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Treatment options

Generalized anxiety disorder (GAD) is becoming a more common problem as the pressures of life grow more challenging. Looking at the fallout from the recession, you can see increasing insecurity as people fight to keep a job, keep their homes, and put enough food on the table. Despite all the pressure, most cope well, but an increasingly significant number of people are falling into a pattern of anxiety. It does not have any specific cause. But the constant worrying slowly grows to disrupt everyday living, leaving people tired and irritable. Sleep becomes more elusive and they feel more restless. If this is you, it will probably have crept up on you. Can you remember when you last felt completely relaxed? Sure, there may be times when the level of worry drops. But when did you string more than one or two days of ease? Well, this is the time to go see a doctor. Your work and relationships are probably suffering. You may be finding relief from the stress through alcohol or drugs. You may even have thought about death as a way out. Before things get too bad, get help. The treatment strategies are well established. You need not watch yourself slowly fall to pieces. Most people respond well to treatment.

What happens when you do get an appointment? The first step is ruling out any physical cause for your mood problems. Thyroid disease and early signs of heart disease may not be obvious, but people are more anxious when they have a formal medical condition. Even small health problems can be picked up and amplified by your mind. Then there are standard psychological questionnaires. These have been approved by the American Psychiatric Association and are the tools for diagnosis accepted by the medical insurance industry for covering the cost of treatment. As an aside, the usual requirement for the disruption to life to have lasted for at least six months. To qualify as GAD, this must be a long-term problem and it must stand on its own – no phobias, panic attacks or problems with alcohol or drugs.

Once GAD is diagnosed, the approach is to balance drugs against talk therapy. This is not an exact science. People react differently both to the diagnosis and to the various drugs. It may be appropriate to try an antidepressant first, or to use one of the benzodiazepines like Xanax. In part, the decision is based on the severity of the problems. The benzodiazepines are very effective over a short period of time. The antidepressants can be taken safely over longer periods. Once the mood is controlled, you can then move on to psychotherapy. This may be “simple” counseling or the more effective cognitive behavioral therapy. The aim is to give you practical coping skills. You must learn to confront your fears and take a more positive outlook. Although Xanax and the other drugs can calm your mind, the long-term solution comes from inside you. With willpower, you can conquer your anxiety and rebuild a good quality of life. Anything less than this risks dependence on drugs which is never a good outcome.