Therapy for Anxiety: Generalized Anxiety disorder

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Though talk therapy and medication are first-line treatments for GAD, you may also find relief with certain home remedies and lifestyle changes.
Generalized anxiety disorder (GAD) is a type of anxiety disorder that’s treatable, often with a combination of medical and lifestyle tools.

But it can be hard to live with excessive, hard to control, and stubborn worry.

Maybe your symptoms keep you up at night. Maybe the worry arises first thing in the morning as you wake up. Or maybe it feels like you’re rarely worry-free.

People with GAD experience excessive worry more days than not, sometimes worrying from 3 to 10 hours a day.

But you’re not alone — even though you might sometimes feel like it. According to data from the Centers for Disease Control and Prevention (CDC), more than 15%Trusted Source of people experienced symptoms of GAD in 2019 over a 2-week period.

Whatever the causes of anxiety may be, there are many GAD treatments available, along with coping tools that can help you prepare for your next doctor’s appointment.

Diagnosis
To help diagnose generalized anxiety disorder, your doctor or mental health professional may:

Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition
Order blood or urine tests or other tests, if a medical condition is suspected
Ask detailed questions about your symptoms and medical history
Use psychological questionnaires to help determine a diagnosis
Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Symptoms of generalized anxiety disorder
According to the DSM-5 criteriaTrusted Source, to be diagnosed with GAD you must experience your symptoms for most days over a 6-month period. You must have 3 or more of the following 6 symptoms in this period:

feeling restless, keyed up, or on edge
having difficulty concentrating or feeling like your mind is “blank”
being irritable
fatiguing easily
feeling tension in your muscles
experiencing sleep issues such as difficulty falling or staying asleep, or restless unsatisfying sleep
Children don’t need to meet as many criteria to be diagnosed with GAD. Only one symptom — rather than three — is required to be diagnosed.

However, symptoms of GAD can go beyond the diagnostic symptoms outlined above, and can include:

feeling a general sense of nervousness
being easily startled
experiencing headaches, muscle aches, or stomachaches, or other unexplained pains
having difficulty swallowing or feeling a lump in your throat
twitching or trembling
sweating a lot or experiencing hot flashes
feeling lightheaded or out of breath
feeling nauseated
having to use the bathroom a lot
These symptoms can be better or worse at different times and are often worse when you’re stressed.

GAD may come on gradually, with many people reporting feeling at least mild anxiety symptoms for their entire lives. An anxiety disorder can begin at any time — in childhood, adolescence, or even late adulthood.

GAD is reportedly more common in women than in men and often occurs in relatives of people with anxiety disorders, meaning there may be a genetic component.

Treatment
Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

Psychotherapy
Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder.

Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you’ve avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.

Medications
Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects.

Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants.
Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective.
Benzodiazepines. In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren’t a good choice if you have or had problems with alcohol or drug abuse.
Alternative medicine
Several herbal remedies have been studied as treatments for anxiety. Results tend to be mixed, and in several studies people report no benefits from their use. More research is needed to fully understand the risks and benefits.

Some herbal supplements, such as kava and valerian, increase the risk of serious liver damage. Other supplements, such as passionflower or theanine, may have a calming effect, but they’re often combined with other products so it’s hard to tell whether they help with symptoms of anxiety.

Before taking any herbal remedies or supplements, talk with your doctor to make sure they’re safe and won’t interact with any medications you take.