Generalized anxiety disorder

Alternative Names

Treatment

The goal of treatment is to help the person function well. The success of treatment usually depends in part on how severe the generalized anxiety disorder is.

The standard approach combines cognitive-behavioral therapy (CBT) and an antidepressant medication.

Selective serotonin reuptake inhibitors (SSRIs), such as Paxil, are usually the first choice. Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor), are another choice. Other antidepressants and some anti-seizure drugs may be used for severe cases.

Other anti-anxiety medications may also be prescribed. Benzodiazepines may be recommended if antidepressants don't help.

Behavioral therapies that may be used together with drug therapy include relaxation techniques, pleasant mental imagery, and cognitive behavioral therapy to change distorted and possibly harmful perceptions of severe anxiety.

Other counseling and therapy techniques may help people gain an understanding of the illness and the factors that protect against or trigger it.

A healthy lifestyle that includes exercise, enough rest, and good nutrition can help reduce the impact of anxiety.

Support Groups

Support groups may be helpful for some patients with GAD. Patients have the opportunity to learn that they are not unique in experiencing excessive worry and anxiety.

Support groups are not a substitute for effective treatment, but can be a helpful addition to it.

Outlook (Prognosis)

The disorder may continue and be difficult to treat, but most patients see great improvement with medications or behavioral therapy.

Possible Complications

People with GAD may develop other psychiatric disorders, such as panic disorder or depression. Substance abuse or dependence may become a problem if you try to self-medicate with drugs or alcohol to relieve anxiety.

When to Contact a Medical Professional

Call your health care provider if you are experiencing the signs and symptoms of generalized anxiety disorder, especially if this has been going on for a period of 6 months or longer, or it interferes with your daily functioning.

References

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. St. Louis, Mo: Mosby; 2004: 174-175.

Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001:416.

Gale C, Davidson O. Generalised anxiety disorder. BMJ, 2007;334:579-581.

Schneier FR. Social anxiety disorder. NEJM, 2006;355:1029-1036.

Katon WJ. Panic Disorder. NEJM. 2006;354:2360-2367.

Bernstein GA, Shaw K. Practice parameters for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry, 2007;46:267-283.