Generalized Anxiety Disorder

We all have times when we worry: about our personal relationships, our families, our jobs, our finances or our futures. But if you live in a constant state of worry that manifests itself in physical and psychological ways, you may be suffering from generalized anxiety disorder, or GAD. Some people who live with this psychiatric disorder report that they’ve lived with the condition since childhood, and that they’ve never felt free from the symptoms. Others lead normal lives until a major transition or a change in their health triggers GAD.

Generalized anxiety disorder is a common condition. The National Institute of Mental Health estimates that 3.1 percent of adults in the US have met the diagnostic criteria for GAD within the last year.

Out of this number, 32.3 percent suffer from severe anxiety. Unfortunately, less than half of the people (43.2 percent) who live with GAD receive treatment, which suggests that many of these individuals are self-medicating instead of getting the therapeutic care they really need.

If you’re like many people who struggle with fear and anxiety, you may use alcohol or drugs to ease your mind and steady your nerves. Although tranquilizers, pain medication or wine might seem like an effective solution to your worries, substance abuse only perpetuates the fears and anxieties that can turn a stable, secure life into a minefield of worry.

Signs and Symptoms of GAD

A feeling of dread, fear or worry that isn’t justified by reality is the hallmark sign of generalized anxiety disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association, people who have experienced this state of mind for six months or more may have a clinical condition that requires professional treatment.

The signs and symptoms of this disorder show up in the way you think, feel and behave:

  • Constant uneasiness
  • Sleep disturbances
  • Restlessness
  • Tension or irritability
  • Shakiness
  • Nausea
  • Fatigue

GAD may cause disturbing physical symptoms that worsen the anxiety, such as heart palpitations, tremors, chest pain or dizziness. People with GAD are easily startled and jumpy, reacting to everyday situations with an intensity that’s out of proportion. They find it very difficult to relax and may have trouble sleeping, which can lead to a state of mental and physical exhaustion.

Unlike people who have specific anxiety disorders, like social phobia or post-traumatic stress disorder, people with GAD experience anxiety all the time rather than in response to isolated situations. They live in a state of “free-floating” anxiety, which means that their attention drifts from one source of concern to another. Worries about their health may transition to fears about having enough health insurance, which may morph into fears about losing their job or getting a divorce. In most cases, these fears are greatly magnified and don’t reflect the reality of their lives.

Causes and Risk Factors

The exact cause of GAD is still unknown. For many people, the condition is chronic, beginning in childhood or adolescence and continuing through adulthood. GAD may last for years, with symptoms improving or worsening depending on the individual’s circumstances. Some of the possible causes and risk factors include:

  • Genetic background. People with a close relative who has an anxiety disorder are more likely to have GAD themselves.
  • Brain chemistry. An imbalance in neurotransmitters like dopamine, serotonin or norepinephrine — naturally produced chemicals that affect your sense of emotional stability and well-being — may contribute to generalized anxiety disorder.
  • A history of trauma. If you’ve been physically, verbally or sexually abused in childhood or adolescence, you may have a higher risk of developing GAD as an adult.
  • Gender. Although gender is not considered to be a cause of GAD, the condition is twice as common in women as in men.
  • Physical illness. According to the Mayo Clinic, generalized anxiety may be a side effect of medical conditions like hyperthyroidism, gastroesophageal reflux disease (chronic heartburn) or heart disease. Menopausal women may also experience anxiety as a result of hormonal changes.
  • Medications. Certain prescription drugs can produce anxiety as a side effect, including medications to treat asthma, high blood pressure, attention deficit disorder and depression. Steroid drugs, hormone replacement drugs and anti-seizure medications may also cause anxiety.
  • Substance abuse. Alcohol and drug abuse can worsen GAD and may even be a direct cause of the condition. Nicotine and caffeine can also make anxiety worse.

For many people with GAD, the cause of the disorder will remain a mystery; fortunately, the symptoms can be managed successfully with the right kind of treatment. If you’ve been using drugs or alcohol to calm your fears, you may also need treatment for substance abuse. By treating both the psychiatric disorder and the addiction, you’ll have a much better chance of leading the healthy, stable live you deserve.

Anxiety and Substance Abuse

The Anxiety and Depression Association of America estimates that 20 percent of those who have an anxiety disorder also have a substance abuse disorder. Because the symptoms of GAD may mimic some of the side effects of alcoholism or drug addiction, it may be hard to tell where one disorder ends and the other begins. Anxiety may be caused by the use of legal or illegal drugs, including:

  • Cocaine
  • Methamphetamine
  • Amphetamines
  • Marijuana
  • Alcohol
  • Prescription drugs that contain stimulants (Adderall, Ritalin)

Paradoxically, the drugs that you turn to when you’re anxious and worried can make your anxiety worse. You may experience anxiety as a direct result of using drugs, or as a result of the consequences of drug abuse.

The financial problems, health troubles, legal difficulties and relationship conflicts associated with substance abuse can cause your tension to escalate.

In some cases, generalized anxiety disorder goes undiagnosed because alcohol and drugs are used to mask the symptoms. If you drink or take tranquilizers on a regular basis in order to relax, you might not recognize your tension as a symptom of a serious psychiatric condition. Finding out that you have a treatable mental health disorder could be a tremendous relief for someone who’s been living with constant worry and stress.

Dual Diagnosis Treatment for GAD

Dual Diagnosis is a psychiatric condition that occurs along with an addictive disorder. Treating a Dual Diagnosis of GAD may be more complicated than treating anxiety alone. The therapist who treats Dual Diagnosis patients must be able to address both the patient’s psychiatric symptoms and her compulsive need to drink or use drugs. Mental health professionals who treat Dual Diagnosis patients are cross-trained in substance use disorders and in psychiatric disorders like GAD.
A person with GAD may live with the condition for a lifetime, but the symptoms can be managed with a combination of psychotherapy, group support and psychotherapeutic medication. A class of medications called SSRIs (selective serotonin reuptake inhibitors) has been used effectively to treat GAD. In the past, tranquilizers were commonly recommended to relieve the more severe symptoms of anxiety, but doctors have become more conservative about prescribing medications that have a high abuse potential.

When you enroll in a comprehensive recovery program for anxiety and substance abuse, you’ll receive care that reflects the principles of integrated treatment:

  • The members of your care team will have training in both substance use disorders and addiction treatment.
  • Care will be provided in a single location.
  • You may receive pharmacological therapy for both your anxiety and your addictive disorder.
  • Counseling and therapy sessions will be tailored to your needs as an individual with a Dual Diagnosis.

At Foundations Recovery Network, we understand the importance of Dual Diagnosis treatment. Our exclusive treatment centers in Tennessee and Southern California are dedicated to treating individuals who suffer from co-occurring disorders. Based in Memphis, Malibu and Palm Beach, our facilities provide the very best in integrated care. Contact our intake team today to find out how a Dual Diagnosis recovery program could offer you new hope for the future.

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