Individuals who suffer from General Anxiety Disorder (GAD) experience pervasive fears and worries. They are anxious about everything, from normal everyday activities to what might happen in the future. While it is not unusual to feel anxious over things that are taking place in your life, a person with excessive worries is unable to stop the anxious thoughts even when they are aware that there is no real reason for those worries.
People with GAD may also just feel worried without really knowing what they are worried about. They may feel that something bad is going to happen and usually are unable to calm themselves from the anxiety. The fears and worries they experience disrupts daily activities and interferes with relationships that they have.
How is General Anxiety Disorder diagnosed?
Your health care provider or doctor will perform a mental health screening to diagnose GAD. Questions about your symptoms will be asked along with your medical history. Psychological questionnaires may also be used to help determine the disorder. Your doctor will also most likely refer to the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for an accurate diagnosis.
Sometimes, there may be an underlying medical condition that is causing the anxiety. Anxiety has also been linked to certain medication as well as substance abuse. For example, thyroid disorders, heart disease, menopause and gastroesophageal reflux disease have all been linked to anxiety.
If your doctor suspects that there is an underlying cause for the anxiety, they may perform blood tests, urine tests, gastric reflux tests, X-rays and stress tests to find out the cause of the anxiety that is being experienced.
Online GAD tests, and assessments
With the internet, the accessibility of anxiety disorder tests is now widely available. You will be able to take self-assessment quizzes to diagnose GAD in private and in the comfort of your own home. However, the reliability of online tests is a real concern and you need to make sure that the test that you take originates from a reputable and reliable source. This is even more so with the numerous sites available on this topic.
Questionnaires are typically made up of true or false questions and multiple choice questions. Your test scores will most probably be rated against a predetermined scale. Look for tests that are adapted from professional questionnaires that are used to diagnosed GAD by medical professionals.
By using these tests, you will have an idea about your condition and seek the professional help and support that is needed. Keep in mind that these online test results are only preliminary and that you should not use it for any diagnosis. The diagnosis of GAD should always come from a qualified medical professional.
An example of a self test is as follows. You will need to answer yes or no to the following questions:
- Do you worry excessively about various aspects of life recently?
- Do you experience restlessness or edginess?
- Are you more easily agitated or irritated than normal by certain events recently?
- Do you feel anxious despite knowing the fact that it is unnecessary?
- Do you have difficulty focusing or concentrating?
- Do you get into arguments with the people around you easily?
- Do you take drugs such as alcohol, cocaine, marijuana or amphetamines on a regular basis?
- Do you get tired easily as compared to before?
- Is it difficult for you to feel relaxed?
- Do you experience any emptiness or sadness alongside worry and tension?
- Any sleep complications such as difficulty falling asleep, tossing and turning, or light sleep lately?
- Do you experience any physical symptoms due to tension such as agitation, chronic stomach upset, diarrhoea, or inability to stay still while sitting or standing?
- Is it that the excessive anxiety you experience revolves around topics such as suspicion of disease, gaining weight, separation, rejection or any social engagements?
- Do you happen to experience an inability to work or get things done due to any or a few of the following: irritability, restlessness, fatigue, sleep complications, and difficulty staying focused?
- Have you experienced extreme anxiety that has stayed constant for the past six months or even longer?
The GAD7 test
The GAD-7 test is a 7 item anxiety scale is easy to use a self-administered patient questionnaire. It is a test that can be used as a screening tool as well as a severity measure of GAD. It only takes 1 to 2 minutes to complete the GAD-7.
Is the GAD-7 reliable?
The GAD-7 is a reliable test that can effectively determine the severity of GAD in an individual. Here are a few reasons why professional health care providers use the GAD-7 test to assess anxiety levels in individuals:
- Research shows that it has internal consistency
- The GAD-7 has a good test-retest reliability
- It has strong criterion validity
- It has strong construct validity
- It has significant concurrent validity
- It has good convergent validity
Research also shows that the GAD-7 test has a:
- 89% sensitivity and 82% specificity for GAD,
- 74% sensitivity and 81% specificity for panic disorder,
- 72% sensitivity and 80% specificity for social anxiety disorder, and
- 66% sensitivity and 81% specificity for post-traumatic stress disorder.
In the GAD-7 score, the response categories of ‘not at all’, ‘several days’, ‘more than half the days’ and ‘nearly every day’ are given scores of 0, 1, 2, and 3, respectively. The total score is calculated by adding the scores of all seven questions on the test.
The score of 5 is the cut of point for mild anxiety, 6 to 10 represents moderate anxiety and a score of 11 to 15 denotes severe anxiety. It is recommended that further assessment is carried out if an individual has a score above 10. In fact, the additional evaluation is essential if this test is being used as a screening tool.
GAD symptoms according to the DSM
An individual is usually diagnosed according to the symptoms that are included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This publication by the American Psychiatric Association is a handbook used by a large majority of health care professionals as a guide to diagnose mental disorders.
According to the DSM, individuals who suffer from GAD display the following symptoms:
- Undue anxiety and worry about certain activities or events for most days of the week, which go on for more than six months;
- Having problems or difficulty controlling your feelings of anxiety;
- Feelings of anxiety that causes distress or disrupt your daily life;
- Anxiety attacks unrelated to other mental conditions;
- At least three of the following indications in adults or one in children – restlessness or sleep problems, fatigue, muscle tension, difficulty concentrating, and irritability.
It can be a relief to finally have a diagnosis for the anxiety that you are feeling because now that you know what the problem is, you can find an effective treatment. Your doctor will most probably suggest psychotherapy and/or medication, depending on the severity of your condition.
Psychotherapy, or talk therapy, is where you work with your therapist to overcome anxiety symptoms. One of the most effective forms of psychotherapy for GAD is cognitive behavioral therapy.
Cognitive behavioral therapy aims to reduce anxiety by helping you with specific skills and techniques to manage your fears and worries. It also gives focus to changing negative and irrational thoughts because it is based on the premise that our thoughts affect our emotions and behaviors. It takes time for your symptoms to improve with cognitive behavior therapy so don’t give up even if the progress you make is slow.
There are several types of medication used to treat GAD. It might take some trial and error to match the individual with the most effective medication. Medication comes with both benefits as well as side effects, so speak to your doctor and find out all that you need to about the medication. Here are several medications that are commonly used for GAD:
- Antidepressants – Antidepressants, including serotonin reuptake inhibitors (SSRIs) are first line treatments for GAD. Be aware that it may take several weeks before you feel the full benefit of the antidepressants that you are taking.
- Benzodiazepines – If your anxiety symptoms are very extreme, your doctor might give you benzodiazepine. This is a sedative and is usually only used on a short term basis. There is a risk of addiction with this medication, so do inform your doctor if you have alcohol or drug abuse issues.
Lifestyle Changes and Home Treatment
You might find that certain lifestyle changes can also help with anxiety. Here are some things that you can do to help with anxiety:
- Have a healthy and balanced diet
- Make a decision to be physically active – exercise can reduce stress and improve your moods and thus help in reducing anxiety. Go for walks to clear your head. Sometimes, just being in the fresh air will help calm you down
- Get proper rest – Sleep is important and you need to make sure that you are getting enough sleep. Do inform your doctor if you have trouble going to bed or trouble staying asleep.
- Avoid recreational drugs and alcohol as they may make anxiety worse.
- Use relaxation techniques – learn to calm yourself with relaxation techniques such as visualization techniques and meditation.
- Art therapy – If you love art, get your paintbrushes and start painting! Painting in itself is a very relaxing activity. Focus on the process and not the end product.
- Stop smoking and cut back on coffee – Nicotine and caffeine can make anxiety worse.
Having a sense of pervasive anxiety can be crippling. It can be a big problem as GAD tends to interrupt daily life. It is extremely hard for people with GAD to function normally and an accurate diagnosis is needed in order to obtain effective treatment. If you feel that you have an anxiety disorder and have used an online anxiety test, inform your health care practitioner so that there is an accurate diagnosis. Do not take any medication to stop anxiety before consulting your doctor.