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PTSD and Generalized Anxiety Disorder

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Updated July 03, 2014

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PTSD and generalized anxiety disorder (also referred to as GAD) often occur together. This is not entirely surprising given that people with PTSD are at heightened risk to develop a number of different anxiety disorders, including panic disorder, social anxiety disorder, and obsessive-compulsive disorder. Before talking about the relationship between PTSD and GAD, it is important to first describe the symptoms of GAD.

What is Generalized Anxiety Disorder?

GAD is an anxiety disorder. According to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, GAD is made up of the following symptoms:

  • A great deal of anxiety and worry that is experienced more days than not for a period of at least six months. This anxiety and worry can be about a number of different things (for example, school, relationships, work, etc).

  • The worry or anxiety is not about a symptom of another anxiety disorder, such as panic disorder, social anxiety disorder, or PTSD.

  • The worry is very difficult to control.

  • At least three of the following symptoms are experienced along with the anxiety and worry:
    • feeling restless or on edge
    • easily getting tired
    • having a hard time concentrating
    • being irritable
    • having tension in your muscles
    • difficulty sleeping
  • The anxiety, worry, and symptoms described above cause many problems in your life, such as at work or in relationships.

The Relationship Between PTSD and GAD

Studies have found that approximately 17% of people who have had PTSD at some point in their life have had GAD, as well. This rate is much higher than what is found in the general population for GAD (4 to 6%). In fact, people with a history of PTSD are almost 6 times as likely to have a current or past diagnosis of GAD compared to people without PTSD.

Why Might PTSD and GAD Occur Together?

Although more research needs to be done to better understand the association between PTSD and GAD, there are some theories as to why these two conditions often co-occur. First, compared to people without PTSD, those with a diagnosis of PTSD may be more likely to engage in worry -- the central, defining feature of GAD. Worry has been found to reduce bodily arousal, and people with PTSD suffering from intense hyperarousal symptoms may be particularly likely to rely on coping strategies that can reduce that arousal.

In addition, people who worry often report that their worry distracts them from more upsetting things. Given this, people with PTSD may use worry as a way of getting some distance (even if it is temporary) from upsetting thoughts and feelings.

Another possible explanation for the association between PTSD and GAD is that these two disorders have similar origins. Just as the experience of a traumatic event increases risk for PTSD, it also increases risk for GAD. People with GAD are much more likely to have had experienced a past traumatic event than people without GAD.

Finally, it is also important to consider that there might be a shared biological cause for both disorders. In other words, some people might have some kind of genetic vulnerability for developing both PTSD and GAD following the experience of a traumatic event.

Getting Help

There are currently no treatments specifically designed to target the co-occurrence of PTSD and GAD. However, the successful treatment of PTSD may result in a reduction in worry, and therefore, GAD.

Finding a mental health provider can be an overwhelming and stressful task if you do not know where to look. Fortunately, there are several websites that provide free search engines to help you find mental health providers in your area that treat PTSD.

In addition, the use of mindfulness has been found to be very effective in addressing worry. Mindfulness is focused on helping people connect with the present moment, and this is contrary to the future-oriented focus of worry. Consequently, if you have PTSD and also experience frequent and uncontrollable worry, mindfulness may be a way of addressing both PTSD and your worry. You may want to learn some ways of becoming more mindful.

Sources:

American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: Author.

Borkovec, T.D., & Hu, S. (1990). The effect of worry on cardiovascular response to phobic imagery. Behaviour Research and Therapy, 28, 69-73.

Borkovec, T.D., & Roemer, L. (1995). Perceived functions of worry among generalized anxiety disorder subjects: Distraction from more emotionally distressing topics? Journal of Behavior Therapy and Experimental Psychiatry, 26, 25-30.

Kessler, R.C., Berglund, P.A., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 593-602.

Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048-1060.

Roemer, L., Molina, S., Litz, B.T., & Borkovec, T.D. (1996/1997). Preliminary investigation of the role of previous exposure to potentially traumatizing events in generalized anxiety disorder. Depression and Anxiety, 4, 134-138.

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