Generalised Anxiety Disorder (GAD)

GAD results in a state of chronic, excessive worry and stress. This causes significant distress, suffering and functional impairment. It develops in the absence of any single stressor and lasts at least 6 months.

It is often associated with restlessness, impaired concentration and sleep. it can lead to muscle tension, palpitations and sweating.  GAD takes a chronic course and can increase the risk of other psychiatric disorders.

It is thought to be caused by abnormal serotonergic and noradrenergic neurotransmitter activity. There may also be a genetic link and is often exacerbated by environmental stress.

Treatment

Psychological therapy is the recommended first line treatment, often in combination with pharmacotherapy. 

Psychological therapy includes Cognitive Behaviour Therapy (CBT), psychodynamic therapy, mindfulness based cognitive therapy.

Pharmacotherapy includes antidepressant drugs such as SSRIs, SNRIs as first line. Treatment resistance may warrant other antidepressants such as tricyclic antidepressants, benzodiazepines or Pregabalin.

Self help measures such as exercising and healthy lifestyle changes are also effective in the management in GAD.

A thorough assessment and diagnosis is important to formulate a long term management plan. GAD can resemble other psychiatric conditions and requires careful evaluation and treatment.

 

Guirish Radja