How Do I Know If I Have Generalized Anxiety Disorder?
The first step is to rule out the possibility that your symptoms are being caused by a medical condition that is not psychiatric. Among the conditions that produce symptoms similar to those of anxietyare hyperthyroidism or other endocrine problems, too much or too little calcium, low blood sugar, and certain heart problems. Certain medicines also can sometimes cause anxiety. A thorough evaluation by your health care provider will determine if any of these conditions are the cause of your symptoms.
If no other medical culprit can be found and the symptoms seem out of proportion to any situation you are facing, you may be diagnosed with an anxiety disorder.
What Are the Treatments for Generalized Anxiety Disorder?
Antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), are widely used to treat and prevent a variety of anxiety disorders. Examples of SSRIs that are commonly used to treat chronic anxiety include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). The antidepressants duloxetine (Cymbalta) and venlafaxine (Effexor), SNRIs (serotonin and norepinephrine reuptake inhibitors) which act on the brain chemicals serotonin and norephinephrine, and some of the tricyclic antidepressants like imipramine (Tofranil), may also help. Antihistamines (such as hydroxyzine) and beta-blockers (such as propranolol) can help mild cases of anxiety as well as performance anxiety, a type of social anxiety disorder. Antidepressants such as SSRIs or SNRIs or tricyclics need to be taken daily whether or not you have anxiety on that particular day, as prescribed by your health care provider. Antihistamines or beta-blockers are usually taken only when needed for anxiety, or immediately before an anxiety-provoking event (for example, taking propranolol shortly before giving a speech). Finally, certain anticonvulsant medicines, such as gabapentin (Neurontin) and pregabalin (Lyrica), are also beginning to show value in treating some forms of anxiety in initial research studies
Several specific forms of psychotherapy have been described in research studies as helpful for alleviating the symptoms of GAD. Two — psychodynamic psychotherapy and supportive-expressive therapy — focus on anxiety as an outgrowth of feelings about important relationships. Another form of psychotherapy, called cognitive-behavioral therapy, involves learning behavioral relaxation techniques as well as restructuring patterns of thinking that foster anxiety.
Biofeedback is another helpful tool. In a series of sessions with a therapist, you watch your own brain-wave patterns on an electroencephalograph and gradually learns to control the waves. This teaches you to achieve a more relaxed state at will. Practitioners estimate that after about a dozen sessions, you will be able to exert control over mental activity without the help of the therapist or monitoring instrument.
Lifestyle Modifications to Alleviate Anxiety
Daily exercise can be another helpful treatment for anxiety symptoms. If you find that exercise works for you, push yourself to go for brisk walks or undertake an active sport that you enjoy. Get your heart rate into the target range for your age for at least 30 minutes each time you exercise.
Since anxiety is often accompanied by shallow breathing, deep breathing exercises can also be helpful. Try the following form of yogabreathing:
- Lie on your back in a comfortable place.
- Breathe in slowly through your nose, using your diaphragm to suck air into your lungs while allowing your abdomen to expand. (Put your hand on your abdomen just below the navel to make sure the abdomen is being pushed up and out by the diaphragm.) After the abdomen is expanded, continue to inhale as deeply as possible.
- When you breathe out, reverse the process: Contract the abdomen while exhaling slowly and completely.
- Repeat several times.