Anxiety Disorder

Anxiety Disorder

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WHAT IS GAD?

A sufferer typically:

  • Experiences relentless and exaggerated anxiety in the absence of valid concerns, which can be debilitating
  • Is prone to always expect the worst
  • Blows things out of proportion
  • Grapples with all-consuming fear and dread to the point of it interfering with their ability to live a normal life

Contents
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THERE ARE FIVE MAJOR ANXIETY DISORDERS
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  1. Generalised anxiety disorder
  2. Obsessive-compulsive disorder (OCD)
  3. Panic disorder
  4. Post-traumatic stress disorder (PTSD)
  5. Social phobia (or social anxiety disorder)

This brochure is based on generalised anxiety disorder (GAD).

COMMON SYMPTOMS OF GAD (GENERAL ANXIETY DISORDER)
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  • Headaches
  • Constant worry
  • Difficulty sleeping
  • Exaggerated worry
  • Muscle tension
  • Easily startled

PHYSICAL SYMPTOMS
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  • Dizziness/immobility
  • Headaches
  • Difficulty with concentration
  • Sweating
  • Chest pain
  • Heart palpitations
  • Nausea
  • Diarrhoea
  • Rapid breathing or breathlessness
  • Increased blood pressure
  • Muscle tension
  • Frequent urination
  • Tiredness or fatigue
  • Change in sleep patterns
  • Trembling

EMOTIONAL SYMPTOMS
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  • Excessive worrying
  • Irritability or agitation
  • Restlessness
  • Feeling tense or highly strung
  • Being on edge

The above illustrates that GAD cannot be ignored or dismissed as a “mental issue”. Rather, it can be crippling and presents immense challenges to an individual’s general health and physical wellbeing.

DEPRESSION VERSUS ANXIETY
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Although depression and anxiety differ considerably, there are some commonalities, such as:

  • Restlessness
  • Excessive worrying
  • Agitation

 

NORMAL STRESS IN COMPARISON TO GAD

THE PROBLEM GOES BEYOND GAD
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Those with GAD may, in addition, also experience one or more of the following:

  • Irrational fears
  • Obsessive-compulsive disorder
  • Clinical depression
  • Addiction problems (drugs, alcohol)
  • Generalised panic disorder
  • Burnout

 

GAD cannot be ignored or dismissed as a “mental issue”. Rather, it can be crippling and presents immense challenges to an individual’s general health and physical wellbeing.

The exact cause has not yet been established. However, experts agree that several factors may play a role, such as:

  • The incorrect functioning of certain nerve cell pathways, particularly those that are involved with emotions and thinking.
  • These pathways depend on messengers, called neurotransmitters, to connect.
  • Thus, problems with these nerve cell pathways and/or messengers may result in “faulty” connections, and subsequently GAD.
  • Genetics
  • Family history may increase the likelihood of the disorder
  • Environmental factors
  • Trauma
  • Stressful event
  • Substance withdrawal

DIAGNOSIS
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The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) defines the diagnosis for mental health professionals as:
For children, the anxiety and worry are associated with fewer (one or more) of the six symptoms compared to adults (three or more).
The process may entail:

  • Medical and psychiatric history
  • A physical examination and lab tests to rule out other causes of the symptoms
  • Reports on the intensity and time-frame of the symptoms
  • Evaluation of the degree of the dysfunction

MANAGEMENT
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GAD is usually managed through medication and cognitive-behavioural therapy, addressing both physical and emotional symptoms

COGNITIVE-BEHAVIOURAL THERAPY
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  • Learning more about the condition
  • Changes in thought and behavioural patterns
  • Relaxation techniques

MEDICATION
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  • Short-term sedative-hypnotics
  • Certain anti-depressants (SSRI’s & SNRI’s)
  • Anti-anxiety medication
  • Other ranges of medication may also play a role, including pregabalin and agomelatine

ADDITIONAL MANAGEMENT TECHNIQUES
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  • Exercise and a healthy diet
  • Avoiding or reducing caffeine, nicotine and alcohol
  • Adequate sleep
  • A support structure


1. BMJ. 2007 Mar 17; 334(7593): 579–581

Christopher Gale, Oliver Davidson, Generalised anxiety disorder

2. Prim Care Companion J Clin Psychiatry. 2004; 6(1): 35–41

Larry Culpepper, Kathryn M. Connor, Effective Recognition and Treatment of Generalized Anxiety Disorder in Primary Care

3. P T. 2013 Jan; 38(1): 30-38, 41-44, 57

Alexander Bystritsky, Sahib S. Khalsa, Michael E. Cameron, Jason Schiffman, Current Diagnosis and Treatment of Anxiety Disorders

4. Journal of the American Academy of Physician Assistants: August 2014 – Volume 27 – Issue 8 – p 42–43

Klingler, Amy M. MS, PA-C, Generalized anxiety disorder

5. JAMA. 2011;305(5):522

Janet M. Torpy, MD; Alison E. Burke, MA; Robert M. Golub, MD, Generalized Anxiety Disorder

6. Am Fam Physician. 2015 May 1;91(9):617-624

AMY B. LOCKE, MD, FAAFP; NELL KIRST, MD; and CAMERON G. SHULTZ, PhD, MSW, Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults

7. Evidence-Based Mental Health, June 2003

Christopher Gale, Mark Oakley-Browne, Generalised anxiety disorder

8. BMJ 2012

Elizabeth A Hoge, Gregory L Fricchione, Generalized anxiety disorder: diagnosis and treatment

9. Medscape June 2017

Nita V Bhatt, MD, MPH, Matthew J Baker, DO, David Bienenfeld, MD, William R Yates, MD, MS, Anxiety Disorders

10. Medscape Oct 2017

Dennis Anthony Nutter, Jr, MD, Pediatric Generalized Anxiety Disorder

11. Journal of Depression and Anxiety, November 2013

Judith A Dygdon and Kimberly A Dienes, Generalized Anxiety Disorder and Depression: A Learning Theory Connection

12. International Journal of Neuropsychopharmacology, Volume 14, Issue 5, 1 June 2011

David S. Baldwin, Sarah Waldman, Christer Allgulander, Evidence-based pharmacological treatment of generalized anxiety disorder

13. BMC Family Practice2015, 16:146

Pasquale RobergeEmail author, François Normand-Lauzière, Isabelle Raymond, Mireille Luc, Marie-Michèle Tanguay-Bernard, Arnaud Duhoux, Christian Bocti and Louise Fournier, Generalized anxiety disorder in primary care: mental health services use and treatment adequacy

14. PubMed Informed Health Online, 19 October 2017

Treatment options for generalized anxiety disorder

 

 

 

 

 

 

 

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