The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).į. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.Į. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).ĭ. Difficulty concentrating or mind going blank.Ħ. Restlessness or feeling keyed up or on edge.ģ. Note: Only one item is required in children.ġ. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): The individual finds it difficult to control the worry.Ĭ. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).ī. Medication should be continued for 12 months before tapering to prevent relapse.Ī. Several common botanicals and supplements can potentiate serotonin syndrome when used in combination with antidepressants. A number of complementary and alternative treatments are often used however, evidence is limited for most. Physical activity can reduce symptoms of GAD and PD. Benzodiazepines are effective in reducing anxiety symptoms, but their use is limited by risk of abuse and adverse effect profiles. Among psychotherapeutic treatments, cognitive behavior therapy has been studied widely and has an extensive evidence base. Treatment often includes medications such as selective serotonin reuptake inhibitors and/or psychotherapy, both of which are highly effective. Successful outcomes may require a combination of treatment modalities tailored to the individual patient.
The GAD-7 and the Severity Measure for Panic Disorder are free diagnostic tools. Screening and monitoring tools can be used to help make the diagnosis and monitor response to therapy.
Diagnosing GAD and PD requires a broad differential and caution to identify confounding variables and comorbid conditions. Evidence suggests that the rates of missed diagnoses and misdiagnosis of GAD and PD are high, with symptoms often ascribed to physical causes.
Patients may end up in the ED.Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient's quality of life and disrupt important activities of daily living.
Somatic concerns of death from cardiac or respiratory problems may be a major focus of patients during an attack. A panic attack generally lasts 20-30 minutes from onset and rarely more than an hour. DSM-5 criteria for panic disorder include four or more attacks in a 4-week period, or one or more attacks followed by at least 1 month of fear of another panic attack.