Coping With Generalized Anxiety Disorder

Coping With Generalized Anxiety Disorder (GAD)

Table of Contents

Generalized anxiety disorder is one of the most common types of anxiety, and can be effectively treated with the help of medication and therapy. There are certain strategies for coping with generalized anxiety disorder to better manage your symptoms and speed up the recovery process.

Some self help strategies for coping with generalized anxiety disorder are discussed below. However, it should be noted that these strategies are most effective when utilized along with medical treatment or therapy.

Physical Strategies For Coping With Generalized Anxiety Disorder

Physical coping strategies for GAD involve engaging in habits and practices that calm the senses and help you lead a healthier lifestyle.  Some of these techniques have been discussed below.  

1. Practice breathing exercises

Shallow breathing or difficulty in breathing is one of the most common physiological symptoms of generalized anxiety disorder. Shortness of breath can also be accompanied by muscle tension and heart palpitations. Breathing exercises are one of the best strategies for coping with generalized anxiety disorder.

Taking deep and slow breaths from your belly, also known as diaphragmatic breathing 1 Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., Wei, G. X., & Li, Y. F. (2017). The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Frontiers in psychology8, 874. https://doi.org/10.3389/fpsyg.2017.00874 , can help you reduce tension, relax muscular spasms, enhance blood supply to muscles, and increase the overall oxygen supply in the body 2 Hamasaki H. (2020). Effects of Diaphragmatic Breathing on Health: A Narrative Review. Medicines (Basel, Switzerland)7(10), 65. https://doi.org/10.3390/medicines7100065 . Studies 3 Perciavalle, V., Blandini, M., Fecarotta, P., Buscemi, A., Di Corrado, D., Bertolo, L., Fichera, F., & Coco, M. (2017). The role of deep breathing on stress. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology38(3), 451–458. https://doi.org/10.1007/s10072-016-2790-8 have found that deep breathing can be highly effective in improving mood and reducing stress, anxiety, heart rate, and salivary cortisol levels.

Moreover, box breathing 4 Norelli , S. K., Long, A., & Krepps, J. M. (2021). Relaxation Techniques. In StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513238/ , another form of deep breathing can be especially effective in overcoming generalized anxiety disorder. Yogic breathing techniques 5 Tiwari, N., Sutton, M., Garner, M., & Baldwin, D. S. (2019). Yogic Breathing Instruction in Patients with Treatment-Resistant Generalized Anxiety Disorder: Pilot Study. International journal of yoga12(1), 78–83. https://doi.org/10.4103/ijoy.IJOY_22_18 or Pranayama have also been found to be beneficial in reducing symptoms in patients with treatment-resistant GAD.

2. Use the 5-4-3-2-1 technique

When you need to calm down quickly in a stressful situation then focusing your senses on the immediate physical environment can enable you to ground yourself almost instantaneously.

In the 5-4-3-2-1 grounding technique 6 Kim, D., Madhani, D., Boevink, G., Sierra, J. Z., & Saldana, M. (2020, April 30). Nature Prescription and Health Outcomes : Grounding Exercise [R]. doi:http://dx.doi.org/10.14288/1.0396367 , you are required to engage all your five senses one by one, starting with acknowledging five things that you can see around you and then four things that you can touch.

Following this, you try to listen to three sounds around you, then identify two smells. Finally, you need to acknowledge one thing that you can taste. This technique has been proven to help reduce stress levels to a significant degree. Hence, it is a wonderful strategy for coping with generalized anxiety disorder.

3. Follow a healthy diet

Although food may not cause or cure anxiety, what we eat can certainly influence our mental well-being 7 Huang, Q., Liu, H., Suzuki, K., Ma, S., & Liu, C. (2019). Linking What We Eat to Our Mood: A Review of Diet, Dietary Antioxidants, and Depression. Antioxidants (Basel, Switzerland)8(9), 376. https://doi.org/10.3390/antiox8090376 .

A 2019 study 8 Masana, M. F., Tyrovolas, S., Kolia, N., Chrysohoou, C., Skoumas, J., Haro, J. M., Tousoulis, D., Papageorgiou, C., Pitsavos, C., & Panagiotakos, D. B. (2019). Dietary Patterns and Their Association with Anxiety Symptoms among Older Adults: The ATTICA Study. Nutrients11(6), 1250. https://doi.org/10.3390/nu11061250 found that diet can be considered a modifiable risk factor for psychiatric problems, like generalized anxiety disorder and depression. Consuming food high in sugar or fat 9 Murphy, M., & Mercer, J. G. (2013). Diet-regulated anxiety. International journal of endocrinology2013, 701967. https://doi.org/10.1155/2013/701967 , eating processed foods, and not eating enough 10 Weng, T. T., Hao, J. H., Qian, Q. W., Cao, H., Fu, J. L., Sun, Y., Huang, L., & Tao, F. B. (2012). Is there any relationship between dietary patterns and depression and anxiety in Chinese adolescents?. Public health nutrition15(4), 673–682. https://doi.org/10.1017/S1368980011003077 or at the right time may lead to unstable blood sugar levels and make us feel fatigued and restless.

This is why it is important to have a nutritious breakfast and healthy meals throughout the day. Consuming green vegetables and fruits can also help stabilize blood sugar and increase the hormone serotonin which regulates our happiness, mood, and feelings of well-being.

Supplements, like omega-3 fatty acids 11 Larrieu, T., & Layé, S. (2018). Food for Mood: Relevance of Nutritional Omega-3 Fatty Acids for Depression and Anxiety. Frontiers in physiology9, 1047. https://doi.org/10.3389/fphys.2018.01047 , kava 12 Pittler, M. H., & Ernst, E. (2003). Kava extract versus placebo for treating anxiety. The Cochrane Database of Systematic Reviews2003(1), CD003383. https://doi.org/10.1002/14651858.CD003383 , green tea, and ashwagandha (Withania somnifera) have also been proven to be helpful in reducing anxiety.

4. Get adequate sleep

Anxiety has been found to cause sleep disorders 13 Oh, C. M., Kim, H. Y., Na, H. K., Cho, K. H., & Chu, M. K. (2019). The Effect of Anxiety and Depression on Sleep Quality of Individuals With High Risk for Insomnia: A Population-Based Study. Frontiers in neurology10, 849. https://doi.org/10.3389/fneur.2019.00849 like insomnia. Sleep deprivation in turn makes general anxiety disorder symptoms even worse 14 Nollet, M., Wisden, W., & Franks, N. P. (2020). Sleep deprivation and stress: a reciprocal relationship. Interface focus10(3), 20190092. https://doi.org/10.1098/rsfs.2019.0092 , as lack of sleep reduces our capacity to cope with stress.

Since sleep disturbances are commonly linked 15 Mellman T. A. (2006). Sleep and anxiety disorders. The Psychiatric clinics of North America29(4), 1047–x. https://doi.org/10.1016/j.psc.2006.08.005 with generalized anxiety disorder, it is imperative that you practice good sleep hygiene and effective bedtime routines, like

  • Avoiding screen time before going to bed
  • Following a relaxation practice, like reading a book or meditating before sleeping
  • Getting at least 7-8 hours of undisturbed sleep every night

Being well rested will help you stabilize your mood and emotions, make you feel calmer, and enable you to better cope with worry and anxiety.

Read More About Sleep Disorders Here

5. Avoid using substances

Alcohol consumption 16 Gibson-Smith, D., Bot, M., Brouwer, I. A., Visser, M., Giltay, E. J., & Penninx, B. (2020). Association of food groups with depression and anxiety disorders. European journal of nutrition59(2), 767–778. https://doi.org/10.1007/s00394-019-01943-4 can make symptoms worse for people with GAD. In fact, alcohol use disorders (AUD) are one of the most common comorbid conditions 17 Smith, J. P., & Randall, C. L. (2012). Anxiety and alcohol use disorders: comorbidity and treatment considerations. Alcohol research : current reviews34(4), 414–431. of general anxiety disorder.

As people with GAD are at increased risk 18 Anker, J. J., & Kushner, M. G. (2019). Co-Occurring Alcohol Use Disorder and Anxiety: Bridging Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol research : current reviews40(1), arcr.v40.1.03. https://doi.org/10.35946/arcr.v40.1.03 for chronic alcohol dependence, it is crucial that you limit or cut off alcohol consumption in order to overcome the condition. It is also advised that you avoid recreational drugs as they can affect your treatment and recovery.

Studies 19 Lee, M. A., Cameron, O. G., & Greden, J. F. (1985). Anxiety and caffeine consumption in people with anxiety disorders. Psychiatry research15(3), 211–217. https://doi.org/10.1016/0165-1781(85)90078-2 also show that people with anxiety disorders have increased caffeine sensitivity 20 Jin, M. J., Yoon, C. H., Ko, H. J., Kim, H. M., Kim, A. S., Moon, H. N., & Jung, S. P. (2016). The Relationship of Caffeine Intake with Depression, Anxiety, Stress, and Sleep in Korean Adolescents. Korean journal of family medicine37(2), 111–116. https://doi.org/10.4082/kjfm.2016.37.2.111 . Moreover, a strong association between chronic nicotine use 21 Picciotto, M. R., Brunzell, D. H., & Caldarone, B. J. (2002). Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport13(9), 1097–1106. https://doi.org/10.1097/00001756-200207020-00006 and anxiety disorders has been observed. According to a 2013 study 22 Moylan, S., Jacka, F. N., Pasco, J. A., & Berk, M. (2013). How cigarette smoking may increase the risk of anxiety symptoms and anxiety disorders: a critical review of biological pathways. Brain and behavior3(3), 302–326. https://doi.org/10.1002/brb3.137 , cigarette smoking may increase the risk of developing increased anxiety.

Thus, limiting your consumption of tobacco and caffeinated beverages like coffee, tea, soda, and energy drinks can also help significantly reduce your symptoms.

Read More About Addiction Here

6. Engage in physical exercise

Exercise 23 Anderson, E., & Shivakumar, G. (2013). Effects of exercise and physical activity on anxiety. Frontiers in psychiatry4, 27. https://doi.org/10.3389/fpsyt.2013.00027 is one of the most effective ways to reduce stress, anxiety, and depression. Exercising helps boost serotonin, which is involved in regulating our mood, and feel-good chemicals like endorphins.

Even as little as 30 minutes of regular physical activity 24 Stonerock, G. L., Hoffman, B. M., Smith, P. J., & Blumenthal, J. A. (2015). Exercise as Treatment for Anxiety: Systematic Review and Analysis. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine49(4), 542–556. https://doi.org/10.1007/s12160-014-9685-9 for 3-4 days a week can be beneficial for people with generalized anxiety disorder. Exercises can include walking, cardio exercises, swimming, running, dancing, or playing sports.

Studies 25 Aylett, E., Small, N., & Bower, P. (2018). Exercise in the treatment of clinical anxiety in general practice – a systematic review and meta-analysis. BMC health services research18(1), 559. https://doi.org/10.1186/s12913-018-3313-5 have found that exercise is a viable useful treatment option for anxiety. However, high-intensity exercise routines are proven to be more effective than low-intensity training routines.

Emotional Strategies For Coping With Generalized Anxiety Disorder

Mental coping is focused on reducing negative reactions to stressors. It can either be solution-focused or emotion-focused. Some of the emotional coping strategies for GAD are as below: 

1. Learn about the disorder

The first step to coping with generalized anxiety disorder is to understand it. While your therapist might help you with the process and psychoeducation, reading and learning about generalized anxiety disorder can help you get more insight into your condition.

2. Know and identify your triggers

Since GAD usually does not have any specific triggers 26 Munir, S., & Takov, V. (2022). Generalized Anxiety Disorder. In StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441870/ , it may be difficult to understand when symptoms of anxiety are more likely to occur. Taking note of the events that usually make you feel anxious and trying to understand the pattern can help you better identify your triggers.

3. Try mindfulness

Mindfulness 27 Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America40(4), 739–749. https://doi.org/10.1016/j.psc.2017.08.008 refers to the practice of bringing our awareness and attention to the present moment. Mindfulness-based techniques 28 Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., Worthington, J. J., Pollack, M. H., & Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. The Journal of clinical psychiatry74(8), 786–792. https://doi.org/10.4088/JCP.12m08083 have been found to be quite useful in reducing symptoms of anxiety. Mindfulness 29 Parmentier, F., García-Toro, M., García-Campayo, J., Yañez, A. M., Andrés, P., & Gili, M. (2019). Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression. Frontiers in psychology10, 506. https://doi.org/10.3389/fpsyg.2019.00506 enables us to become aware of the present, instead of thinking about the past or the future.

It is a powerful yet simple coping strategy that can reduce the continuous flow of negative thoughts and worries. Research 30 Takahashi, T., Sugiyama, F., Kikai, T., Kawashima, I., Guan, S., Oguchi, M., Uchida, T., & Kumano, H. (2019). Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators. BioPsychoSocial medicine13, 4. https://doi.org/10.1186/s13030-019-0145-4 shows that mindfulness-based interventions are becoming increasingly popular for coping with generalized anxiety disorder and depression due to strong evidence of efficacy. According to a 2010 study 31 Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology78(2), 169–183. https://doi.org/10.1037/a0018555 , mindfulness-based therapy is a promising and effective intervention for treating anxiety and mood problems.

Read More About Mindfulness Here

4. Maintain a journal

Journaling, or maintaining a thought diary 32 Cincidda, C., Pizzoli, S., & Pravettoni, G. (2022). Remote Psychological Interventions for Fear of Cancer Recurrence: Scoping Review. JMIR cancer, 8(1), e29745. https://doi.org/10.2196/29745 has been established as an effective technique to understand anxiety and to try and overcome it better. It is usually used as a homework assignment in cognitive-behavioral therapy and goes hand-in-hand within-session work.

Social Strategies For Coping With Generalized Anxiety Disorder

Social coping strategies are focused on interpersonal interaction and communication. Here are a few such strategies to aid you in coping with generalized anxiety disorder better:  

1. Confide in someone

GAD can often lead to unhealthy behavior patterns like social withdrawal. However, it is crucial to openly and honestly talk to a trusted person. It could be a family member, relative, teacher, coach, supervisor, or even a counselor.

Communicate your feelings, thoughts, and experiences with your loved ones instead of isolating yourself. Talking to others can even help you gain new perspectives and rejuvenate your faith in yourself.

2. Join a support group

Support groups help you connect and share your feelings with other people who might also be suffering from anxiety. Knowing that you are not alone in your struggles can possibly help you come to terms with them. Focus groups under the supervision of a professional can also aid in brainstorming and discussing solutions and skills for coping with generalized anxiety disorder.

3. Spend time with a pet

Studies 33 Beetz, A., Uvnäs-Moberg, K., Julius, H., & Kotrschal, K. (2012). Psychosocial and psychophysiological effects of human-animal interactions: the possible role of oxytocin. Frontiers in psychology3, 234. https://doi.org/10.3389/fpsyg.2012.00234 have found that human-animal interactions (HAI) can improve mental health conditions, mood, stress, self-reported fear & anxiety; and overall mental & physical health. Moreover, it has also been observed 34 Fiocco, A. J., & Hunse, A. M. (2017). The Buffer Effect of Therapy Dog Exposure on Stress Reactivity in Undergraduate Students. International journal of environmental research and public health14(7), 707. https://doi.org/10.3390/ijerph14070707 that playing with dogs can also buffer stress responses.

According to a 2020 study 35 Machová, K., Procházková, R., Vadroňová, M., Součková, M., & Prouzová, E. (2020). Effect of Dog Presence on Stress Levels in Students under Psychological Strain: A Pilot Study. International journal of environmental research and public health17(7), 2286. https://doi.org/10.3390/ijerph17072286 , animal-assisted activities (AAAs) with a dog have been found to be effective in improving mood and stress. Other animal-assisted interventions 36 Barker, S. B., & Dawson, K. S. (1998). The effects of animal-assisted therapy on anxiety ratings of hospitalized psychiatric patients. Psychiatric services (Washington, D.C.)49(6), 797–801. https://doi.org/10.1176/ps.49.6.797 have also been established to be greatly beneficial for reducing anxiety.

Other Ways To Cope With GAD

Some other ways for coping with generalized anxiety disorder are:

  1. Learning and practicing self-acceptance 37 Heydari, M., Masafi, S., Jafari, M., Saadat, S. H., & Shahyad, S. (2018). Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff. Open access Macedonian journal of medical sciences6(2), 410–415. https://doi.org/10.3889/oamjms.2018.064 and acceptance of negative experiences 38 Shallcross, A. J., Troy, A. S., Boland, M., & Mauss, I. B. (2010). Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Behaviour research and therapy48(9), 921–929. https://doi.org/10.1016/j.brat.2010.05.025
  2. Systematically replacing negative emotions with more positive affirmations 39 Conversano, C., Rotondo, A., Lensi, E., Della Vista, O., Arpone, F., & Reda, M. A. (2010). Optimism and its impact on mental and physical well-being. Clinical practice and epidemiology in mental health : CP & EMH6, 25–29. https://doi.org/10.2174/1745017901006010025
  3. Viewing calming images and videos such as that of nature 40 Brown, D. K., Barton, J. L., & Gladwell, V. F. (2013). Viewing nature scenes positively affects recovery of autonomic function following acute-mental stress. Environmental science & technology47(11), 5562–5569. https://doi.org/10.1021/es305019p
  4. Using scents 41 Kadohisa M. (2013). Effects of odor on emotion, with implications. Frontiers in systems neuroscience7, 66. https://doi.org/10.3389/fnsys.2013.00066 and perfumes (eg: in candles or diffusers)
  5. Listening to music 42 Thoma, M. V., La Marca, R., Brönnimann, R., Finkel, L., Ehlert, U., & Nater, U. M. (2013). The effect of music on the human stress response. PloS one8(8), e70156. https://doi.org/10.1371/journal.pone.0070156 or pleasant sounds 43 Amiri, M. J., Sadeghi, T., & Negahban Bonabi, T. (2017). The effect of natural sounds on the anxiety of patients undergoing coronary artery bypass graft surgery. Perioperative medicine (London, England)6, 17. https://doi.org/10.1186/s13741-017-0074-3
  6. Receiving physical affection (eg: hugs 44 Murphy, M., Janicki-Deverts, D., & Cohen, S. (2018). Receiving a hug is associated with the attenuation of negative mood that occurs on days with interpersonal conflict. PloS one13(10), e0203522. https://doi.org/10.1371/journal.pone.0203522 ) from loved ones
10 Ways to Cope with Generalized Anxiety Disorder
10 Ways to Cope with Generalized Anxiety Disorder

Takeaway

Research 45 Morris-Rosendahl D. J. (2002). Are there anxious genes?. Dialogues in clinical neuroscience4(3), 251–260. https://doi.org/10.31887/DCNS.2002.4.3/dmrosendahl indicates that generalized anxiety disorder may be caused by a wide range of factors, like genetics, life experiences, etc. Thus, self help strategies for GAD are bound to differ based on the individual. It is possible that some GAD coping strategies work for one person, but the same may not work for others.

It could take some amount of time and trial and error for you to figure out which strategies work best for you. However, a generalized anxiety disorder can be overcome in the long run. Learning to identify and manage triggers, seeking help, and having a positive attitude can be quite helpful when trying to combat anxiety.

At A Glance

  1. Generalized anxiety disorder is a treatable condition that can be managed better and more effectively with certain coping strategies.
  2. There are different ways to cope with generalized anxiety disorder.
  3. Some physical coping strategies for coping with generalized anxiety disorder are practicing breathing exercises, healthy diet, avoiding the use of substances, etc.
  4. Knowing and identifying triggers, using mindfulness techniques, and maintaining a thought diary are some of the emotional coping strategies for GAD.
  5. Social methods of coping are equally important when dealing with an anxiety disorder such as GAD.
  6. Confiding in a trusted person, joining a support group, or spending time with a pet are some social coping strategies for GAD.

References:

  • 1
    Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., Wei, G. X., & Li, Y. F. (2017). The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Frontiers in psychology8, 874. https://doi.org/10.3389/fpsyg.2017.00874
  • 2
    Hamasaki H. (2020). Effects of Diaphragmatic Breathing on Health: A Narrative Review. Medicines (Basel, Switzerland)7(10), 65. https://doi.org/10.3390/medicines7100065
  • 3
    Perciavalle, V., Blandini, M., Fecarotta, P., Buscemi, A., Di Corrado, D., Bertolo, L., Fichera, F., & Coco, M. (2017). The role of deep breathing on stress. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology38(3), 451–458. https://doi.org/10.1007/s10072-016-2790-8
  • 4
    Norelli , S. K., Long, A., & Krepps, J. M. (2021). Relaxation Techniques. In StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513238/
  • 5
    Tiwari, N., Sutton, M., Garner, M., & Baldwin, D. S. (2019). Yogic Breathing Instruction in Patients with Treatment-Resistant Generalized Anxiety Disorder: Pilot Study. International journal of yoga12(1), 78–83. https://doi.org/10.4103/ijoy.IJOY_22_18
  • 6
    Kim, D., Madhani, D., Boevink, G., Sierra, J. Z., & Saldana, M. (2020, April 30). Nature Prescription and Health Outcomes : Grounding Exercise [R]. doi:http://dx.doi.org/10.14288/1.0396367
  • 7
    Huang, Q., Liu, H., Suzuki, K., Ma, S., & Liu, C. (2019). Linking What We Eat to Our Mood: A Review of Diet, Dietary Antioxidants, and Depression. Antioxidants (Basel, Switzerland)8(9), 376. https://doi.org/10.3390/antiox8090376
  • 8
    Masana, M. F., Tyrovolas, S., Kolia, N., Chrysohoou, C., Skoumas, J., Haro, J. M., Tousoulis, D., Papageorgiou, C., Pitsavos, C., & Panagiotakos, D. B. (2019). Dietary Patterns and Their Association with Anxiety Symptoms among Older Adults: The ATTICA Study. Nutrients11(6), 1250. https://doi.org/10.3390/nu11061250
  • 9
    Murphy, M., & Mercer, J. G. (2013). Diet-regulated anxiety. International journal of endocrinology2013, 701967. https://doi.org/10.1155/2013/701967
  • 10
    Weng, T. T., Hao, J. H., Qian, Q. W., Cao, H., Fu, J. L., Sun, Y., Huang, L., & Tao, F. B. (2012). Is there any relationship between dietary patterns and depression and anxiety in Chinese adolescents?. Public health nutrition15(4), 673–682. https://doi.org/10.1017/S1368980011003077
  • 11
    Larrieu, T., & Layé, S. (2018). Food for Mood: Relevance of Nutritional Omega-3 Fatty Acids for Depression and Anxiety. Frontiers in physiology9, 1047. https://doi.org/10.3389/fphys.2018.01047
  • 12
    Pittler, M. H., & Ernst, E. (2003). Kava extract versus placebo for treating anxiety. The Cochrane Database of Systematic Reviews2003(1), CD003383. https://doi.org/10.1002/14651858.CD003383
  • 13
    Oh, C. M., Kim, H. Y., Na, H. K., Cho, K. H., & Chu, M. K. (2019). The Effect of Anxiety and Depression on Sleep Quality of Individuals With High Risk for Insomnia: A Population-Based Study. Frontiers in neurology10, 849. https://doi.org/10.3389/fneur.2019.00849
  • 14
    Nollet, M., Wisden, W., & Franks, N. P. (2020). Sleep deprivation and stress: a reciprocal relationship. Interface focus10(3), 20190092. https://doi.org/10.1098/rsfs.2019.0092
  • 15
    Mellman T. A. (2006). Sleep and anxiety disorders. The Psychiatric clinics of North America29(4), 1047–x. https://doi.org/10.1016/j.psc.2006.08.005
  • 16
    Gibson-Smith, D., Bot, M., Brouwer, I. A., Visser, M., Giltay, E. J., & Penninx, B. (2020). Association of food groups with depression and anxiety disorders. European journal of nutrition59(2), 767–778. https://doi.org/10.1007/s00394-019-01943-4
  • 17
    Smith, J. P., & Randall, C. L. (2012). Anxiety and alcohol use disorders: comorbidity and treatment considerations. Alcohol research : current reviews34(4), 414–431.
  • 18
    Anker, J. J., & Kushner, M. G. (2019). Co-Occurring Alcohol Use Disorder and Anxiety: Bridging Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol research : current reviews40(1), arcr.v40.1.03. https://doi.org/10.35946/arcr.v40.1.03
  • 19
    Lee, M. A., Cameron, O. G., & Greden, J. F. (1985). Anxiety and caffeine consumption in people with anxiety disorders. Psychiatry research15(3), 211–217. https://doi.org/10.1016/0165-1781(85)90078-2
  • 20
    Jin, M. J., Yoon, C. H., Ko, H. J., Kim, H. M., Kim, A. S., Moon, H. N., & Jung, S. P. (2016). The Relationship of Caffeine Intake with Depression, Anxiety, Stress, and Sleep in Korean Adolescents. Korean journal of family medicine37(2), 111–116. https://doi.org/10.4082/kjfm.2016.37.2.111
  • 21
    Picciotto, M. R., Brunzell, D. H., & Caldarone, B. J. (2002). Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport13(9), 1097–1106. https://doi.org/10.1097/00001756-200207020-00006
  • 22
    Moylan, S., Jacka, F. N., Pasco, J. A., & Berk, M. (2013). How cigarette smoking may increase the risk of anxiety symptoms and anxiety disorders: a critical review of biological pathways. Brain and behavior3(3), 302–326. https://doi.org/10.1002/brb3.137
  • 23
    Anderson, E., & Shivakumar, G. (2013). Effects of exercise and physical activity on anxiety. Frontiers in psychiatry4, 27. https://doi.org/10.3389/fpsyt.2013.00027
  • 24
    Stonerock, G. L., Hoffman, B. M., Smith, P. J., & Blumenthal, J. A. (2015). Exercise as Treatment for Anxiety: Systematic Review and Analysis. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine49(4), 542–556. https://doi.org/10.1007/s12160-014-9685-9
  • 25
    Aylett, E., Small, N., & Bower, P. (2018). Exercise in the treatment of clinical anxiety in general practice – a systematic review and meta-analysis. BMC health services research18(1), 559. https://doi.org/10.1186/s12913-018-3313-5
  • 26
    Munir, S., & Takov, V. (2022). Generalized Anxiety Disorder. In StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441870/
  • 27
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Mental Health Topics (A-Z)

  • Coping With Generalized Anxiety Disorder (GAD)