Worrying About Worry: A Look at Generalized Anxiety Disorder
Life is a series of hills. Sometimes it feels like everything is possible and the limits are endless, and other times it feels like the force of life will get the upper hand. There are times when happiness and fulfillment are infinite and times when depression and anxiety permeate. These emotional waves are normal and come with the flow of life. For some people, however, feelings of anxiety rule their lives. Generalized anxiety disorder will cause a person to feel as if he or she is living in a constant state of worry and this worry will interfere with everyday life.
Maladaptive behavior is behavior that leaves an individual with an inability to cope with changing situations. It creates a significant amount of stress for that individual and this makes daily living difficult (Sarason & Sarason, 2005). Maladaptive behavior can take on many forms and affect each person in a different way. For example, two people may share the same diagnosis, but experience different sets of symptoms.
The list of maladaptive disorders is a long one that continues to grow as more research is done. Some of the most commonly diagnosed psychological disorders in the United States are those that involve anxiety (Kavan, Elsasser, & Barone, 2009). Anxiety is a term that is used to describe feelings of fear and apprehension. Most people experience some level of anxiety in their lifetime however, for some people the feelings are very intense, and interfere with daily life.
Anxiety is a cycle that most people encounter. The cycle starts with the feeling of anxiousness and then continues with a thought that one may be in danger. This starts the biological responses such as a pounding heart or feelings of nausea. When the biological symptoms start more thoughts occur that make a person feel as if something really bad is happening or going to happen (Buck, 2008). For most people, over time, the anxious feelings subside and things return to normal. The problem for those that have anxiety disorders, is that the cycle is never ending.
Common anxiety disorders include panic disorder, phobic disorders, obsessive-compulsive anxiety disorder, post-traumatic stress disorder, and generalized anxiety disorder. Aside from phobic disorders, generalized anxiety disorder is one of the most commonly diagnosed anxiety disorders (Sarason & Sarason, 2005). It is estimated to occur is about three percent of the American population and affects more women than men. The disorder can manifest itself in many different ways but the main symptom is uncontrollable worry.
Some More Information on Generalized Anxiety Disorder
- Symptoms and Treatment of Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive worry or anxiety. Generalized anxiety disorder can affect both adults and children. This condition is highly...
- Generalized Anxiety Disorder: An Overview
An overview of the symptoms, causes, medical treatment and prevention of Generalized Anxiety Disorder.
Generalized anxiety disorder is accompanied by feelings of worry about things like family, health, finances, and work, but the source of the worry is often unspecific. A person that has generalized anxiety disorder cannot control his or her worry and this worry interferes with relationships and social and work activities (Kavan, Elsasser, & Barone, 2009). Individuals may also experience physical symptoms such as trouble sleeping, headaches, fatigue, and gastrointestinal problems.
Generalized anxiety disorder has comorbidity with, or shares symptoms with, other anxiety and psychological disorders, and often times will occur with the presence of another anxiety disorder (Sarason & Sarason, 2005). For example, an individual can have both symptoms of generalized anxiety disorder and panic disorder, and therefore would need to be treated for both. Comorbidity could also lead to a misdiagnoses of a more serious mental health issue or a medical problem, so clinicians should really examine the source of the anxiety before making a definite diagnosis.
There are two main diagnosing and classification systems that are popularly used to diagnosis maladaptive behaviors. The DSM-IV-TR, the Diagnostic and Statistical Manual of Mental Disorders is the most commonly used diagnostic tool in research and in the United States, while the ICD-10, International Statistical Classification of Diseases and Related Health Problems, is the most commonly tool used worldwide in clinical assessment (Sorensen, Mors, & Thomsen, 2005). Each system has it's strengths and weaknesses and use is a matter of preference for some experts.
According to the DSM-IV-TR, in order for a diagnosis of generalized anxiety disorder to be made specific symptoms need to be present for at least six months and interfere with the patient's everyday life. Excessive anxiety and worry and the inability to control that worry is one of the first main cues to this disorder. Also, three or more of the following symptoms need to be present: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances (Sarason & Sarason, 2005). Only one of those symptoms need to be present in the case of a child.
The symptoms are very similar on the ICD-10, but only four of the symptoms need to be present. There is also more focus on biological disturbances of the autonomic nervous system (Buck, 2008). Both systems acknowledge the fact that generalized anxiety disorder is real, but the outcome with treatment is favorable. Both systems lay out a foundation for treatment.
Like other anxiety disorders, the exact cause of generalized anxiety disorder is not known. There are many theories as to the cause. The theory that is used to describe the causes of generalized anxiety disorder really depends on the thinking of the clinician that is doing the diagnosing. This thinking also tends to influence treatment options and steps of care. When discussing abnormal behavior, experts tend to follow one or two of six possible schools of thought. The biological perspective and the behavioral perspective are two approaches that are used.
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There are many different therapies that a person with generalized anxiety disorder can choose to use as a course of treatment. While the choice for which therapy to use will be a personal one, professionals dealing with this disorder, usually have specific ways that they treat their patients. In order to find a professional that is right, make sure the professional that is being seen offers the treatment plan that is being looked for. This will allow for a more positive relationship between the patient and the professional.
The behavioral approach is just one of the many ways that are used to set treatment plans in place. For those experts that take a behavioral approach to treating generalized anxiety disorder, the focus will be on learning and changing learned responses to situations that cause anxiety (Sarason & Sarason, 2005). Treatment, known as behavioral therapy, focuses on altering a person's response to situations that cause high emotions and anxiety.
One form of behavioral therapy is exposure therapy. This treatment has proven to be especially successful in the treatment of phobias and obsessive-compulsive anxiety disorder, but it also benefits those that have generalized anxiety disorder (Sarason & Sarason, 2005). It involves exposing the patient to the real (or imagined) stimuli until the anxiety is gone. There are three forms of therapy that are commonly used in behavioral treatment, systematic desensitization, implosive therapy, and vivo exposure, which includes flooding.
Modeling is another form of behavioral therapy that is used to treat generalized anxiety disorder. This therapy is often used in combination with exposure therapy (Sarason & Sarason, 2005). With this combination a person is exposed to the anxiety provoking stimuli and then taught normal behavioral responses. This may be done with the professional modeling the appropriate behavior before, during, and after the anxiety provoking stimuli is introduced. It has proven to be an effective treatment for this disorder.
The behavioral approach is just one of the ways that professionals can use to guide their treatment of patients. The biological perspective is another. Those that take the biological approach base treatment on the idea that a person's mental problems are caused by a problem with biological functioning (Sarason & Sarason, 2005). There are many ways in which biological functioning can interfere with mental state.
Genetics determines the color of a person's eyes, hair, whether he or she is tall, short, thin, or fat. Genetics is also responsible for some psychological conditions, including anxiety and depression. The genetic make-up of a person may predispose him or her to certain mental disorders (Sarason & Sarason, 2005). While it has been proven that some disorders are genetic, much more research needs to be done in the area of genetics and that may reveal even more.
Those that take the biological approach to treatment, tend to use drug therapies on their patients. Several drugs have been proven to be beneficial to those that have generalized anxiety, and other mental disorders ( Sarason & Sarason, 2005). Antidepressants have been proven to be helpful to not only those who have depression, but a host of other problems as well. There are many different drugs available and each person responds differently to the treatments. It will be a joint effort between the patient and the doctor to determine which drug is best.
There has been an increase in the number of drugs available to patients with generalized anxiety disorder. There are many things that need to be taken into consideration before drug therapies are used. The goal of drug therapy should be to eliminate symptoms but do not cause a long-term addiction to the medication (Kavan, M., Elsasser, G., & Barone, E.,2009). There are also side effects associated with each drug, so the decision to use drug therapy is not one that should be made without an extensive evaluation by the proper professionals.
While professionals tend to have a pull towards one approach over the others, some may use a combination of approaches when treating patients. For example, a cognitive-behavioral approach to generalized anxiety disorder has been proven an affective form of treatment. This type of therapy involves altering cognitive functioning in combination with therapeutic drugs. This type of treatment has proven both short-term and long-term results (Fava, Ruini, Rafanelli, Finos, Salmaso, Mangelli, & Sirigatti, 2005). The ultimate goal of treatment should be to reduce symptoms and a return to normal functioning. The professional also needs to make sure that the patient's disorder can be treated and managed successfully. This will give them confidence their own abilities.
Generalized anxiety disorder is not one of the most interesting psychological disorders out there, but it is one that is familiar to many people. The constant feelings of worry can really interfere with a person's daily life and prohibit proper functioning. The hills of life can intensify these feelings even more. The good news is that treatment and prognosis for generalized anxiety disorder is very positive. People do not have to live with a constant state of worry. Medicine has come farther than that.
Buck, A.. (2008). Dealing with anxiety. Practice Nurse, 35(2), 34-37. Retrieved February 19, 2010, from ProQuest Nursing & Allied Health Source.
Fava, G., Ruini, C., Rafanelli, C., Finos, L., Salmaso, L., Mangelli, L., & Sirigatti, S.. (2005). Well- Being Therapy of Generalized Anxiety Disorder :. Psychotherapy and Psychosomatics, 74(1), 26-30. Retrieved February 19, 2010, from ProQuest Health and Medical Complete.
Kavan, M., Elsasser, G., & Barone, E.. (2009). Generalized Anxiety Disorder: Practical Assessment and Management. American Family Physician, 79(9), 785-791,9-10. Retrieved February 19, 2010, from Research Library.
Sarason, I & Sarason, B. (2005) Abnormal Psychology the problem of maladaptive behavior. 11th ed. Pearson, Upper Saddle River, NJ
Sørensen, Mors, & Thomsen. (2005). DSM-IV or ICD-10-DCR diagnoses in child and adolescent psychiatry: does it matter? European Child & Adolescent Psychiatry, 14(6), 335-40. Retrieved February 19, 2010, from Research Library.
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