Diagnosis
Diagnosis is clinical. Use a brief validated screening tools like the GAD-7 scale to assess the severity of symptoms and response to treatment.
H&P:
Risk Factors:
Common presentation:
Associated conditions:
Diagnostic studies:
DDx & Causes:
Assessment. GAD-7 score:
Treatment
-1st line therapy: CBT, pharmacotherapy (with SSRI/SNRI), or combination of CBT + SSRI/SNRI.
-To avoid relapse, continue pharmacotherapy for 12 months after symptoms improve before tapering.
-Exercise – physical activity reduces stress and is effective for GAD or Panic disorder.
-Eat healthy foods.
-Get Enough Sleep. Get enough sleep, about 7-8hrs per day.
-Don’t drink alcohol or use other sedatives. They worsen anxiety.
-Stop smoking and cut back or quit drinking coffee. Both nicotine and caffeine can worsen anxiety.
-Mindfulness meditation may reduce anxiety severity more than stress management education in pts with GAD.
-Relaxation therapy and cognitive therapy are equally effective for GAD
-Acceptance-based therapy is associated with a reduction in GAD symptoms.
-Use relaxation techniques. Visualization techniques, meditation, and yoga are examples of relaxation techniques that can ease anxiety.
-Herbal therapies: Lavender oil gel caps reduce anxiety symptoms in pts with GAD; Kava appears as effective as buspirone; Galphimia glauca extract appears to work as much as lorazepam in pts with GAD.
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References
N Engl J Med 2015; 373:2059-2068. Generalized Anxiety Disorder. https://www.ncbi.nlm.nih.gov/pubmed/26580998
Am Fam Physician. 2015 May 1;91(9):617-624. http://www.aafp.org/afp/2015/0501/p617.html
http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/basics/treatment/con-20024562