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Frequently asked questions

What is Generalized Anxiety Disorder?
What is "excessive worry"?
How is one diagnosed with GAD?
What are some physical symptoms of GAD?
How prevalent is GAD?
What is a "Cognitive-Behavioral Treatment Program"?
How was this program developed?

Q: What is Generalized Anxiety Disorder?
A: Generalized Anxiety Disorder (GAD) is a chronic disorder with two core features: excessive worry, and a high level of physical tension. One often feeds off or provokes the other, so GAD sufferers are more likely to keep worrying when they feel tense, and to get tense when they start to worry.Worry is usually about events that are upcoming, and is often characterized by "what if"" statements.

Problems with GAD don"t usually become so out of control that sufferers are unable to complete tasks. On the contrary, sometimes worriers use much more energy than they need in completing unnecessary tasks, or complete tasks in an unreasonably short period of time due to the self-imposed sense of pressure. On the other hand, worrying about possible negative outcomes can sometimes lead to procrastination and perfectionism.

The most common impairment that can result from generalized anxiety is a feeling that one isn"t enjoying life, either because leisure activities are given up as one believes there are too many other things to do, or because the worry interferes with activities that were once fun and pleasurable.

Q: What is "excessive worry"?
A: Excessive worry is characterized by:

  • Worry about things that most people do not worry about (such as little things around the home)
  • The recognition that one"s worrying is irrational, but the inability to stop worrying
  • Worry about things that are more commonly worried about, but in a more exaggerated manner
  • Worry that tends to go on and on without ever reaching a possible solution for a particular problem
  • The belief that the cessation of worrying will cause a terrible event to happen
  • Worry that persists even when everything is going well in one"s life, as in a "calm before the storm"

Q: How is one diagnosed with GAD?
A: Mental health professionals use criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association (DSM-IV; APA 1994.) The key feature of GAD is defined as excessive and pervasive worry about several life circumstances. Life circumstances can be relationships with family and friends, health and well-being of oneself or one"s family, home management and work responsibilities, finances, self-worth, and so on. Typically, the worry is focused on striving for perfection, avoiding making mistakes, a strong sense of responsibility, and attempts to maintain guardedness and control as a means of being prepared for and preventing bad things from happening. According to the DSM-IV, this type of worry must persist for at least 6 months, and must not be the direct cause of a real-life trauma.

DSM-IV also emphasizes the difficulty in stopping or "turning off" the worry, as would occur if you had difficulty going to sleep due to worrisome thoughts at bedtime. In addition, three or more physical symptoms must be experienced chronically for at least six months. These symptoms must not be the direct result of a physical disease or condition, such as menopause or thyroid problems.

Q: What are some physical symptoms of GAD?
A: Physical symptoms include:

  • Restlessness or feeling keyed up or on edge
  • Being easily fatigued
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

Q: How prevalent is GAD?
A: Generalized anxiety is very common. The prevalence rate of GAD in the general population over the past year is estimated to be approximately 4%. In the United States as many as 12 million people suffer from generalized anxiety. However, the experience of severe generalized anxiety is also an important part of most other anxiety and phobic disorders. In combination with other phobic and anxiety disorders, the percentage of the general population suffering from a disorder that involves generalized anxiety as a major component increases to approximately 10% to 12%. All sorts of people, across all levels of socioeconomic status and professions experience GAD.

Q: What is a "Cognitive-Behavioral Treatment Program"?
A: A goal of cognitive-behavioral treatment (sometimes referred to as "cognitive-behavioral therapy" or CBT) is to identify those thoughts (cognitions) and behaviors that exacerbate the symptoms of GAD. Once identified, these unnecessary and detrimental thoughts/behaviors can be overcome by using concrete strategies and skills for coping with a disorder. The types of skills that you will learn in this treatment program include reducing physical tension, controlling excessive worry, and dealing with real problem situations.

Q: How was this program developed?
A: This program was first developed at the Center for Stress and Anxiety Disorders, in Albany, New York then substantially revised and updated at the Centers at Boston University (directed by Dr. Barlow) and the University of California at Los Angeles (directed by Dr. Craske). From research studies conducted at the various Centers, it has been found that the type of treatment described in this program is quite successful. Approximately 70% of the people who complete the program are markedly improved, in terms of their physical symptoms, their tendency to worry, and the extent to which they generally find enjoyment in their daily lives.

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