The History of Generalized Anxiety Disorder

Generalized anxiety disorder, or GAD, has been distinguished from other anxiety disorders since 1980. Characterized as excessive worry for at least six months, GAD has been diagnosed in more and more people during the last 30 years. More research is still needed before its causes can be determined and treatment can be fine-tuned.

  1. Distinguishing GAD

    • In 1980, the American Psychiatric Association changed its classifications and separated anxiety neurosis into GAD, a chronic anxiety that is sustained for a long period of time, and panic disorder, intense anxiety presenting itself in spontaneous episodes. Although Sigmund Freud observed "free-floating anxiety" in the general public in the early 1900s, there is limited information about GAD's history.

    Symptom Criteria

    • One of the reasons GAD's history is difficult to follow is because of the mildness of its symptoms, such as tension, restlessness, irritability, headaches, nausea, fatigue, insomnia and trembling. GAD also has a high rate of occurring simultaneously with other mental health disorders, like phobias, depression and obsessive-compulsive disorder.

      To be diagnosed with GAD, a patient has to present with excessive or pathological worry that is difficult to control and usually negatively impacts his life. GAD is a more severe disorder than panic disorder due to its longer course, earlier age of onset and lower rates of response to treatment. Many GAD patients report anxiety symptoms from as early as 10 years old.

    Causes

    • While there is no one cause of GAD, psychiatric researchers believe genetics, brain chemistry and environmental stresses all contribute to its development. Current GAD research indicates that it is a disorder that can be passed down in families. It has also been associated with abnormal levels of the brain's neurotransmitters. Trauma such as abuse, death of a loved one, divorce and changes in jobs or schools, can trigger GAD.

    Gender Impacts

    • Twice as many women than men have been diagnosed with GAD, according to studies in the past 30 years. In fact, researchers of the data collected in the 1994 National Comorbidity Survey (NCS) determined that homemakers and unemployed respondents, who were mostly female, had higher prevalence of GAD than others.

    Further Research

    • Much is still being learned about GAD. To date, there have not been many conclusive studies on GAD patients' responses to treatment, for instance. It is also nearly impossible to perform follow-up studies on any research done before 1980 because of the inability to determine the percentage of patients who had GAD versus panic disorder and vice versa.

      The one-year, follow-up Environmental Catchment Area (ECA) study in 1980 determined that there was a 56 percent recovery rate for GAD, as well as the possibility for GAD to last decades, if not an entire lifetime; however, coexisting disorders were not taken into account. Current research is still attempting to separate GAD from panic disorder.

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