Generalized Anxiety Disorder. Introduction
Generalized Anxiety Disorder (GAD) is a common mental health condition characterized by excessive and uncontrollable worries.
Fear is a natural human experience warning and protecting individuals from threats. However, in the modern world people experience fears often detached from dangerous situations. When anxieties spiral out of control, they develop “life on their own”. Those affected by Generalized Anxiety Disorder find themselves constantly consumed by irrational worries without any particular triggers. Experts refer to such fears as “generalized anxiety”, as it extends beyond specific threats or situations.
Symptoms of Generalized Anxiety Disorder
Individuals with Generalized Anxiety Disorder experience continuous stream of unrealistic and exaggerated fears not tied to any immediate danger. As a result, people with GAD live in a constant state of apprehension, fearing everything from unfounded worries about their health, their loved ones’ safety, to trivial matters like losing keys. They might also worry about the anxiety itself. The individuals with generalized anxiety live in constant state of emergency which impacts their social and professional performance limiting significantly their life quality.
Generalized anxiety is frequently associated with depression, adding additional burden on the sufferers.
Physical symptoms in GAD
In response to anxiety, the body’s release adrenaline, the “fight and flight” hormon preparing the individual to master an imaginative danger. People with generalized anxiety develop physical response typical for the fight and flight reaction such as heart racing, palpitations, sweating and muscle tension. Additional physical symptoms include dizziness, shortness of breath, and gastrointestinal distress. Constant fears cause also sleeplessness, fatigue and decreased concentration.
It’s crucial to distinguish Generalized Anxiety Disorder from panic attacks, as the latter typically occur suddenly, “out of the blue” with symptom free intervals between the attacks.
Causes of Generalized Anxiety Disorder
The causes of Generalized Anxiety Disorder are only partially understood. They likely involve genetic, psychological and environmental factors. Evidence also suggests a genetic predisposition, with some families having a higher incidence of anxiety disorders. Some individuals may have experienced traumatic events in childhood or later in life. Such traumas can be caused by losses of significant others, or prolonged periods of extreme stress related to social or occupational pressure. Life crises can trigger fears that might evolve into a full-blown generalized anxiety. Additionally, generalized anxiety can be comorbid with other conditions like depression, panic disorder, phobias or substance abuse.
Prevalence of GAD
Generalized Anxiety Disorder is a common condition, affecting an estimated 5% of the population at some point in their lives. Women are twice as likely to be affected as men. While the onset typically occurs in mid-adulthood, it can also manifest in childhood or in older age.
Course of Generalized Anxiety
The course of Generalized Anxiety Disorder typically unfolds gradually, with fears and physical symptoms like heart racing and palpitation, initially going unnoticed. It’s only over time that these symptoms increasingly encroach upon one’s daily life and well-being.
GAD can be remarkably persistent, often taking years to overcome. During this journey, individuals may experience phases of reduced anxiety. The studies show that approximately one in four individuals had recovered from generalized anxiety spontaneously withing 2 years. In long-term, many people do manage their anxieties, and as individuals age, GAD often diminishes naturally.
Diagnosing GAD
Diagnosing Generalized Anxiety Disorder can be challenging. Its symptoms may overlap with those of other mental health conditions like phobias, panic disorder, or obsessive-compulsive disorder. Additionally, many affected individuals may experience symptoms more aligned with depression.
The physical symptoms associated with generalized anxiety, such as fears, rapid heart rate, sweating and muscle tension can also occur in conditions like hyperthyroidism or be triggered by stimulating drugs, for example amphetamine.
As a result, reaching a diagnosis for Generalized Anxiety Disorder can be time-consuming, especially if individuals initially seek help due to physical symptoms, perhaps even in an emergency room setting. In some cases, only one aspect of the disorder, such as sleep disturbances, may be addressed. However, through initial conversations in the context of psychotherapy, professionals can ultimately arrive at the correct diagnosis.
A diagnosis of “generalized anxiety disorder” is established when anxiety:
- Persists for at least six months, occurring on most days within that period
- Becomes uncontrollable
- Significantly impairs daily functioning
- Is accompanied by at least three physical symptoms, such as a rapid pulse, trembling, muscle tension, or gastrointestinal problems
Treatment for Generalized Anxiety Disorder
There are several treatment approaches for managing Generalized Anxiety Disorder over time, including:
Medications:
The fastest treatment for generalized anxiety is the use of medication. The first line of treatment is the use of antidepressants. However, the antidepressants need few weeks to unfold their efficacy. Therefore, the initial use of an anti-anxiety medication with immediate fears reducing effect, called benzodiazepines, might be indicated. In severe cases of anxiety, the common pharmacotherapy requires the combination of antidepressants with benzodiazepines. The latter get obsolete after the effect of antidepressants takes over.
Psychological and psychotherapeutic treatments:
The most researched, evidence-based treatment approach of generalized anxiety is cognitive behavioral therapy (CBT). Recent studies also proved the effectiveness of psychodynamic psychotherapy with even fewer relapses compared with CBT.
Complementary treatment such as:
Relaxation techniques, including autogenic training, progressive muscle relaxation, and breathing exercises can be used for treatment of GAD not alone but in combination with psychotherapy and/or medication.
Self-help:
Support groups offer opportunities for individuals to connect with others experiencing similar challenges. Informing oneself about the condition through books, brochures, or online resources can also be beneficial.
Living with Generalized Anxiety
Living with generalized anxiety impacts both professional and personal life. Anxiety impacts the work performance, and the social life of the affected individuals. They tend to withdraw socially, retreating to the safety of their homes, avoiding situations that might exacerbate their anxiety or trigger physical symptoms. In extreme cases generalized anxiety leads to full invalidism.
Opening up about an anxiety disorder is challenging and often limited to the closest circle of family and friends. With therapeutic support, however, it’s possible to share one’s struggles with family members, educating them about the condition and involving them into the treatment.
Seeking professional assistance and support are crucial steps in managing anxiety. It should be stressed out that generalized anxiety is a well treatable disorder, which can be fully curded under the condition of a proper management.
Generalized Anxiety Disorder. Summary
Generalized anxiety is a complex mental health condition characterized by excessive and persistent worries affecting various aspects of life. While anxiety serves as a natural defence mechanism, generalized anxiety is a psychiatric condition with fears spiralling out of proportion. In consequence the affected individuals are significantly impaired in their daily functioning and quality of life.
Recognizing the symptoms and understanding the causes, are crucial steps toward effective management and treatment. While no treatment method promises a “quick fix,” the use of medication combined with psychotherapy helps alleviate symptoms and improve one’s ability to cope with anxiety. Over time and under the guidance of a therapist, patients begin to notice improvement within few weeks. By using a proper setting such as long-term psychiatric monitoring and psychotherapy generalized anxiety can be fully cured.