General Anxiety Disorder

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Hyper-vigilance and Tension

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Low Energy

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Headaches and Muscle Tension

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Irritable

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Difficulty Focusing

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Excessive worrying

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Generalized Anxiety Disorder

Sometimes anxiety can just come out of nowhere, you could be relaxing and studying at a coffee shop and it hits, the dreadful feeling that something bad is just about to happen.  You’re not sure what it could be, or why it is, but it’s an unmistakable feeling of extreme worry, it could be about certain daily routines, or it could be about nothing at all, yet still, unfortunately this is a common occurrence, for some it’s as often as every day, and even several times a day for others.  Everyone worries from time to time, which can be a healthy response to stress, but those with Generalized Anxiety Disorder may have the same type of worries;  however the level is far more extreme, the symptoms are extreme and debilitating, and those thoughts and concerns take up a large proportion of their day. This is called Generalized Anxiety Disorder; you feel tension, dread, and constant worry without any logical reason attached to it. 

Sigmund Freud (1856-1939) was the first to note anxiety that is ‘free floating’ in nature, which he termed this phenomenon as ‘neurotic’, and a reaction we have to expected danger.  Those with Generalized Anxiety Disorder; (GAD) unfortunately continually to sense expected danger.  GAD is a category within the Anxiety Disorders spectrum.  One who suffers from this disorder could feel agitated and restless with excessive and irrational worry that is un-proportional to the situation.  The feeling is persistent, inexplicable and uncontrollable, leaving the individual feeling helpless. Onset appears to occur at the ages of 45 – 59, however symptoms can decrease by the age of 60 and women are twice as likely as men to be diagnosed with GAD.  About 4% of Americans suffer from this disorder and unless they are properly treated, the symptoms can become chronic.

In accordance with the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) the symptoms of GAD are extreme anxiety and worry accompanied with:

  • Being easily fatigued
  • Irritability and on edge
  • Persistent worry causing significant distress
  • Difficulty concentrating, and difficulty functioning
  • Difficulty controlling the worry
  • Restlessness
  • Muscle tension
  • Sleeping disturbances
  • Heart palpitations
  • Sweating
  • Trembling
  • Upset stomach, pain or nausea

The criteria required to be diagnosed with GAD, according to the DSM 5, are the existence of three or more symptoms accompanied with excessive worry for more days than not within a minimum of 6 months.  And that these symptoms are not a result of other medical illnesses or the result of substance abuse.  The symptoms must also significantly impair daily life functions at home, work, school or in relationships.  The GAD7 is a standardized rating scale with a set of questions that healthcare providers will use to assess the severity of the disorder.

Causes:

Studies have shown that GAD is hereditary; and also suggest that chronic stress or a negative trauma or event can contribute to this disorder.  Another finding has shown the Amygdala, two almond shaped brain structures located at each side of the brain responsible for emotions such as fear and anxiety, to some extent, have impaired pathways to and from this structure which can contribute to confusion of emotions.  Another possible neurological cause found to be correlated to GAD is a deficit in a brain chemical or (neurotransmitter) called GABA which reduces activity in the brain cells to keep emotions intact. When this is not balanced, then too many neural firings can happen in the brain causing high stress and anxiety.  It is very common that GAD is comorbid (coexists) with other anxiety disorders such as Major Depressive Disorder, Panic Disorder, Social Phobia, Obsessive Compulsive Disorder, Bipolar Disorder and substance abuse problems.

Treatments:

Cognitive Behavioral Therapy has been found to be successful in treating GAD in way of introducing the patient to view their anxiety from a different perspective, and to recognize the error within their rationalization of the apprehension they feel.  The individual is taught to reattribute their fears to another source, and not within.  Certain interventions of Cognitive Behavioral Therapy include learning more about the anxiety they are feeling, learning how to monitor themselves, learning relaxation exercise and to exercise more control over their own thoughts, to sum it up, basically they learn to gain control over their anxiety, and to ultimately learn to recognize the issue immediately, and to self-administer their own behavioral therapy.   Medication such as SSRI’s (Selective Serotonin Reuptake Inhibitors) has also shown to be affective, and in combination with Cognitive Behavioral Therapy there is a higher chance of success.

For those living with Generalized Anxiety Disorder the fear and dread they feel is real, and it exists as a part of their daily routine.  Seeking medical care is extremely important so the proper treatment can be implemented.   Joining a support group can be beneficial in learning to live with this disorder, and a strong family or friend support system will also help the individual to cope with this very real struggle.

Sources:

 

  1. http://www.theravive.com/therapedia/Generalized-Anxiety-Disorder-(GAD)-DSM--5-300.02-(F41.1)
  2. http://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890425596.dsm05
  3. http://www.healthcentral.com/anxiety/c/1950/20288/freud-101/
  4. http://www.aafp.org/afp/2015/0501/p617.html
  5. https://www.adaa.org/resources-professionals/practice-guidelines-gad
  6. https://med.stanford.edu/news/all-news/2009/12/brain-scans-show-distinctive-patterns-in-people-with-generalized-anxiety-disorder-in-stanford-study.html
  7. https://www.ncbi.nlm.nih.gov/pubmed/11225508
  8. https://www.ncbi.nlm.nih.gov/pubmed/25289805
  9. https://www.verywell.com/cognitive-behavioral-therapy-for-gad-what-to-expect-1393177

 

 

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