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Generalized Anxiety Disorder or GAD


Generalized Anxiety Disorder or GAD

I am always worried. I worry about not being able to fall asleep; I worry about sleeping through my alarm. I can’t concentrate at work because I am worrying about falling asleep in a meeting. I know these fears don’t make sense, but I cannot stop them.
— unknown

This is a common thought pattern that individuals with Generalized Anxiety Disorder (GAD) express. GAD can be formally diagnosed when an individual worries excessively about normal everyday problems for a minimum of 6 months. It is commonly accompanied by physical symptoms such as such as fatigue, headaches, muscle aches, sweating, and lightheadedness. The average age of onset is 31 years old and 18% of individuals 18 years or older have GAD. In addition, the disease effects more than twice as many women than men.

While Caucasians are more likely than African Americans to be diagnosed, it is thought that this may stem from under-diagnosis in the African American community.  The GAD-7 is an assessment tool that many doctors use to check for GAD. It is known, however, that this model underestimates rates of GADs in African Americans as we are less likely to report “feeling nervous, anxious, or on edge,” “being so restless that it is hard to sit still,” and “becoming easily annoyed or irritable.”

In addition to being under diagnosed, studies have suggested that African Americans are less compliant with therapy. This is potentially because we are concerned and hesitant to talk to mental health providers about GAD because we do not know if they will understand African-American Issues. The Anxiety and Depression Association of America suggests that those who have this concern ask their therapist these three questions:

 Have you ever treated an African American with an anxiety disorder?

  1. I’m concerned that you may not understand my issues, concerning being an African-American female or male and being anxious. Do you feel you can?
  2. Have you been trained in multicultural issues?

There are also books written by African American individuals about GAD such as Soothe Your Nerves: The Black Woman’s Guide to Understanding and Overcoming Anxiety, Panic, and Fear by Dr. Angela Neal-Barnett.

While GAD can be very debilitating, there are several treatment options: 1) Psychotherapy such as Cognitive Behavior Therapy (CBT) during which individuals focus on changing how they think and react to situations that would cause anxiety. 2) Antianxiety medications and antidepressants also help. It is important to not use antianxiety medications for a long time as they can become addictive. It is also important to monitor your loved ones, particularly teens, on antidepressants as they have been shown to increase the risk of suicidal thoughts. Some people benefit from a combination of therapy and medication. There are also many support groups. If you believe you have GAD it is important to talk to your primary care doctor who can refer you to an appropriate therapist.