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Generalized Anxiety Disorder (GAD)
The primary symptoms of GAD are:
- excessive worry; and
- excessive physiological arousal, especially muscle tension.
Some experts refer to GAD as a basic anxiety disorder because it is
more general, not as focused as Panic Disorder, a specific phobia, or
Posttraumatic Stress Disorder. In GAD, an individual often worries excessively
about a number of different areas.
Psychophysiologically, some interesting research has been performed
indicating that individuals with GAD tend to respond to stress with
more muscle tension than individuals who do not have GAD (Brown, Marten,
& Barlow, 1995; and Hoehn-Saric et al., 1989, as cited in Brown et al,
2001). Incidentally, chronically high levels of muscle tension may set
the stage for other physical problems.
It is not unusual for this generalized worry state to set the stage
for later development of depression or a more specific anxiety disorder.
GAD tends to be a more chronic problem, but interventions developed
and tested in the last 15 years have helped individuals to become much
more comfortable. 
Treatment for GAD
As discussed in Brown et al. (2001) and elsewhere, treatment for
GAD typically involves a combination of:
- Relaxation training in order to help decrease excess physiological
arousal.
- Cognitive therapy. Specific strategies to decrease worry including
worry exposure and desensitization and worry behavior prevention.
Often, an individual with GAD will jump from worry to worry at a
rapid pace, returning to each area of worry, but not spending enough
concentrated time with one area of worry to fully process it. Or,
a person will only superficially process a worry as opposed to delving
into it more deeply. This is similar to avoiding a feared object
or situation as soon as it is encountered - the short-term, temporary
anxiety reduction that occurs when the individual jumps to the next
worry reinforces the pattern of avoiding the full processing of
one area of worry and of jumping from one item to another, sometimes
in quick succession. Since trying to avoid the topic of worry provides
brief, temporary relief, there is more tendency to worry in the
first place. It is analogous to having brief contact with a feared
object or situation, avoiding the object, feeling slightly better
with the avoidance, and then being more sensitized to the possible
presence of the feared stimulus in the future. Over a number of
years, this has a huge impact. Correspondingly, by taking one worry
and focusing on it for an extended period of time, after an initial
increase in anxiety, this tends to lead to desensitization.
- Many individuals with GAD report that they tend to procrastinate
and avoid areas of worry. Again, the avoidance feels good in the
short run but then creates even more worry. When appropriate, an
individual receives training in organizational, problem solving,
and time management skills, in order to help decrease the need for
worry.
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