The generalized anxiety disorder (TAG) is characterized by indiscriminate preoccupation with anything. Worry can be useful, as it allows you to prepare for vital challenges (pass an exam, do a job well), although in this disorder, such worry is unproductive and undesirable.
This excess of concern interferes with the functioning in daily life, since the person anticipates the disaster in different areas: money, death, family, friends, relationships, work ...
Every year 6.8 million Americans and 2% of European adults experience generalized anxiety disorder (GAD). It occurs twice as often in women than in men and is more common in people with a history of substance abuse and family members with a history of anxiety disorders.
Once GAD develops, it can be chronic, although it can be controlled with correct treatment. In the United States it is the leading cause of disability at work.
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Worries, fears, and doubts are a normal part of life. It's normal to be anxious about a test score or worry about home economics.
The difference between these types of normal concerns and those of the TAG is that those of the TAG are:
For example, after seeing a news story about a terrorist attack in another country, the normal person may feel temporarily worried. However, a person with GAD may stay up all night or worry for days about an attack coming..
Normal concerns:
TAG:
The TAG can include:
There may be the following physical signs:
In addition to the above symptoms, children and teens with GAD may have excessive concerns about:
They may also experience:
As in other mental conditions, the exact cause of GAD is not known, although it may include genetic and other risk factors..
One third of the variance of the GAD is attributed to genes. People with a genetic predisposition to GAD are more likely to develop it, especially in response to a life stressor.
Long-term use of benzodiazepines can worsen anxiety, while reducing benzodiazepines can decrease your symptoms.
Likewise, long-term alcohol consumption is associated with anxiety disorders, with evidence that prolonged abstinence can result in the disappearance of symptoms..
Recovery from benzodiazepines tends to take much longer than alcohol, but previous health can be restored.
Smoking tobacco has also been established as a risk factor for developing anxiety disorders, as has the consumption of caffeine.
GAD has been associated with a disruption in the function of the amygdala and its processing of fear and anxiety.
Sensory information enters the amygdala through the complex basolateral nucleus. The basolateral complex processes memories related to fear and communicates the importance of threats to other parts of the brain, such as the medial prefrontal cortex and sensory cortices..
People with GAD may visit a doctor many times before discovering their disorder.
They ask doctors about their headaches and sleep problems, although their true pathology is not always discovered.
First of all, it is advisable to go to a doctor to make sure that there is no physical problem that is causing the symptoms. The doctor can then refer the patient to a mental health specialist..
The diagnostic criteria for generalized anxiety disorder, defined by DSM V, published by the American Psychologists Association (APA) is:
A. Excessive anxiety and worry (apprehensive expectation), which occurs on most days during a 6-month period in relation to a number of activities or events.
B. Individual finds it difficult to control worry.
C. Anxiety and worry are associated with three or more of the following six symptoms (with at least some of the symptoms present on most days during a 6-month period).
Note: in children, only one item is enough):
D. Anxiety, worry, or physical symptoms cause significant discomfort or dysfunctions in social, occupational, or other important areas of life.
E. The disturbance cannot be attributed to the effects of a substance (eg drug, medication) or other medical condition (eg hyperthyroidism).
F. The disturbance is not better explained by another mental disorder (eg anxiety or worry about having panic attacks, negative evaluations in social phobia, obsessions in obsessive compulsive disorder, separation of attachment figures in separation anxiety disorder, flashbacks of traumatic events in post-traumatic stress, gaining weight in anorexia nervosa, physical complaints in somatic disorder, physical defects in body dysmorphic disorder or erroneous beliefs in schizophrenia or delusional disorder).
A. A period of at least 6 months with prominent tension, worry and feelings of apprehension, about daily events and problems.
B. At least four symptoms from the following list of items must be present, with at least one of items 1 through 4.
C. The disorder does not meet the criteria for panic attack disorder, phobias, obsessive compulsive disorder, or hypochondria.
D. Most commonly used exclusion criterion: not supported by a physical disorder such as hyperthyroidism, an organic mental disorder, or a substance use disorder.
As previously mentioned, some anxiety is normal, although it is advisable to see a professional if:
Worries don't usually go away on their own, and in fact they tend to get worse.
Cognitive-behavioral therapy (CBT) is more effective in the long term than medication (such as SSRIs), and although both treatments reduce anxiety, CBT is more effective in reducing depression.
Generalized anxiety is a disorder based on psychological components that includes cognitive avoidance, worries, ineffective problem solving and emotional processing, interpersonal problems, intolerance to uncertainty, emotional activation, poor understanding of emotions ...
To combat prior cognitive and emotional issues, psychologists often include some of the following components in the intervention plan: relaxation techniques, cognitive restructuring, progressive stimulus control, self-control, mindfulness, resolution techniques problems, socialization, emotional skills training, psychoeducation and acceptance exercises.
Cognitive behavioral therapy (CBT) is a method that requires working with the patient to understand how their thoughts and emotions influence their behavior.
The goal of therapy is to change negative thought patterns that lead to anxiety, replacing them with more positive and realistic thoughts..
Elements of therapy include exposure strategies to allow the patient to confront their anxiety gradually and become more comfortable in the situations that provoke it..
CBT can be used alone or in conjunction with medication.
Components of CBT to treat GAD include: psychoeducation, self-observation, stimulus control techniques, relaxation techniques, self-control techniques, cognitive restructuring, exposure to worry (systematic desensitization), and problem solving..
CT is a behavioral treatment designed to achieve three goals: 1) reduce avoidance strategies of thoughts, memories, feelings, and sensations, 2) reduce the person's response to their thoughts, and 3) increase the person's ability to maintain your commitment to change your behavior.
This therapy teaches attention to purpose, to the present - in a nonjudgmental way (mindfulness) - and acceptance skills to respond to uncontrollable events.
Works best in combination with drug treatments.
This therapy focuses on helping patients develop skills to tolerate and accept uncertainty in life to reduce anxiety.
It is based on the psychological components of psychoeducation, awareness of worry, training in problem solving, exposure in imagination and real, and recognition of uncertainty.
A new approach to improve recovery rates in GAD is to combine CBT with motivational interviewing (ME).
It focuses on increasing the patient's intrinsic motivation and works, among other personal resources, on empathy and self-efficacy..
Rely on open-ended questions and listening to promote change.
Different types of medication are used to treat GAD and should always be prescribed and supervised by a psychiatrist.
Although antidepressants can be safe and effective for many people, there can be risks for children, adolescents, and young adults.
These factors could increase the risk of developing GAD:
Having GAD can influence:
In a 2005 US survey, 58% of people diagnosed with major depression also had anxiety disorders. Among these patients, the comorbidity rate with GAD was 17.2%.
Patients with comorbid depression and anxiety tend to have greater severity and greater difficulty in recovering than those with a single illness..
On the other hand, people with GAD have a comorbidity with substance abuse of 30-35% and with drug abuse of 25-30%.
Finally, people with GAD can also have illnesses associated with stress, such as irritable bowel syndrome, insomnia, headaches, and interpersonal problems..
Most people with GAD need psychological treatment or medication, although lifestyle changes can also help a lot..
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