By Dhanashree
MA (Psychology)
22 September 2022 -
Medically reviewed by
Dhanashree
MA (Psychology)
What is Generalized Anxiety Disorder?
Table of Contents

What is Generalized Anxiety Disorder?

Generalized Anxiety disorder (GAD) is a mental health condition that causes fear, worry, and a constant feeling of being overwhelmed. It is related to excessive, frequent, and unrealistic worry about everyday things, such as job responsibilities, health, etc. (Rowa, K. and Antony, M.M., 2008)

Children as well as adults may get affected by GAD. GAD develops slowly. It often starts around age 30, but it may occur in childhood. The disorder is more common in women than in men.

Patients with symptoms of GAD always expect disaster and are always concerned about health, money, family, work, or school. 

GAD is one of several Anxiety disorders. Data regarding the frequency of specific Anxiety disorders in the community had been reported by investigators, known as the ECA study, concerned with the distribution of mental disorders in five American cities 

Depression and drug Abuse are usually associated with Anxiety disorders.

Recent studies have indicated that GAD produces disability more significantly than in psychiatrically healthy subjects without any major depression co-morbidity. A study showed that 13% of GAD in primary care present with Anxiety as the primary complaint. 

Generalized Anxiety Disorder

Signs and Symptoms 

Physical and mental symptoms:

  • Restlessness
  • Being easily fatigued
  • Heart palpitations
  • Muscle tension
  • Observing situations as more threatening 
  • Facing problems in letting go of worries
  • Difficulty in concentrating
  • Difficulty falling asleep and staying asleep.
  • Difficulty with uncertain situations
  • Irritability, nervousness, overthinking, and difficulty relaxing
  • Fatigue and exhaustion
  • Muscle tension
  • Twitching or trembling
  • Sweating 
  • Repeated stomach aches, diarrheic
  • Feeling unsteady and sickly (Herring, M.P., Jacob, M.L., Suveg, C. and O’Connor, P.J., 2011)

Causes and Risk Factors

Causes 

The cause of generalized Anxiety disorder will arise from a complex interaction between biological and environmental factors, including: 

· Differences in brain chemistry and function
· Genetics
· Differences in the way threats are perceived
· Development and Personality

Genetic:  A person has a genetic vulnerability, and some environmental factors contribute to developing Generalized Anxiety Disorder. Family members who are close relatives, such as parents, siblings, or children, are considered first-degree relatives of GAD.

Brain Structure: The amygdala is essential to people's ability to discern and feel fear. People diagnosed with GAD show elevated amygdala activity while processing negative emotions. Heightened activity within the amygdala might influence inaccurate interpretations of social behavior for patients with GAD.

Gray Matter: There is an increased amount of gray matter in the brain, which is responsible for GAD and other mood disorders. An area of the brain named the right putamen shows an increased volume of gray matter in patients with GAD.

Life Experiences

Experiencing trauma: Trauma in childhood leads to an increased risk of developing GAD. Experiences like physical and mental abuse, neglect, the death of a loved one, abandonment, divorce, or isolation are all contributing factors.
Learned Behaviour: According to some behavioral scientists, anxiety is a learned behavior. When a person has a parent or caregiver, who indicates anxious behavior, they may tend to mirror that behavior.

Societal Factors: Interacting with others on social media can place us through the same challenges. People with GAD are not capable of interpreting social cues, leaving them to feel a heightened sense of danger or rejection possibly.

Lifestyle factors 

Caffeine

Using Caffeine everyday addictive substances like caffeine can heighten feelings of worry or nervousness, which will then lead to the development of Anxiety. These substances may cause people to feel restless and anxious if consumed in large quantities.

Relationships

Relationships can be an important source of Anxiety for women since women are twice as likely as men to develop GAD. Dangerous and fearful experiences within intimate relationships will influence the development of Anxiety. 

Job stress

Work can be a significant source of stress through which employers can develop Anxiety. Some employers expect extraordinarily high levels of performance and productivity that can threaten a person's sense of employment security. Career and work-related stress, particularly the loss of a job, can be a symbolic source of heightened Anxiety. (Kendler, K.S., Walters, E.E., Neale, M.C., Kessler, R.C., Heath, A.C. and Eaves, L.J., 1995)

Diagnosis and treatment 

Diagnosis

The client is asked to do a physical exam to check if the signs of anxiety are linked to medications or an underlying medical condition. If a medical condition is suspected, he is expected to order blood or urine tests or other tests as suggested.

A professional will ask detailed questions about his symptoms and medical history. He will then use psychological questionnaires to help determine a diagnosis with the help of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. (Coutinho, F.C., Dias, G.P., Nascimento Bevilaqua, M.C.D., Gardino, P.F., Range, B.P. and Nardi, A.E., 2010)

Treatment

Psychotherapy, also called talk therapy, can be used for GAD, which aims to help a person identify and change their unhealthy emotions, thoughts, and behaviors.

Mental health professionals often use cognitive behavioral therapy (CBT) specifically to help treat GAD. At the time of CBT, a mental health professional will help the client take a closer look at his thoughts and emotions, guiding the client to understand how his ideas and excessive worrying affect his actions. Through CBT, we can unlearn negative or worrying thoughts and behaviors.CBT helps us to adopt healthier thinking patterns and habits.

In CBT, the client may also learn progressive muscle relaxation and other techniques to reduce the physical symptoms of GAD. Cognitive Behaviour Therapy will be significant in challenging unhelpful thoughts that provoke your Anxiety. We can learn to change our worries into problems we can solve and create actionable plans with CBT.

In Acceptance and commitment therapy (ACT) therapist will use an approach of Mindfulness and goal setting to reduce the discomfort and Anxiety. It focuses on decreasing the governing function of Anxiety and strongly focuses on behavior change. (Gorman, Jack M)

ACT has two main objectives:

(a) training acceptance of problematic unhelpful thoughts and feelings that cannot and perhaps need not be controlled

(b) commitment and action toward living life due to chosen values.

There are a few exercises and actions which are helpful in milder anxiety disorders, which include:

  • Stress management
  • Relaxation techniques
  • Positive thinking exercises to replace negative ideas
  • Support network
  • Exercise 

Other mental issues from GAD

Some mental health disorders that commonly go with a generalized anxiety disorder include:

· Phobias.
· Panic disorder.
· Post-traumatic stress disorder (PTSD)
· Obsessive-compulsive disorder (OCD)
· Depression.
· Suicidal thoughts or suicide.
· Substance Abuse.

Prevention

There are different ways to reduce the risk of Anxiety disorders. It's necessary to remember that some anxious feelings are a natural factor of our daily life, and experiencing them does not mean we have a mental health disorder.

To assist regulate anxious emotions, use the following steps:

  • Caffeine, tea, cola, and chocolate should be avoided.
  • Consult a doctor or pharmacist before taking over-the-counter (OTC) or herbal medications.
  • Maintain a healthy diet.
  • Keep a regular sleep pattern.
  • Avoid alcohol, cannabis, and other recreational drugs.

Conclusion

Generalized Anxiety Disorder (GAD) is a type of mental health issue that may seem difficult to handle as it is characterized by excessive worrying, stress, and other physical symptoms. 

There are warning signs and risk factors that will help us to identify Generalized Anxiety Disorder. Suppose we pay close attention to these hereditary and environmental risk factors; in that case, we can use an appropriate way to treat them with different therapies like Talk therapy, Cognitive Behavioural Therapy, and Acceptance and Commitment Therapy.

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