Excessive Worry

Excessive Worry Treatment in Baltimore

Are you consumed by worry? Excessive worry, also known as Generalized Anxiety Disorder (GAD), is an ongoing mental health condition that involves persistent and intense worries about various facets of life. These apprehensions are usually unfounded or disproportionate, and too much to bear. The result is a disruption in one’s daily life, hindering one’s ability to live normally.

Anxiety disorders are experienced by 6.8 million American adults, with women generally more likely to be diagnosed than men. It usually starts in childhood or teenage years and may have a genetic component. Dr. Ranen describes excessive worry in more detail below, as well as his treatment options.


What is Excessive Worry/GAD?

General Anxiety Disorder (GAD) is a significant mental health issue that can hinder one’s ability to thrive in everyday life. Those struggling with GAD may feel persistently overwhelmed, discouraged, fearful, and unable to relax or participate in activities that would otherwise bring them joy. If left untreated, the effects of this disorder could potentially lead to depression, substance abuse/addiction issues, or other psychological conditions.


What are the symptoms?

Excessive worry can be a daunting and emotionally draining experience, as relentless worrying may lead to persistent stress or anxiety. Common signs include:


  • Constant worry about everyday events, such as work, health, finances, or relationships
  • Restlessness and feeling on edge
  • Irritability
  • Muscle tension
  • Difficulty sleeping or staying asleep
  • Fatigue
  • Trouble concentrating
  • Physical symptoms, such as headaches, nausea, or heart palpitations
  • Impact of Excessive Worry on Daily Life


What causes Excessive Worry?

Although the precise cause of GAD remains elusive, research suggests its onset may be attributed to a combination of genetic, environmental, and psychological elements. Individuals who have a relative dealing with depression or anxiety are more likely to suffer from it. However, even minor occurrences in life like financial problems and relationship difficulties can spark symptoms for those without the same hereditary inclination. To promote successful prevention and treatment of this widespread condition, comprehending how an individual’s environment impacts their genetics is paramount.


How is Excessive Worry Diagnosed?

The diagnostic process typically involves:

  • Medical evaluation: The psychiatrist will conduct a thorough evaluation to rule out any underlying medical conditions that may be causing the symptoms. Lab tests like thyroid and vitamin B12 levels, and others, may be obtained.
  • Psychological assessment: To assess the patient’s condition, the psychiatrist will explore their current symptoms and intensity of worry, as well as any physical manifestations. They may also inquire into their medical history and family background to gain further insight, in addition to evaluating past treatments for similar issues.
  • Diagnostic criteria: DSM-5 outlines the diagnostic criteria for GAD. These criteria include having an excess amount of worry about multiple events or activities for at least six months, being unable to successfully control said worries and experiencing three physical symptoms–like muscle tension, fatigue or difficulty sleeping.
  • Differential diagnosis: A mental health expert may also identify any conditions that have similar symptoms to the patient’s, including depression, panic disorder, obsessive-compulsive disorder or bipolar disorder. This will assist with an accurate diagnosis and treatment plan for the individual.


What are the types of Worry Diagnoses?

From person to person, the signs of Generalized Anxiety Disorder (GAD) can vary. But there are some familiar types of GAD that many experiences, including:

  • Free-floating anxiety: This particular form of generalized anxiety disorder is characterized by constant, uncontrollable worrying that isn’t isolated to any certain event or circumstance. This can involve a constant sense of uncertainty and that something bad is going to happen. This persistent, pervasive worry can be hard to manage and keep in check.
  • Health anxiety: This also known as Illness Anxiety Disorder and is characterized by excessive worry surrounding the possibility of a serious medical illness. Such thoughts can lead to frequent doctor appointments and extensive testing procedures in an attempt to alleviate their fears.
  • Separation anxiety: This type of GAD is characterized by excessive worry about being separated from loved ones or fear of being alone. This type of worry can lead to difficulty sleeping, or reluctance to leave home or go to school.
  • Phobia-related anxiety: This kind of generalized anxiety disorder is marked by an inordinate degree of the fear linked to certain phobias, including the dread of flying, speaking publicly, or being confined.
  • Catastrophic thinking: This form of GAD is defined by anxiety that often fixates on disastrous outcomes in everyday situations, with a tendency to worry excessively about the worst possible conclusion.

It is not uncommon for people with GAD to experience multiple types simultaneously. A proper diagnosis is crucial to arrive at the correct treatment plan. Dr. Ranen’s experiences, processes, and professional due diligence all contribute to reaching an accurate diagnosis.

What are the treatments for Excessive Worry?

Research conducted by Johns Hopkins University School of Medicine in Baltimore has revealed that excessive worrying, which can affect adults, teenagers, and children alike, is a highly treatable disorder.

When treated under the supervision of an experienced psychiatrist, Generalized Anxiety Disorder (GAD) often responds positively to treatment. Fusing medication with therapy can be a powerful solution to reducing symptoms and improving one’s quality of life.

Cognitive Behavioral Therapy (CBT): CBT, a form of psychotherapy that promotes shifting maladaptive thought and behavior patterns, is the proven method for producing rapid beneficial life changes. CBT emphasizes the relationship between our thoughts, emotions, and actions. Negative thought processes can bring about debilitating anxiety and replacing them with positive perspectives results beneficial behavioral change. Albert Ellis, founder of the first form of CBT, famously said, “People disturb themselves”.

During CBT sessions, Dr. Neal Ranen helps patients recognize unhelpful thought patterns and beliefs. Then they work together to substitute them with more rational and constructive ones.

Other forms of CBT include Acceptance and Commitment Therapy (ACT) and Exposure/Response Prevention (ERP). Mindfulness approaches, meditation, breathing exercises, and self-hypnosis can also help.


Medication: Medications used for the treatment of Generalized Anxiety Disorder (GAD) include:

  • Antidepressants: Many of these are firmly established as anti-anxiety medications, and some are actually more effective for anxiety than depression. Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly used class of antidepressants for the treatment of GAD — almost all of these have a formal FDA-approved indication for one or more anxiety disorders. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), and fluvoxamine (Luvox). Serotonin and Norepinephrine Reuptake Inhibitors (SNRI’s) such as duloxetine (Cymbalta) and venlafaxine (Effexor XR) can be effective too.
  • Benzodiazepines: These medications are used for their calming and relaxing effects. They can help reduce anxiety and improve sleep, but they should be used with caution, as they can be addictive and cause drowsiness. Examples of benzodiazepines include alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), and diazepam (Valium). If used, they are best used only occasionally as needed for peak levels of anxiety, although there are circumstances where these are appropriate as ongoing regular medication.
  • Buspirone (Buspar): This medication works by affecting neurotransmitters in the brain to reduce anxiety. It is not as fast acting as benzodiazepines, but it does not cause drowsiness or have the risk of addiction associated with benzodiazepines.
  • Beta-blockers: These medications are primarily used to treat high blood pressure, but they can also be effective in reducing symptoms of anxiety, such as rapid heartbeat and sweating. They are typically used for performance anxiety such as stage fright or before a presentation.


The most effective treatment for Generalized Anxiety Disorder (GAD) is often medication combined with therapies such as Cognitive Behavioral Therapy (CBT) in order to reach the most beneficial outcomes. The type of medicine and dosage will depend both on the strength of symptoms, and each person’s medical/psychological makeup and history.

Remember that seeking help is a sign of strength and courage, and taking control of your mental health is the first step towards a brighter future. Dr. Ranen can be a catalyst for walking on the most beneficial path toward that desired future.

Why choose Dr. Neal Ranen?

Dr. Ranen has an extensive professional background in treating patients experiencing issues associated with excessive worry. He will perform an exhaustive assessment that will help him determine a proper diagnosis and develop a tailored made treatment plan. He is available for both in-person and teletherapy sessions, catering to the mental needs of adults.