Generalized Anxiety Disorder

Experiencing occasional anxiety is a natural part of life. It is your body’s natural way of responding to stress. Anxiety is generally a feeling of apprehension or fear about what’s ahead. The first day of school, a job interview, or giving a speech may cause most people to feel fearful, anxious, and nervous.

However, individuals with anxiety disorders often have excessive, intense, and persistent worry and fear about basic, mundane situations. Anxiety disorders often involve repeated episodes of abrupt feelings of intense worriment and fear or terror that reach a peak within moments (panic attacks).

Such feelings of anxiety and panic interfere with daily activities, are difficult to keep in control, and are typically out of proportion to the actual danger lasting a long time. Sufferers of anxiety may tend to avoid situations, places, or even people to prevent these feelings.

Symptoms

Symptoms of Generalized Anxiety Disorder (GAD)

Symptoms of generalized anxiety disorder can vary. They may include:

  • Persistent worrying about a number of things beyond reason.
  • Inability to set aside or let go of a worry
  • Perceiving events or situations as threatening, even when they aren’t
  • Overthinking every possible situation and outcome
  • Indecisiveness due to fear of making the wrong decision
  • Inability to relax, constantly feeling restless or on edge
  • Difficulty handling uncertainty
  • Difficulty concentrating or going completely blank.

Physical signs and symptoms may include:

  • Irritability
  • Fatigue
  • Muscle tension or muscle aches
  • Nervousness or being easily startled
  • Trouble sleeping
  • Trembling, feeling twitchy
  • Sweating
  • Nausea, diarrhea, or irritable bowel syndrome

Causes and Risk Factors for GAD

Causes and risk factors of GAD

The exact roots and causes of generalized anxiety disorder are not known. Several factors, including brain chemistry, genetics, and environmental stresses — may contribute to its development.

Genetics

Some research suggests that family history and genetics play a crucial part in making it more likely for individuals to develop GAD, meaning the tendency to develop GAD may be passed on in families. However, no anxiety genes have yet been identified, and families may also pass down the tendency through environment or lifestyle.

Brain chemistry

This is complex. GAD has been linked to issues with certain nerve cell (neurons) pathways connecting particular brain regions involved in thinking and emotions. These neuron connections depend on brain chemicals called neurotransmitters that transmit information from one neuron to the next. If the pathways that connect specific brain regions don’t function well, problems related to anxiety or mood may occur.

Environmental factors

Trauma such as abuse, the death of a loved one, divorce may contribute to GAD. The condition may also worsen when stress feels out of hand.

Substance use

The use/abuse of and withdrawal from substances including drugs, alcohol, nicotine, and caffeine can also result in worsened anxiety.

Stress

The build-up of smaller stressful life situations or a major event may trigger excessive anxiety — for instance, changing jobs or schools, work stress, or ongoing worry about finances.

Personality

A person whose temperament is negative or timid may be more prone to generalized anxiety disorder than others.

Complications

Suffering from generalized anxiety disorder can be disabling, causing several complications such as:

  • Impair your ability to perform mundane tasks because you have trouble concentrating.
  • Take your time, energy, and focus from other activities
  • Increase risk of depression in individuals

GAD can also lead to or worsen underlying physical health conditions, such as:

  • Issues related to digestive or bowel, such as ulcers or irritable bowel syndrome
  • Chronic pain and illness
  • Headaches and migraines
  • Sleep troubles and insomnia
  • Heart issues

Generalized anxiety disorder can often occur along with other mental health illnesses, making diagnosis and treatment much more challenging. Some common mental health disorders that occur with GAD include:

  1. Panic disorder
  2. Phobias
  3. Post-traumatic stress disorder (PTSD)
  4. Obsessive-compulsive disorder (OCD)
  5. Depression
  6. Substance abuse
  7. Suicidal tendencies

Diagnosis

To diagnose GAD in an individual, the first step is to evaluate symptoms criteria, as outlined in the 5th Edition of “The Diagnostic and Statistical Manual of Mental Disorders” (DSM-5).

Mental health professionals look for factors such as excessive and hindering worry paired with a variety of other physical symptoms, then utilize proven diagnostic assessments to arrive at a diagnosis and rule out other possibilities.

The DSM-5 outlines specific criteria to help mental health professionals diagnose GAD easily and efficiently. Having a standard set of symptoms to refer to when assessing clients helps them diagnose mental health concerns more accurately and, in turn, create a more effective treatment plan.

Criteria for Diagnosing GAD

When evaluating for individuals for GAD, clinical professionals are looking for the following:

The presence of excessive anxiety and constant worry about a variety of topics or events. Worry due to GAD occurs more often than not for at least six months or more and is clearly excessive.

The worry is experienced as extremely challenging to keep in control. The worry may quickly shift from one topic to another.

The worry and anxiety are accompanied by at least three of the following physical or cognitive symptoms (only one of these symptoms is necessary for the diagnosis of GAD in children):

  • Edginess or restlessness
  • Tiring easily; more tired/fatigued than usual.
  • Increased muscle aches or soreness
  • Irritability (which may or may not be easily observable to others)
  • Impaired concentration or feeling as if the mind goes blank
  • Trouble sleeping (falling/staying asleep, unsatisfying sleep, or restlessness at night)

How is generalized anxiety disorder treated?

How is Generalized Anxiety Disorder (GAD) treated?

Treatments are based on how significantly this disorder is affecting your ability to function in your day-to-day life. Psychotherapy, medications, and certain lifestyle changes are some of the best treatments for GAD. You may benefit most from a combination of all three. It may take some trial and error to understand and discover which treatment works best for you.

Psychotherapy

Also known as talk therapy, it involves working with a therapist to reduce your symptoms of anxiety. Cognitive-behavioral therapy (CBT) has proven to be the most effective form of psychotherapy for GAD.

Cognitive-behavioral therapy, generally a short-term treatment, focuses on specific root causes of your anxiety and skills to manage your worries and help you gradually efficiently.

Medication

There are a number of medications that help relieve the symptoms of anxiety. However, unsupervised and ignorant use of these medications is strongly ill-advised. The following types of medications are generally prescribed for anxiety:

Benzodiazepines (sedatives)

Anti-depressants (such as SSRI and SNRI)

Anxiolytics (anti-anxiety medications)

Lifestyle

Various factors of your lifestyle can affect your mental health condition. Replacing the negative aspects of your lifestyle with a healthier and positive one can drastically help improve your condition. For instance, replace sleeping in bed all day with exercise, unhealthy foods with healthy and nutrient-dense foods, and meditating instead of substance use to calm oneself.

We understand that this mental illness can be debilitating and disabling. PAS is here to help you get through this low point of your life and move on to a better one.

Reference

https://www.sciencedirect.com/science/article/abs/pii/S0140673606698656

https://www.bmj.com/content/334/7593/579.short

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