Summary
The protocol defines generalized anxiety disorder as persistent, pervasive, and difficult-to-control anxiety that is not restricted to one object or situation. Worry extends across several areas of life, is disproportionate to current circumstances, and lasts for at least six months. It may be accompanied by irritability, hypervigilance, concentration and sleep problems, muscle tension, pain, palpitations, sweating, dizziness, and other autonomic symptoms.
Diagnosis evaluates the duration, content, controllability, and functional impact of anxiety. The history explores current stressors, depression, bipolar disorder, post-traumatic stress disorder, psychoactive-substance use, and relevant medical illness. GAD is differentiated from panic and phobic disorders, obsessive-compulsive disorder, mood disorders, and endocrine, neurological, or cardiovascular conditions. The Hamilton Anxiety Rating Scale and GAD-7 may support measurement of severity and change, but do not replace clinical diagnosis. Laboratory and instrumental investigations are primarily used to exclude alternative causes and support safe treatment.
The main strategy combines psychotherapy with individualized pharmacotherapy. The protocol identifies SSRIs, SNRIs, or pregabalin as first-line medication approaches; medicines carrying dependence risk are limited in duration and require caution. Cognitive behavioral therapy addresses intolerance of uncertainty, beliefs about worry, avoidance, and problem-solving skills. Relaxation methods, biofeedback, dynamic psychotherapy, and supportive therapy may also be used. Response, tolerability, suicide risk, and adherence are monitored, and medication withdrawal is gradual. Rehabilitation aims to restore social and occupational functioning, while sleep regulation, physical activity, and avoidance of harmful substance use support prevention. This is a content summary of the protocol and not individualized medical advice.