AssessmentsGeneralized anxiety disorder
Generalized anxiety disorder
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 57-year old woman comes to the office because of difficulty sleeping that has been ongoing for years. She says that she has always had difficulty sleeping, but due to a recent change in jobs, the lack of sleep has been affecting her more, and she feels tired throughout the day. She attributes her sleep problems to uncontrollable worry about her children, her job, the family's financial situation, and her relationship with her husband. She denies using alcohol or any other psychotropic medications and has no chronic medical conditions. Which of the following is the most necessary before a diagnosis of generalized anxiety disorder can be made?
Content Reviewers:Rishi Desai, MD, MPH
Contributors:Tanner Marshall, MS
Say you’ve got a huge presentation in front of all your colleagues—you’re feeling a bit nervous, and you get even more stress in the final days leading up to the presentation.
That stress is completely normal, and really, probably useful in certain situations since it can make you more alert and careful.
After the presentation’s over you feel the stress start to fade away, right?
Well, for 3% of the population, the stress doesn’t go away, and the stress isn’t even necessarily brought on by a specific event; it’s just always just sort of… there.
At this point it’s considered to be anxiety.
That anxiety might even get worse over time, and might even cause further problems like chest pains or nightmares.
Sometimes the anxiety is so severe that it causes someone to be anxious about leaving the house or doing everyday things like going to work or school.
This anxiety may be a sign of Generalized Anxiety Disorder, sometimes shortened to GAD.
GAD’s characterized by excessive, persistent, and unreasonable anxiety about everyday things, like money, family, work, and relationships; even sometimes the thought of getting through the day causes anxiety.
There are three general categories for anxiety.
If the anxiety doesn’t seem to go away, it’s called persistent anxiety.
If someone feels greater levels of anxiety than the average person, it’s called excessive anxiety.
If the anxiety is about something that shouldn’t really be causing much stress at all, it’s called unreasonable anxiety.
People who have GAD might understand that their anxieties are excessive and unreasonable, but they feel it’s out of their control and don’t quite know how to stop it.
People with severe GAD might be completely debilitated and have trouble with the simplest daily activities, or they might be only mildly affected and be able to function socially and hold down a job.
Sometimes the feelings might worsen or improve over time.
In addition to having feelings of worries and anxiety, other symptoms of generalized anxiety disorder include edginess and restlessness, difficulty concentrating or feeling like the mind just goes blank, and irritability.
These psychological symptoms can also lead to physical manifestations of symptoms like digestive problems from eating more or eating less.
People with generalized anxiety disorder might have muscle aches and soreness from carrying tension in their muscles.