What it is
Worry dogs you constantly for no logical reason, and you imagine terrible things happening to you. Or maybe you're fearful about taking trips or going to parties or meetings. If so, you might have generalized anxiety disorder. People with GAD experience "uncontrollable worrying," says Peter Norton, PhD, director of the Anxiety Disorder Clinic at the University of Houston. Symptoms include chronic nervousness, trouble sleeping, and fatigue.
Why it happens
Some 7 million American adults?twice as many women as men?have GAD. There's a genetic connection: Children of anxious parents are far more likely to develop GAD. Though traumatic events can trigger anxiety, mysteriously, it may also strike out of the blue. A goal of treatment is to ease the symptoms so they don't interfere with your life. Here's how.
This heavenly therapy slows the release of stress hormones, such as cortisol, which are linked to anxiety, says Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine. Her research found that a month of weekly 20-minute massages lowers cortisol levels?"a very good objective index of anxiety," she says?by 31%. Massage also causes a relaxation response, which eases anxiety. (FYI: Many day spas offer 20-minute chair massages for around $20.) Or you can practice self-massage using a tennis ball, suggests Dr. Field.
"Exercise makes you pay attention to its sensations, such as breathing faster, and the things around you," says Jasper A. J. Smits, PhD, professor of psychology at the University of Texas at Austin. "It helps you disengage from worry." In one study, he found that exercise slashed anxiety in half.
Cognitive behavioral therapy
CBT helps you "evaluate how you think about danger and teaches techniques for reevaluating the degree of that threat," says Dr. Norton. You learn to shift your worry to match the actual amount of danger, he adds. In one review, 46% of people whose anxiety was treated with this talk therapy responded, versus 14% of those who received no CBT. You usually engage in an hour-long session every week for 3 to 4 months; insurance may cover it.
In anxious people, "we see a deactivation in areas of the brain that govern thought," so worries can spiral out of control, says Fadel Zeidan, PhD, a research fellow at Wake Forest School of Medicine. Mindfulness meditation helps you stop the cycle of worry. In Dr. Zeidan's study, anxiety levels of meditators eased by up to 39%.
Hour-long yoga sessions three times a week improved people's moods and anxiety levels after 12 weeks in one study. The level of GABA (gamma-aminobutyric acid), an amino acid in the brain, is lower in people who report anxiety. Among study participants who took a yoga class, GABA levels increased and reports of anxiety decreased after the session. Yoga's deep breathing "stimulates the parasympathetic nervous system, which is associated with the ability to relax," says Chris C. Streeter, MD, an associate professor at Boston University School of Medicine.
Cognitive bias modification helps "change a person's pattern of thinking," says Risa Weisberg, PhD, an associate professor at Alpert Medical School at Brown University. Different clinics administer CBM differently; you might watch a computer screen with threatening and nonthreatening faces and perform tasks that lessen your anxiety when the scary face appears. You can find attention modification via a computer program, developed in partnership with San Diego State University, at managingyouranxiety.com. Four modules?for social anxiety, GAD, fear of public speaking, and fear of germs?are available for $139.99 each.
For chronic anxiety, your doctor may prescribe a selective serotonin reuptake inhibitor. SSRIs, such as paroxetine (Paxil) and sertraline (Zoloft), affect serotonin levels and can improve mood and lessen anxiety. It takes 4 to 8 weeks to see if the drug works for you, says Franklin Schneier, MD, a professor of clinical psychiatry at Columbia University. Tranquilizers, including alprazolam (Xanax), may cause dependency, so they're usually prescribed for short-term use for problems such as fear of flying. "These work almost immediately," says Dr. Schneier. Discuss anxiety drugs' side effects with your doctor; never combine tranquilizers with alcohol.
Taking kava for 6 weeks eased anxiety for 26% of people with GAD in a 2013 study. Research shows that it's effective for up to 6 months. Kava is available in capsules and liquid tinctures; follow label directions.
Norwegian researchers discovered that sleep-deprived people are more likely to be anxious. Here's why: "Sleep loss activates areas of the brain that are also activated during anxiety," says Jack B. Nitschke, PhD, an associate professor of psychiatry and psychology at the University of Wisconsin School of Medicine in Madison. To ward off the willies, aim to get 7 to 9 hours of sleep each night. Dr. Nitschke suggests stepping away from electronic devices 30 minutes before bedtime and jotting your worries down on paper.
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