Generalized Anxiety Disorder

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Fear that seems to appear completely unexpected, perhaps while in the middle of grocery shopping, or en-route to work; can occur out of the blue; sudden and unpredictable. Too much time booked off work, outings with friends cancelled and drained relationships are just some of  the symptoms of Generalized Anxiety Disorder, also known as (GAD).  As categorized in American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders; GAD falls under the spectrum of Anxiety Disorders. However, the symptoms are varied, and the leading indication of GAD is the actual generality of the symptoms itself.

‘Free floating’ is the term used to describe the nature of the anxiety, meaning that panic can occur anytime without warning or cause.  This can result in extreme feelings of uneasiness and fear as the sufferer is expecting ‘something bad’ to happen as a result of the anxiety attack.  The feelings of dread may cause one to attribute anxiety to fear of situational circumstances that may not even occur. This fear can happen frequently and tends to be disproportionate to the situation or trigger.  Generalized or ‘free floating’ anxiety is different from other forms of anxiety in that it is not contributed to a specific circumstance; it is a physiological reaction, one that is difficult to control without treatment.

 

Criteria

The fear from generalized anxiety can be persistent, interfering with daily function and quality of life.  According to the DSM-5, criteria for diagnosis is the presence of three or more symptoms that occur frequently for at least 6 months.  These symptoms will affect employment, social life, family life and relationships that are not the direct cause of another illness.

 

Symptoms

Symptoms of Generalized Anxiety Disorder are persistent feelings of irrational fear, chronic negative biases and anxiety, with or without the following:

  • Overwhelming fatigue
  • Persistent distress, heart palpitations, sweating and trembling
  • Irritability and restlessness
  • Sleep disturbances
  • Nausea, or stomach pain
  • Tense muscles, Dizziness

 

Causes

Generalized Anxiety Disorder may also be comorbid with other mental health disorders, such as depression, agoraphobia, obsessive compulsive disorder (OCD), or eating disorders.

Living with GAD is difficult for the sufferer, as well as those around them, often creating tension among relationships. A large part of the disorder is the persistent feeling of dread; always expecting something bad to happen which puts great strain on the individual.

There are various theories as to the causes of GAD.  Genetics can play a large role in this disorder, but chronic stress or trauma can also be a key indicator of Generalized Anxiety.

Neurophysiology and Neurophysiological Structures such as abnormalities of the Amygdala (involved in fear and anxiety), or neural pathways leading to or from the Amygdala can cause feelings of panic and anxiety. Deficiencies in GABA, the neurotransmitter responsible for controlling anxiety and excitatory activity, has been found to be a significant contributor to Generalized Anxiety Disorder.

 

Treatment

There are many successful steps one can take to alleviate the symptoms of GAD such as Therapy.  Cognitive Behavioral Therapy (CBT) is one of the more well-received treatments in learning to live with this disorder. It teaches the individual to understand the free-floating nature of the anxiety.

Cognitive restructuring technique is a psychotherapeutic form of treatment that will train the individual to dismiss maladaptive thoughts, and to become more cognizant of the bio physiological nature of the disorder. It is imperative to understand that these feelings of fear are a result of a chemical imbalance that will pass, and will not result in a catastrophic event.

Relaxation techniques are important in successfully overcoming the attacks.  Breathing exercises, autogenic training (cognitive imagery to ease anxiety symptoms), meditation, and progressive muscle relaxation are essential in managing stress and aiding in the reattribution of anxiety to that of a symptom, rather than dread and fear of an unknown force.

A significant variable in controlling one’s negative reactions to Generalized Anxiety Disorder is to understand it. Generalized Anxiety Disorder is a mental illness, just like any other illness; understanding the symptoms and causes, can remove the power this disorder has.  Once GAD is understood, the power of this disorder diminishes, and the sufferer can control episodes as they occur, greatly reducing the fear it had once caused.  Treatment is essential in reducing the perceived severity of the symptoms, it can offer the individual an improved quality of life, greater control over their feelings and an increased inner strength that can combat the intolerance of Generalized Anxiety Disorder.  Cognitive Behavioral Therapy is a strong tool that can transition feelings of helplessness to that of knowledge and competency, which for anyone that has experienced GAD, knows the significance that controlling the fear truly has.

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