Generalized Anxiety Disorder

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Generalized Anxiety Disorder (GAD) :

Generalized Anxiety Disorder (GAD) GAD is diagnosed when a person worries excessively about a variety of daily problems for at least 6 months; Startle easily, have trouble relaxing or focusing on a task; Physical symptoms can include fatigue, headaches, muscle tension, muscle aches, trouble swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes; Twice as many women as men are affected by this disorder; Comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age; Substance misuse or depression oftentimes accompany this disorder; Commonly treated with medication or cognitive-behavioral therapy

Signs and symptoms of generalized anxiety disorder (GAD) :

Signs and symptoms of generalized anxiety disorder (GAD) The symptoms of generalized anxiety disorder (GAD) fluctuate. You may notice better and worse times of the day, or better and worse days in general. And while stress doesn’t cause generalized anxiety disorder, it can make the symptoms worse. Not everyone with generalized anxiety disorder has the same symptoms. But most people with GAD experience a combination of a number of the following emotional, behavioral, and physical symptoms.

Emotional symptoms of generalized anxiety disorder (GAD) :

Emotional symptoms of generalized anxiety disorder (GAD) Constant worries running through your head Feeling like your anxiety is uncontrollable; there is nothing you can do to stop the worrying Intrusive thoughts about things that make you anxious; you try to avoid thinking about them, but you can’t An inability to tolerate uncertainty; you need to know what’s going to happen in the future A pervasive feeling of apprehension or dread

Behavioral symptoms of generalized anxiety disorder (GAD) :

Behavioral symptoms of generalized anxiety disorder (GAD) Inability to relax, enjoy quiet time, or be by yourself Difficulty concentrating or focusing on things Putting things off because you feel overwhelmed Avoiding situations that make you anxious

Physical symptoms of generalized anxiety disorder (GAD) :

Physical symptoms of generalized anxiety disorder (GAD) Feeling tense; having muscle tightness or body aches Having trouble falling asleep or staying asleep because your mind won’t quit Feeling edgy, restless, or jumpy Stomach problems, nausea, diarrhea


CAUSES OF (GAD) FOLLOWING ARE THE CAUSES OF (GAD) Biological Environmental Integrative Perspective Brain Chemistry

Biological :

Biological The most current research into the causes of GAD focuses on genetics and biological factors. There is evidence that anxiety disorders like GAD can be shared between family members, and that having a parent or relative with GAD makes one more likely to develop it.

Environmental :

Environmental Another view is that GAD develops through environmental factors, meaning the things you are exposed to on a daily basis. If children have parents with an anxiety disorder like GAD, they can learn by observation and direct interaction on how to deal with stress anxiously. For example, if a child watches and hears about her mother constantly worrying, this practice and be adopted by the child and become her way of dealing with stress as well. There is also evidence that being in an unsafe environment or experiencing abuse can also lead to (GAD)

Integrative Perspective :

Integrative Perspective Many clinicians believe that GAD is likely caused by a combination of these factors. For example, one person may have a genetic predisposition to develop GAD but it never becomes a problem because the person learns strong coping strategies and never experiences intense stress at critical points of time. However, another person with the same disposition may develop it due to a strong environmental influence from a parent or because he experienced a traumatic event as a young person.

Brain chemistry:

Brain chemistry GAD has been associated with abnormal levels of certain neurotransmitters in the brain. Neurotransmitters are special chemical messengers that help move information from nerve cell to nerve cell. If the neurotransmitters are out of balance, messages cannot get through the brain properly. This can alter the way the brain reacts in certain situations, leading to anxiety.


CRIETERIAS A . A period of at least six months with prominent tension, worry and feelings of apprehension, about every-day events and problems. B . At least four symptoms out of the following list of items must be present

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Autonomic arousal symptoms (1) Palpitations or pounding heart, or accelerated heart rate. (2) Sweating. (3) Trembling or shaking. (4) Dry mouth (not due to medication or dehydration).

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Symptoms concerning chest and abdomen (5) Difficulty breathing. (6) Feeling of choking. (7) Chest pain or discomfort. (8) Nausea or abdominal distress (e.g. churning in stomach).

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Symptoms concerning brain and mind (9) Feeling dizzy, unsteady, faint or light-headed. (10) Feelings that objects are unreal (derealization), or that one's self is distant or "not really here" (depersonalization). (11) Fear of losing control, going crazy, or passing out. (12) Fear of dying.

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General symptoms (13) Hot flushes or cold chills. (14) Numbness or tingling sensations.

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Symptoms of tension (15) Muscle tension or aches and pains. (16) Restlessness and inability to relax. (17) Feeling keyed up, or on edge, or of mental tension. (18) A sensation of a lump in the throat, or difficulty with swallowing

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Other non-specific symptoms (19) Exaggerated response to minor surprises or being startled. (20) Difficulty in concentrating, or mind going blank, because of worrying or anxiety. (21) Persistent irritability. (22) Difficulty getting to sleep because of worrying.

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C . The disorder does not meet the criteria for panic disorder , phobic anxiety disorders , obsessive-compulsive disorder or hypochondriacal disorder . D . Most commonly used exclusion criteria: not sustained by a physical disorder, such as hyperthyroidism, an organic mental disorder or psychoactive substance-related disorder , such as excess consumption of amphetamine-like substances, or withdrawal from benzodiazepines.

Treatment :

Treatment Cognitive behavior therapy SSRI’s

Cognitive behavioral therapy :

Cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a psychological method of treatment for GAD that involves a therapist working with the patient to understand how thoughts and feelings influence behavior. The goal of the therapy is to change negative thought patterns that lead to the patient's anxiety, replacing them with positive, more realistic ones. Elements of the therapy include exposure strategies to allow the patient to gradually confront their anxieties and feel more comfortable in anxiety-provoking situations, as well as to practice the skills they have learned. CBT can be used alone or in conjunction with medication. CBT usually helps one third of the patients substantially, whilst another third does not respond at all to treatment

SSRI’s :

SSRI’s Pharmaceutical treatments for GAD include selective serotonin reuptake inhibitors (SSRIs), which are antidepressants that influence brain chemistry to block the reabsorption of serotonin in the brain. SSRIs are mainly indicated for clinical depression, but are also very effective in treating anxiety disorders. Common side effects include nausea, sexual dysfunction, headache, diarrhea, constipation, among others. Common SSRIs prescribed for GAD include: fluoxetine (Prozac, Sarafem) paroxetine (Paxil, Aropax) escitalopram (Lexapro, Cipralex) Sertraline (Zoloft)

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