Generalized Anxiety Disorder

What is Generalized Anxiety Disorder?

Generalized Anxiety Disorder (GAD) is a mental health condition, where individuals struggle with excessive worry, most days of the week, and the degree to which they worry is out of proportion to their stressor(s). Symptoms must have persisted for the last 6 + months to make the diagnosis. With that said, many individuals with Generalized Anxiety Disorder will report that they’ve struggled with Anxiety daily –  “for as long as I can remember.”

Patients with Generalized Anxiety Disorder will worry about several different stressors. For example, they may worry about finances, relationships, work, health and their families. Just when they seem to get control over one stressor, they may start worrying about something new. This can be incredibly frustrating and demoralizing, especially if the individual has been working to control their anxiety about a specific topic.

How Common is GAD?

Generalized Anxiety Disorder (GAD) affects about 7 million adults in the US, or 3% of the US population. Women are twice as likely to suffer from GAD than men.

What are the Symptoms of Generalized Anxiety?

• Excessive worry and distress, beyond what “most” would experience given the same stressors.
• An inability to control one’s anxiety.
• Worrying about several different topics or types of stressors, and a sense that once stress from one topic decreases, another tends to take over.
• Anxiety and its symptoms affecting one’s academic, work, social life and relationships.

Physical Symptoms of Anxiety may include:

• Increased heart rate, palpitations
• Gastrointestinal Distress (diarrhea, constipation, bloating)
• Shaking, trembling, twitching
• The feeling of shortness of breath
• Chest pain or discomfort
  • If this occurs, be sure to have a medical evaluation.
• Nausea or even vomiting due to stress
• Headaches
• Muscle Tension
• Fear of Losing control or “going crazy.”
• Others

How is Generalized Anxiety Disorder Treated?

Generalized Anxiety Disorder can be treated with psychotherapy, medication management, or both. We generally recommend Cognitive Behavioral Therapy (CBT) as an effective evidenced-based non-medication option for GAD treatment. Medications such as Selective Serotonin Re-uptake Inhibitors (SSRIs), Selective Serotonin Norepinephrine Re-uptake Inhibitors (SNRIs) and others, can also be very effective for the treatment of Generalized Anxiety Disorder (GAD).

While as needed medications, such as benzodiazepines, can be utilized to treat Generalized Anxiety Disorder, they are typically not utilized as first line agents. This is because individuals with GAD worry most days of the week, for significant portions of their days. Therefore, to treat their anxiety, they may need to take the “as needed” medication most days, daily or even several times a day. This can result in physiological dependence, withdrawal anxiety between doses, or other difficulties. A once daily medication (such as an SSRI or SNRI) that provides 24 hour symptom relief, therefore, tends to be safer, and cause less distress between doses. The experienced clinician may recommend a once daily medication non-controlled medication, and a “rescue” as needed medication, to only be used for “breakthrough” anxiety symptoms.

When to Get Help

We recommend that individuals schedule a psychiatric evaluation for their Anxiety if they experience:

• Symptoms interfering with academic or occupational life
• Symptoms interfering with social life or relationships
• Feeling overwhelmed
• Symptoms affecting sleep, focus, energy or libido
• Feelings of hopelessness
• Crying episodes
• Difficulty being present with friends or loved ones.
• Using poor coping mechanisms (gambling, alcohol or substance use, self-injurious behavior)
• Feelings of depression due to anxiety
• Suicidal thoughts
  • If you have suicidal thoughts, call 911 or 988. Do not wait for an appointment.

Do You Offer Both In-office and Virtual Online Psychiatric Appointments for the Treatment of Generalized Anxiety Disorder?

Yes, we offer both in-office and virtual online psychiatric appointments for the treatment of GAD.

Why Choose Rittenhouse Psychiatric Associates for Treatment of Generalized Anxiety Disorder?

The providers at Rittenhouse Psychiatric Associates are academically oriented providers, most of whom teach, or have taught, at academic institutions. Our providers are Board Certified Psychiatrists and Psychiatric Nurse Practitioners and we have several licensed and doctoral level therapists and psychologists. We are experienced in working with individuals who struggle with various psychiatric conditions, including Generalized Anxiety Disorder.

• Licensed Therapists and Doctoral Level Psychologists
• Board Certified Psychiatrists and Psychiatric Nurse Practitioners
• Academically Oriented providers, most of whom teach, or have taught, at local Academic Institutions, such as Johns Hopkins Hospital & The University of Pennsylvania.
• Appointments generally available within 2 weeks.
• In-office and online Virtual Appointments for the treatment of Generalized Anxiety Disorder
• Providers experienced in treating co-occurring psychiatric conditions.
• Providers who are welcoming to all individuals.