Generalized Anxiety Disorders

We often feel nervous, tensed, and worried at times due to our everyday life experiences such as work and financial difficulties, family problems and other challenges. Anxiety is a normal part of life, as we may feel anxious from time to time, however, if the feeling of anxiety does not go away for six (6) months and is already putting much traction in your daily life, then you might already be suffering from generalized anxiety disorders (GAD).

Globally, GAD is one of the most common mental illness and is associated with increased use of health services. Alongside depression and substance use disorder, anxiety completes the list for the most prevalent mental and psychiatric conditions in Australia. More than two million Australians experience anxiety in 12 months. Globally, around 1 in every four people (one in three women and one in five men) will experience anxiety in some way or another at a point in their lives. It tends to be more common among women than in men. Manifestations of anxiety may begin at childhood or teenage years and may persist into adulthood.

Treatment of GAD may involve psychotherapy (psychologist provides the therapy and do not use drugs or other medical means) or medical interventions with medicines, in some cases, a combination of medications and psychotherapy may be required.

Manifestations

The most significant symptom of generalized anxiety disorder is excessive, persistent worrying. Alongside the long duration of nervousness, feeling of tension and worrying, below are also frequent manifestations of GAD.

• Hyperarousal
• Muscle tension
• Insomnia/poor sleep
• Fatigue
• Difficulty concentration
• Headaches and back pain
• Work avoidance
• Increased heart rate
• Diarrhea/Stomach upset
• Finding it hard to control worrying thoughts
• Sweating

Causes

The causes of GAD are not yet fully explained by medicine although researchers found that genetic factors may play a role in the existence of GAD; it can also be passed on from parents to siblings.Children who have been exposed to traumatic events during their childhood may have a higher chance of developing GAD in their adult life. It is also more likely to occur to people with timid and shy type personality and to people who have “neuroticism” (negative affectivity)

Severe life experiences may likely trigger GAD to people predisposed to anxiety disorders. However, in other people, anxiety disorders may be secondary to medical problems such as heart, thyroid,and endocrine disorders or may be a result of withdrawal from alcohol, medications or illicit drugs. Drugs that may trigger anxiety include alcohol, caffeine, cocaine, stimulants, steroids, and weight loss products.

Diagnosis

The doctors will be looking at these criteria (adopted from Diagnostics and Statistical Manual DSM-5) for them to diagnose you with Generalized Anxiety Disorders: You must experience a disproportionate level of anxiety and worry that is:

• Is too much
• Concerns several activities and events (work or school performance)
• Is existing more days than not for six months or longer

You also need to present 3 or more of the following symptoms:

• Restlessness or a keyed-up or on-edge feeling
• Fatigue or easy tiredness
• Difficulty concentrating
• Irritability
• Muscle tension
• Insomnia/Disturbed sleep (difficulty falling or staying asleep, or restless, unsatisfying sleep)

A psychologist can also give a psychological test and examination to evaluate your anxiety further. Your doctor may also advise getting more routine medical test such as blood test, physical examination,and history taking. These tests will help your doctor check if your anxiety is related to other medical causes such as substance abuse, endocrine disorders, hyperthyroidism or heart-related diseases.

Management

Your doctor or psychologist can provide non-drug therapy in the initial diagnosis of your GAD such as:

• Providing information about anxiety disorders, relaxation techniques, and coping skills.
• Stress management strategies such as
  • Activity scheduling
  • Modifying lifestyle factors
  • Keeping a stress diary
  • Managing time wisely
  • Avoiding or minimizing the intake of caffeine, alcohol, and nicotine
• Cognitive behavioral therapy can be effective
  • “Cognitive behavioral therapy is where the therapist helps the patient identity and correct distorted, maladaptive beliefs. Behavioral therapy uses thought exercises or real experiences to facilitate symptom reduction and improved functioning. This may occur through learning, through decreased reactivity from repeated exposure to a stimulus, or through other mechanisms.”

Otherwise, if the condition does not improve with non-drug treatments, your doctor may add pharmacotherapy. Patients with anxiety disorders may require more than 6 months of treatment with drugs. Remission is highly possible with a combination of non-drug therapy and medications. Common medications use in anxiety disorders are the following:

• An antidepressant such as Selective Serotonin Reuptake Inhibitors (SSRI), it is the most effective class of drugs for the management of generalized anxiety disorders, but it may take weeks before the results may become apparent.
• Benzodiazepines or anti-anxiety/sedative drugs are used with caution due to the risk of drug dependence. Antianxiety and sedative drugs are medications that can relieve anxiety instantly.
• Buspirone is another class of drug used to treat anxiety, but it may also take 2-weeks for it to improve the condition