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Practical Treatments for Generalized Anxiety Disorder
Generalized Anxiety Disorder is a recognized and common condition. With the levels of stress that most of us face every day, it is no wonder that this disorder could easily develop. It is good to know that it is a medical condition that can be practically treated with medications and/ or psychotherapy. The primary symptoms associated with Generalized Anxiety Disorder (GAD) are tension, inability to relax and persistent worrying over matters that don't call for any extreme concern. Any person with GAD will find it difficult to control the symptoms. It is as if there is a roller coaster of anxiety running through the mind at all times and it will not stop unless the person experiencing these symptoms can find quiet isolation. Other symptoms that accompany this disorder are difficulty concentration, being easily startled, chronic irritability which could lead to drug seeking behavior, general restlessness and insomnia (Hoffman SG, 2008).

The most practical approach to treating GAD is a combination of cognitive therapy and medication. Cognitive therapy is a way or re-training the brain to react to certain stimuli in a healthy manner. For example, if the sound of a dog barking induces a panic attack, the therapist would work with someone to discover what triggers this reaction. These triggers set off a chemical cascade in the brain that induces anxiety. By discovering the thoughts that cause the anxious reaction, the cognitive therapist is then able to help re-route the thinking process to eliminate the sensation of anxiety and panic. Often, by the time a person has reached the doctor's office for this problem, it is necessary to use medication to alleviate the symptoms and protect the body from the dangers of chronic stress.

Currently, the primary pharmacological treatment of Generalized Anxiety Disorder is a class of drugs called SSRIs (Selective Serotonin Reuptake inhibitors). These medications have been proven to be the best treatment for GAD. They increase the levels of a neurotransmitter (a chemical that facilitates a specific electrical impulse in the brain) called serotonin. When there is enough serotonin in our brains, we feel content, confident, trusting and safe. When serotonin is deficient, we feel scared, worried, shy and insecure (Pollack MH, 2008 ). SSRIs have been proven effective in countless studies. These include medications such as fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and citalopram (Celexa), among many others. When someone has remained on one of these medications for 6-8 months, they may be taken off of the medication to determine if it is still needed. The only drawback to SSRIs is the time it takes for them to demonstrate any benefit. This could take 4-6weeks before any results are perceived.

In the interim, drugs known as benzodiazepines are prescribed for short-term relief until the SSRI begins to work and the cognitive therapy starts to show results. These drugs are immediately effective within less than an hour. Alprazolam (Xanax), lorazepam (Ativan) and oxazepam (Serax) are some of the commonly prescribed benzodiazepines. These are the most effective medications for anxiety disorders, but they are highly addictive, so doctors usually prescribe a small amount until other treatments begin to help.

All of this is good news. Psychiatrists around the world have a plan to treat GAD. You don't have to live with this problem or be afraid of treatments.

Hoffman SG, S. J. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69;621-632 [Pub Med].

Pollack MH, K. G. (2008 ). The Pharmacology of Anxiety Disorders. Massachusets General Hospital Comprehensive Clinical Psychiatry, Chapter 41