ANXIETY DISORDER 8
Generalizedanxiety disorder (GAD) is a common type of anxiety disorder,centrally characterized by excessive worry about everyday life’sevents. People with generalized anxiety disorder may becomedistressed and expect disaster at all times. Sometimes, the worryingmay prevent them from doing their routine tasks. Generalized anxietydisorder is common in families with a history of mental disorder.However, women are more likely to suffer from this condition thanmen.
Generalizedanxiety disorder starts to develop slowly during adolescence or earlyadulthood, and its symptoms tend to gradually change where it maybecome worse at times, especially when one is undergoing stress.Before an individual finds that they are suffering from generalizedanxiety disorder they may have to visit a doctor several times. As aresult, this is may take some time before doctors become completelyconvinced that an individual’s has generalized anxiety disorder,and not any other disease. In children, the major impairmentresulting from the symptoms of generalized anxiety disorder include,inability to effectively work in school or relate well with others athome. The formal diagnostic criterion for generalized anxietydisorder is known as DSM-IV. By performing a mental health screeningwhere a patient will be asked question concerning his/her worries andthe period of occurrence, a doctor can diagnose this condition.Alternatively, medical tests may be used by clinicians to determineany underlying illness causing symptoms of anxiety.
Causesof Generalized anxiety disorder
Itis still unclear why some people have generalized anxiety disorder,and other doesn’t though occasionally it may be genetic. Thus, afamily with a history of anxiety is a risk factor. Another factorthat can cause this condition is prolonged exposure to stress,including personal or familial. According to researchers, fear andanxiety may originate from the brain. They also believe thatenvironmental factors and stress may a causative factor ofgeneralized anxiety disorder. In addition, excessive use of tobaccoor caffeine is another risk factor to this condition. In children,being a victim to abuse can also cause generalized anxiety disorder.
Thesigns and symptoms associated with generalized anxiety disorderinclude too much worrying about different things, havinguncontrollable worrying, unable to relax, having a hard time toconcentrate, stays awake, tiredness, headaches, stomach aches, muscleaches or unfathomable pain. These signs and symptoms have to bepresent for at least six months.
Generalizedanxiety disorder can significantly affect a person’s life if leftuntreated. However, in patients with less severe symptoms lessintensive interventions is required with the decision for treatmentbased on symptoms severity and persistence, impact of functioningand any physical disorders. Normally, generalized anxiety disordermay be treated with medication or psychotherapy, or both. Boththerapies are similarly effective in generalized anxiety disordertreatment. Nonetheless, the rate of relapse for psychotherapy may belower compared to drug therapy. Therefore, a patient is advised tofirst start with either psychotherapy or drug therapy only as noevidence show that using them together is more effective. Cognitivebehavior therapy (CBT) is useful for this condition, and has beendemonstrated efficient in relieving generalized anxiety disordersymptoms. Cognitive behavior therapy involves a mental healthcounselor whose goal is to alter the patient’s thinking andbehaviors. This therapy may take six-twelve weeks during which apatient works with the trained therapist and taught behavioralmethods including, different ways to think, behave and react tosituations, to help them feel less worried. Many patients haveachieved permanent change through this approach, thus successful. Usually, the clinician may prescribe medicines to be used along withthis therapy to treat generalized anxiety disorder (Heimberg, Turk &Mennin, 2004).
Alternatively,doctors may prescribe different types of medication, includingantidepressants and anti-anxiety medications to treat generalizedanxiety disorder. These medicines may be taken in short-term basisand for longer periods. Many types of anti-anxiety medications areshort-term and prescribed to relax certain physical symptoms, such asmuscle tension. These medicines include buspirone, clonazepam andalprazolam which are powerful and start to work right away. However,anti-anxiety medicines are not intended to be used for longer periodsbecause they may be habit-forming. Antidepressants are also powerfuland used to treat generalized anxiety disorder for longer period oftime. In contrast, they are may not start to work immediately, ratherafter several weeks. Side effects associated with these medicationsinclude, nausea, sleeping difficulties and headaches. Other specificdrug therapies include SSRI, which can be used for longer periodswithout risk of abuse. The choice of SSRI depends on adverse effectslikelihood, patient’s preference and interactions. SSRIs can alsobe used to effectively treat depression. Treatment may initially take12 weeks before efficacy is assessed, and may continue for 6-12months after the establishment of anxiety symptoms (Heimberg et al,2004).
Adverseside effects associated with SSRIs include a temporary increase inanxiety, nausea and insomnia that may have an effect on a patient’scompliance. According to Rygh & Sanderson (2004), adverse effectsassociated with SSRIs may be reduced by first prescribing low dosesto the patient and then be slowly increasing to full doses with timeas the level of toleration raises. On the contrary, if the temporaryanxiety increase is intolerable, then the clinician may recommendbenzodiazepine treatment. Most significantly, the doctor has toexplain to the patient and make it clear that benzodiazepine is onlyused as a short-term therapy. Furthermore, SSRIs can have an effecton the sexual functions of a patient which may continue with thetaking of drugs. Sexual dysfunction is the main reason why somepatients discontinue with treatment. However, inhibitors such assildenafil may be used to help some men suffering from sexualdysfunction with use of SSRI. Discontinuation of SSRI is associatedwith symptoms such as nausea, dizziness, anxiety and headache.Therefore, it is recommended for one to gradually withdraw from usingthese drugs over several weeks (Rygh & Sanderson, 2004).
Benzodiazepineis another drug therapy that has been commonly used to managegeneralized anxiety disorder because of its rapid onset of action ina short time. Additionally, the main therapeutic effect ofbenzodiazepine is to minimize anxiety symptoms, but less effective onthe main psychological aspects. For this reason, they may only beused to treat generalized anxiety disorder only when other cognitivebehavior therapy or drugs have been unsuccessful. The main adverseeffect associated with benzodiazepine use includes sedation.Additionally, the drug has a tendency of cognitive impairment in agedpeople. Patients with a history of addictive behavior are advised toavoid benzodiazepine because the drug tends to increase the risks ofdependency. To avoid rebound of anxiety and withdrawal symptoms ofbenzodiazepine discontinuation should be gradually decreased (Rygh &Sanderson, 2004).
Buspironeis another drug used to treat generalized anxiety disorder. This drugis used only when other agents have been ineffective. Similar tobenzodiazepine use of this drug is effective in the treatment of thiscondition. On the contrary, buspirone use is better because there areno withdrawal symptoms and physical dependence involved. For thisreason, an individual with generalized anxiety disorder is advised totalk to a doctor regarding treatment that suits them since some maydo better with medication, while others with the cognitive behaviortherapy, or a combination of both. Finally, to make the treatment ofthis condition more effective the patient can gain from joining asupport group and share with others their problems and achievement.Alternatively, meditation and use of stress management techniques canhelp an individual with this anxiety disorder to get calm and enhancetherapy effects (Hazlett-Stevens, 2008).
Inconclusion, generalized anxiety disorder is a condition that is quitecommon and affects millions of people. Although no clear causes havebeen associated with this condition, many other factors such asstress and environmental factors may increase the risk of anindividual having this disorder. This paper has analyzed emotional orbehavioral signs and symptoms of generalized anxiety disorder.However, gender difference seems to affect the expression of anxiety.As a result, an extensive medical assessment as well as physicalexaminations should be conducted if a medical professional suspects aperson may be having this condition. Usually, treatment is requiredto resolve generalized anxiety disorder, although some lifestylechanges and family interventions can be useful in preventing andreducing anxiety.
Hazlett-Stevens,H. (2008). Psychologicalapproaches to generalized anxiety disorder: A clinician`s guide toassessment and treatment.New York: Springer.
Heimberg,R. G., Turk, C. L., & Mennin, D. S. (2004). Generalizedanxiety disorder: Advances in research and practice.New York: Guilford Press.
Rygh,J. L., & Sanderson, W. C. (2004). Treatinggeneralized anxiety disorder: Evidence-based strategies, tools, andtechniques.New York: Guilford Press.