense, it empowers the patient to overcome the disorder by making different choices.



During therapy, the patient spends a good chunk of the session talking. When they are not talking, they are listening to a licensed professional. It is an opportunity to learn social skills, too. Plus, it is a safe environment to learn coping skills.

Exposure therapy may be  with CBT. The goal is to identify, challenge and neutralize thoughts that are preventing the patient from overcoming GAD. A patient may have homework in between the sessions. This gives them something to talk about at the next session and also gives the licensed professional the opportunity to assess how the patient is progressing.


Medication for Anxiety

There are several prescription medications available to individuals suffering from anxiety as well as GAD. They include:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Benzodiazepines
  • Anti-anxiety medications
  • Antidepressants
  • Beta-blockers

A doctor will make a careful assessment before prescribing medication for anxiety disorders. They have to ensure that there is no existing substance use disorder first. A doctor also has to find out if the patient is already on any prescriptions. Benzodiazepines, for example, can have a negative reaction with prescription opioids. Any prescription consumed for an extended period of time can lead to tolerance and other side effects.


Self-Help Tips

Individuals who cannot get the professional help that they need immediately can take advantage of some self-help tips. When it comes to an anxiety disorder such as GAD, achieving a clear mind and relaxation are key. This can be done without medication and as stepping stone towards therapy. Relaxation techniques include:


Some Self-Help Tips

  • Connecting with others
  • Learning to achieve calm in a quick manner
  • Looking at situations that cause anxiety in a new light
  • Learning to distinguish between productive and unproductive worrying
  • Relaxation techniques
  • Adopting anxiety-busting habits

Exercise is particularly good for anxiety because it produces natural endorphins that an individual may be missing. Endorphins flood the brain with good feelings that can replace anxiety and worry.

If you’re dealing with generalized anxiety, there is no reason to suffer in silence. Please give us a call today.