Generalized Anxiety Disorder Treatment: The Complete Guide

Generalized anxiety disorder (GAD) is one of the most common forms of anxiety disorder and one of the most prevalent mental health disorders in the United States and around the world. It affects an estimated 6.8 million adults in the United States each year, which is approximately 3.1% of the U.S. population. 

Generalized anxiety disorder has significant consequences on both physical and emotional health. Left untreated, it can have a profoundly negative impact on one’s ability to lead a normal life. But with treatment, individuals can learn to manage their symptoms and return to a more productive lifestyle. Keep reading to learn more about generalized anxiety disorder treatment options and more.

What is Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is a long-term condition characterized by persistent and excessive worry, and the reasons for concerns are exaggerated. Symptoms of GAD can make an individual feel persistently on edge, expecting the worst and worrying about health, money, family, work, or school. This worry and fear can become so overwhelming that it disrupts their ability to lead a normal life. Fortunately, GAD can be managed with effective treatments.

Causes of Generalized Anxiety Disorder

The exact causes of generalized anxiety disorder are still unknown, but several potential factors can contribute to it. These include:

1. Genetic predisposition

Studies have shown that people who have a close relative, such as a parent or sibling, with the disorder are more likely to develop it themselves. This suggests that a person can inherit certain genes that make them more prone to developing anxiety.

2. Brain chemistry

GAD is thought to be caused by an imbalance of certain neurotransmitters in the brain, such as serotonin, dopamine, gamma-aminobutyric acid (GABA), and norepinephrine. These neurotransmitters are responsible for regulating mood and fear responses in the brain. So, an imbalance of any of them can lead to the symptoms of GAD. For instance, low levels of serotonin can cause an increase in anxious thoughts and behaviors, while low levels of GABA can induce heightened levels of worry and tension.

3. Medical conditions

General medical conditions such as heart disease, thyroid problems, breathing disorders, and certain types of pain can cause physical symptoms that can lead to the development of GAD or exacerbate existing symptoms. Also, so can certain medical conditions that cause stress and uncertainty.

4. Environmental factors

There can be stressful life events such as the death of a loved one, financial difficulties, or traumatic experiences that can lead to GAD. Other environmental factors, such as chronic stress, lack of social support, and a negative family environment, can also contribute to the development of GAD.

5. Personality traits

People who are more prone to worrying, perfectionism, and negative thinking are more likely to develop GAD. So are people with a tendency towards negative self-talk and feelings of low self-worth. The same can happen with those who are more easily overwhelmed by stress and find it difficult to cope with it. Finally, people with a tendency towards avoidance behaviors, such as avoiding activities and tasks that cause anxiety, may also be more likely to develop GAD.

6. Lifestyle factors

A poor diet lacking essential nutrients can contribute to anxiety due to the body not having the nourishment it needs to function properly. Alcohol and drug abuse can lead to an increase in symptoms of GAD, such as feelings of worry, fear, and difficulty sleeping. It can also exacerbate existing mental health issues such as depression or anxiety. Regular exercise, as well as proper sleep, help reduce stress and anxiety levels.

Also, the risk for women to develop generalized anxiety disorder (GAD) is higher than for men. This is in part because women are more likely to experience heightened levels of stress and worry, which can contribute to GAD.

It is important to remember that GAD does not discriminate—anyone can develop it, regardless of age, gender, race, or socioeconomic status.

Symptoms of Generalized Anxiety Disorder

Individuals with generalized anxiety disorder (GAD) experience worrying and tension that is disproportionate to their actual problems, along with physical symptoms. To be diagnosed with GAD, these symptoms must persist for at least 6 months and cannot be caused by any other medical condition.

Common generalized anxiety disorder symptoms include:

• Excessive and persistent worrying or anxiety concerning multiple issues that do not necessarily commensurate with the actual gravity of the situation.
• Difficulty relaxing, restlessness, and feeling anxious or tense.
• Constantly examining plans and solutions for potential worst-case scenarios.
• Viewing situations and occurrences as potential dangers, even when they are not.
• Struggling with uncertainty.
• Inability to move on or let go of concerns.
• Apprehension of being unable to make the right choice and being afraid of the potential consequences of a wrong decision.
• Avoidance of situations or activities that induce or amplify anxiety.
• Feelings of dread or fear of the future.
• Irritability, nervousness, or being easily startled.

Possible physical signs and symptoms are:

• Difficulty sleeping and concentrating.
• Fatigue.
• Muscle tension or aches.
• Digestive disturbances such as nausea, diarrhea, and irritable bowel syndrome.
• Sweating.
• Trembling, feeling twitchy.

If a person experiences multiple symptoms that dramatically affect their everyday life, medical help should be sought. With a correct assessment and adequate treatment, those affected by GAD can learn to manage the condition.

Assessment and Diagnosis

In this next section we review self-assessment for GAD and getting a medical diagnosis.

Self-Assessment

Although self-assessment questions are not definitive in diagnosing GAD, they can help identify worrisome trends or behaviors. Taking a self-test is a good way to start understanding anxiety levels, but it should only be a step in a comprehensive treatment plan.

One simple self-assessment tool is the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. It was designed to help individuals evaluate their anxiety symptoms based on seven questions. The results of the GAD-7 can help to decide if it is time to seek professional help.

Another self-assessment tool is an online anxiety test on our website. It contains 20 statements that make it possible to check the symptoms over the past month, evaluate the possibility of having an anxiety disorder, and decide on seeking professional attention.

The GAD self-assessment tests are typically administered online or in paper form. They can be completed by the individual alone or with the assistance of a mental health professional. The results of the tests are not meant to diagnose a disorder but rather to provide the individual with an indication of the severity of their symptoms. The information can then be used to help guide further assessment and treatment.

Medical Diagnosis

Diagnosing GAD requires a health care provider to evaluate a person’s symptoms as well as their medical and psychiatric history. During an initial evaluation, a mental health professional asks questions about health and any symptoms a patient may be experiencing. An individual may also be asked to complete a standard mental health questionnaire.

While diagnosing generalized anxiety disorder, DSM-5 criteria is normally used. According to it, the doctor assesses whether the patient’s symptoms impact daily life, if they are causing significant distress or disrupting their functioning in social, occupational, or other important areas. This can help to determine the severity of GAD and the patient’s ability to fulfill daily tasks and obligations. In addition, the health care provider will make sure the symptoms are not the direct physiological effects of another medical condition or substance use. 

Once all the necessary evaluations have been completed, the mental health provider will make a diagnosis. Depending on the severity of the symptoms, they may also recommend a treatment plan and refer a patient to a therapist.

Generalized Anxiety Disorder Treatment Options

GAD can be successfully managed and treated, and it is possible to return to a full and productive life. Treatment should be tailored to each individual, and the right combination of medications and other therapies can help alleviate the symptoms of GAD and improve one’s quality of life.

Therapy

Psychotherapy is an umbrella term that encompasses a variety of different approaches.

1. Cognitive-behavioral therapy (CBT) is a type of psychotherapy that helps people identify and change negative patterns of thinking and behavior that can lead to anxiety and other mental health issues. It focuses on teaching individuals how to recognize and challenge their irrational thoughts and beliefs. It also shows how to manage their emotions and behaviors to reduce anxiety symptoms.
2. Psychodynamic psychotherapy focuses on exploring and understanding the unconscious motivations and conflicts that drive a person’s thoughts, feelings, and behaviors. This approach seeks to uncover and address the underlying causes of anxiety, such as unresolved issues from childhood, traumatic experiences, or relationship issues. The therapist helps the patient uncover these issues and work through them to better understand the anxiety and how to manage it.
3. Supportive-expressive therapy focuses more on providing emotional support and helping patients express their feelings and experiences in a safe and supportive environment. This approach helps the patient to identify their anxiety triggers and learn coping strategies to manage them. The therapist will also help the patient develop new problem-solving skills and self-confidence.

Medication

The two primary types of medications for GAD are antidepressants and benzodiazepines. However, other types of drugs can be prescribed as well in some cases. A doctor or psychiatrist can provide an assessment and recommend the best medication for a patient’s particular needs.

Antidepressants

Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine inhibitors (SNRIs), work by increasing neurotransmitter levels in the brain. This, in turn, can reduce the anxiety and worry that characterize GAD. Popular antidepressant medications such as Prozac (fluoxetine), Zoloft (sertraline), Lexapro (escitalopram), and Effexor XR (venlafaxine) can take several weeks to start working, and it may take up to several months for the full effects to be felt.

The benefits of antidepressants for GAD treatment have been well-documented in numerous studies. A meta-analytic review study suggests that SSRIs and SNRIs are effective in 60-75% of adult patients in managing GAD symptoms. Moreover, SSRIs and SNRIs are generally well-tolerated, and the few side effects that may occur usually diminish over time as the body adjusts to the medication.

Benzodiazepines

Benzodiazepines are a class of medications used to treat anxiety disorders like generalized anxiety disorder by increasing the amount of a calming brain chemical called GABA (gamma-aminobutyric acid), which reduces over-activity in the brain. The most common drugs in this category are Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), and Valium (diazepam). Benzodiazepines can be used in two ways: for short-term or long-term treatment.

Short-term treatment of GAD with benzodiazepines is usually recommended for those experiencing severe, acute symptoms, such as panic attacks. These drugs can be taken as needed when the symptoms become too severe. They typically take effect within minutes, relieving the intense symptoms associated with anxiety attacks. However, benzodiazepines can be habit-forming and should be used with caution. The dosage should never exceed the recommended amount, as it could lead to dependence and tolerance.

Long-term treatment of GAD with benzodiazepines is reserved for those with persistent and long-standing anxiety symptoms. In this case, the drugs are used to maintain a regular level of anxiety relief daily. This is done by taking the medication either once or twice a day. As with short-term treatment, tolerance and dependence can become an issue when taking benzodiazepines over a long time.

Beta-blockers

Other medications, such as beta-blockers, can also help reduce physical symptoms of anxiety, such as rapid heart rate and sweating.

Before taking prescribed medication, it is important to discuss any potential risks with a doctor and keep them informed about experiencing any side effects.

Routine Changes

Here are some lifestyle changes that can help manage GAD:

1. Getting enough sleep. Getting enough rest can help improve mood as well as reduce anxiety symptoms and the risk of developing certain physical health problems.
2. Exercising regularly. Regular exercise can reduce the severity of symptoms and even prevent them from occurring.
3. Spending time in nature. Physically, being in nature can help reduce stress hormones and increase endorphins, leading to improved mood and decreased anxiety. Psychologically, being in nature can provide a sense of calm and relaxation. It can also help provide perspective and clarity, which reduces rumination and excessive worrying.
4. Practicing mindfulness and relaxation techniques. Mindfulness can decrease stress and distract a person from worries. Such relaxation techniques as progressive muscle relaxation (PMR) and deep breathing can slow breathing rates, reduce muscle tension, and promote feelings of calm.
5. Eating a healthy diet. Eating a balanced diet that is rich in fresh vegetables, fruits, and whole grains may contribute to reducing the symptoms of anxiety.
6. Limiting caffeine and alcohol. Consuming too much caffeine can lead to increased anxiety, restlessness, and difficulty sleeping. Alcohol is a depressant and can worsen symptoms such as difficulty sleeping, restlessness, and fatigue.
7. Connecting with others. Joining a support group can provide a safe place for a patient to talk about their experience with GAD and get support from people who understand what living with anxiety is.

Final Thoughts on Generalized Anxiety Disorder Treatment

Thank you for reading our guide on generalized anxiety disorder treatment. GAD can interfere with daily functions, from work to social activities, leading to decreased job performance and worsening relationships. It is a complex disorder that requires a comprehensive treatment approach.

So, in order to get hold of generalized anxiety disorder, medication, psychotherapy, and routine life changes or their combination should be used. A qualified mental health professional will determine the best course of treatment.

At MEDvidi, licensed MDs from your state can prescribe anxiety medication online and provide you with same-day therapy sessions according to your individualized treatment plan.

Find more mental health professionals that treat generalized anxiety disorder

Author: Dr. Taryn Fernandes, MD

Born and raised in Northern California, graduated from San Diego State University in 2009 with a Bachelor’s Degree in Biology. Continued my education with a double Master’s degree in healthcare administration and management and biomedical sciences. Finished my education with an MD from Chicago medical school in 2016. Attended internal medicine residency program at Northwestern Medicine and began practicing in 2020. My primary practices have been mental health, medical weight loss, Geriatrics and Regenerative Medicine. My practice philosophy is providing evidence based, patient centered care. I believe mental wellness is the starting point in achieving overall health, happiness and success. With the correct tools and guidance, the possibilities are endless. I am honored to guide patients along their journey to reach their personal health goals.