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How to Treat Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) is a condition featuring excessive, exaggerated, unrealistic, and persistent worry and anxiety about the future and daily life. People struggling with this condition typically have no clear reasons or triggers for those concerns, and they are unable to stop worrying about certain aspects of their lives, such as education, relationships, money, etc.
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Different from Panic Disorder

Steps to Treat Generalized Anxiety Disorder

Once the physician has determined that the individual is being affected by GAD, there are some common treatment steps.

Generalized Anxiety Disorder: Symptoms and Diagnosis

There are several symptoms of GAD that therapists use to diagnose the condition. Some of these include:

  • Inability to let go of worry
  • Inability to relax or constantly feeling restless
  • Difficulty concentrating
  • Mind goes “blank”
  • Worry about feeling excessively worried
  • Imagining every scenario to a possible negative conclusion

Generalized anxiety disorder can take a physical toll on the person struggling with this disorder, so there are physical effects of this mental illness. Some of these include:

  • Fatigue
  • Muscle tension or aches
  • Twitchiness or trembling
  • Feeling excitable or easily startled
  • Difficulty sleeping, insomnia, or waking up frequently
  • Sweating
  • Nausea or stomach pain
  • Headaches

In order to appropriately diagnose GAD and create a treatment plan, a therapist will use the DSM-5 to determine whether the condition is GAD, a different anxiety disorder, a phobia, or another mental health condition. Some of the diagnostic process may include a physical exam and tests of the urine or blood.

Treating Generalized Anxiety Disorder

Step 1: Medication

Generalized anxiety disorder can interfere with daily functioning, and starting treatment with medication can reduce anxiety and fear by changing the person’s brain chemistry. This regimen may begin with slightly higher doses of a particular medication in order to stabilize the individual, help them get rest and sleep, and assist in lowering heart rate and blood pressure. This is a short-term solution, and once the person has emotionally and physically stabilized, the therapist or physician is likely to reduce or change the dose or the medication. More powerful medications may be prescribed on an “as-needed” basis. This helps to stop panic attacks or insomnia if the individual should begin suffering more intense symptoms later in the course of GAD treatment.

Short-term medications are typically in the benzodiazepine class. Due to a high potential for abuse and addiction, these medications are not prescribed for more than one month or only on an as-needed basis. However, they are very useful for helping an individual struggling with intense GAD symptoms to relax and get some needed rest. These medications include:

  • Xanax (alprazolam)
  • Klonopin (clonazepam)
  • Ativan (lorazepam)
  • Buspar (buspirone)

Some common medications used in the treatment of generalized anxiety disorder are antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). These may include brand names like Lexapro, Cymbalta, Effexor, or Paxil.

Step 2: Cognitive Behavioral Therapy and Medication Balance

Once the individual’s mood has stabilized with the help of short-term medications, they are ready to begin therapy, though therapy often begins before full stabilization has occurred. Although there are many options for therapeutic treatment, the most effective and widely used is Cognitive Behavioral Therapy. The approach of this treatment involves regular sessions in which the therapist helps their client learn to recognize specific patterns in thoughts or behaviors, how those represent symptoms of anxiety, and how they can jumpstart cycles of anxiety. The person struggling with generalized anxiety disorder will learn more about these thoughts, feelings, and behaviors, and learn ways to manage symptoms. They will also learn to think through problems more realistically and examine potential positive outcomes instead of simply negative outcomes.

The therapist may also use biofeedback and deep breathing exercises to help their client relax in the moment and manage symptoms of a panic attack. Hypnotherapy can also be used to help clients who are more suggestible.

Step 3: Lifestyle Changes

Once a person struggling with generalized anxiety disorder has started their medication and therapy, they can support long-term management of their condition by making changes to their lifestyle as well. Some of these changes include:

  • Reducing or quitting caffeine and sugar intake, and quitting stronger drugs like nicotine, alcohol, marijuana, and illicit drugs
  • Getting regular exercise, daily or every other day
  • Participating in meditation, breathing exercises, and yoga
  • Eating healthier foods and drinking enough water
  • Talking to as family and friends, so they are informed about the condition, patient, and helpful in times of stress or crisis
  • Preparing a plan with their therapist in the event of emergency situations, such as major life changes or a return of symptoms

It is especially important for people who have been diagnosed with GAD to reduce their consumption of intoxicating substances. Alcohol in particular, as a central nervous system depressant, can make a person feel relaxed and calm almost immediately. Nicotine can provide the same effect in some people, as can marijuana. However, once the effects of the first dose of these or other drugs wears off, the person’s brain chemistry can rebound, and they may continue to suffer anxiety, or their symptoms can get worse. People who ingest stimulants, from caffeine to club drugs like MDMA, can also experience increased levels of anxiety and the potential for panic attacks during the drug’s peak effects or when the effects of the drugs begin to wear off.

Help for Generalized Anxiety Disorder

People who struggle with mental health problems like generalized anxiety disorder are at a greater risk of self-medicating their conditions if they do not receive appropriate treatment. Self-medication with alcohol or other CNS depressants can actually make symptoms worse, even if the symptoms initially feel better.

When a person becomes addicted to a substance because of an attempt at self-medicating a mental health problem, they develop co-occurring disorders. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 7.9 million Americans struggle with both a mental health and substance abuse problem.

As more people are being diagnosed with these co-occurring conditions, rehabilitation programs are becoming better able to understand and help these patients. It is increasingly likely that a person will receive thorough treatment in a rehabilitation program for both their mental health and substance abuse problems. Help is available; reach out for it today.