Generalized Anxiety Disorder Generalized Anxiety Disorder (GAD) is a chronic and often disabling condition that is associated with uncontrollable worry and tension. The vicious cycle of anxiety and worry interferes with relationships, careers, and education, and often leads to depression. This disorder is much more than the normal anxiety that everyone experiences from time to time, and can be crippling in its severity. GAD is unlikely to disappear without proper treatment, and often worsens over time. Physical manifestations of GAD often include headaches, trembling, twitching, fatigue, irritability, frustration, muscle tension, and inability to concentrate. Sleep disturbances may also occur.
Individuals suffering from this disorder may appear to be always tense and unable to relax, or may startle more easily than others. Often they might seem to be constantly moving or fidgeting, unable to sit comfortably through a movie without worrying about something else that needs to be done. Some research suggests that GAD may run in families, and it Generalized Anxiety Disorder may grow worse during times of stress. Symptoms can begin at any age, but the risk is highest between childhood and middle age. GAD affects about 4 million adult Americans. Women are twice as likely to be affected than men.
The disorder usually comes on gradually, although it can be suddenly triggered by a childhood psychological trauma, the death of a loved one, divorce, and losing or changing a job. DSM-IV Diagnostic Criteria: 1. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). 2. The person finds it difficult to control the worry. 3.
The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children. - restlessness or feeling keyed up or on edge- being easily fatigued - difficulty concentrating or mind going blank- irritability- muscle tension- sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep) 4. The focus of the anxiety and worry is not confined to features of an Axis I disorder, e.
g. , the anxiety or worry is not about having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder. 5. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
6. The disturbances is not due to the direct physiological effects of a substance (e. g. a drug of abuse, a medication) or a general medical condition (e. g. hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.
Treatment of GAD: Medications: Benzodiazepines- Medications such as Klonopin, Ativan, Valium, and Xanax often bring quick relief from the symptoms of anxiety. They are generally used while waiting for other medications to begin working, as addiction and tolerance is possible. Antidepressants- Antidepressants can be useful in managing anxiety and in treating the depression that often accompanies it. The SSRIs are the most common antidepressants used to treat generalized anxiety disorder.
Buspirone (BuSpar) - Buspirone is an anti-anxiety drug that can be effective for generalized anxiety disorder. Some individuals respond very well to this medication, although many do not find it effective in treating all the symptoms of their disorder. Unlike the, must be taken consistently for at least two weeks to achieve relief of symptoms. Beta-blockers- Medications such as are often used to treat heart conditions but have also been found to be helpful in certain anxiety disorders. Psychotherapy: There are a number of different psychotherapy techniques available to treat GAD. Some may be more effective for certain individuals, and all can be used with or without the addition of medications.
Applied relaxation- This method teaches individuals with GAD to control their symptoms by using imagination and muscle control. Relaxation techniques, such as diaphragmatic breathing, meditation and visualization, can relieve some of the more troublesome physical symptoms. Biofeedback- This form of therapy uses special sensors to teach people suffering from GAD to recognize physical symptoms of anxiety, such as pulse, skin temperature and muscle tone, and ways to modify and control the effects of anxiety on the entire body. Cognitive-behavioral therapy- GAD often responds very well to this form of therapy, especially when used in conjunction with medication. There are three steps in cognitive-behavioral therapy.
In the cognitive (thinking / belief process) part of therapy the patient learns new methods and ways to change old destructive thinking patterns and habits. In the behavioral (what we do) part of therapy is when the patient puts their new way of thinking into place in everyday, real-life situations that cause anxiety. This is always handled at the same time or after cognitive therapy, because the patient needs a strong foundation of cognitive and emotional skills / strategies so that they can begin living and acting differently before the confront real-life challenges. In the emotional (relaxation / peaceful /strength and power strategies) part of therapy the patient learns how to get the brain to get quiet and relaxed so that the previous therapy techniques can be processed effectively. When peace and calmness become stronger in the thinking process it tends to crowd out the anxiety the patient is having. There are many studies pertaining to generalized anxiety disorder.
The studies examine the genetic and environmental risks for major anxiety disorders, their course-both alone and when they occur along with other diseases such as depression-and their treatment. Like heart disease and diabetes, these brain disorders are complex and probably result from a combination of genetic, behavioral, developmental, and other factors. Much of the research of anxiety centers on the amygdala, an almond-shaped structure deep within the brain. The amygdala is believed to serve as a communications hub between the parts of the brain that process incoming sensory signals and the parts that interpret them. Other research focuses on the hippocampus, another brain structure that is responsible for processing threatening or traumatic stimuli. By learning more about brain circuitry involved in fear and anxiety, scientists may be able to devise new and more specific treatments for anxiety disorders.
Researchers are attempting to learn how genetics and experience interact in each of the anxiety disorders-information they hope will yield clues to prevention and treatment.