Feelinganxious is normal, especially when one’s life is frequentlysubjected to stressful conditions. However, an ongoing, excessiveanxiety, and worry that hampers the day-today functioning of anindividual may be an indication of a generalized anxiety disorder. Ageneralized anxiety disorder is defined as an anxiety that is mainlycharacterized by exaggerated tension, worry, and chronic disquiet(The National Institute of Mental Health, 2015). Both children andadults can develop GAD as long as they are exposed to conditions thatculminate in chronic anxiety. GAD patients develop symptoms that aresimilar to those that are developed by patients withobsessive-compulsion and panic disorder, by a professionalpsychologist can distinguish them using the DSM-IV criteria. GAD canbe treated using the talk therapy or medication irrespective of theunderlying cause. This paper will address the comorbidity, clinicalcharacteristics, risk factors, diagnosis, treatment, and preventionof GAD.
Comorbidityin Generalized anxiety disorder
Thegeneralized anxiety disorder is the most common type of disorderaffecting members of the contemporary society. It is estimated thatapproximately 58 % of the people who are diagnosed with depressionalso suffer from anxiety disorder, where 17.2 % of them are affectedby generalized anxiety disorder (Moffitt et al., 2004). Generalizedanxiety disorder predisposes the patient to multiple health risks andunhealthy behaviors. For example, the people suffering from thegeneralized anxiety disorder have a comorbidity prevalence of about35 % with alcohol dependence and 30 % for drug dependence (Moffitt etal., 2004). The relationship between substance abuse (both alcoholand hard drugs) is two ways, which means that GAD can increase therisk of abuse and abuse can increase the risk of suffering from GAD.This implies that the psychologists should address the generalizedanxiety disorder from a broader perspective since the client could behaving other risk factors that might delay recovery or increasechances of relapse.
Causesand risk factors for generalized anxiety disorder
Theexact cause of the GAD is not yet known, but there are three factorsthat have been shown to increase the risk of suffering from GAD.Genetic predisposition is common in most of the patients sufferingfrom GAD. According to WebMD, LLC (2015) GAD runs in families, whichmeans that the fact that an individual is suffering from DAD could beused to indicate the rest of the family members are at a higher riskof suffering from GAD than the general population. To this end,understanding the family history of the client is critical to apsychologist who is offering therapy for GAD patients.
Secondly,the brain chemistry of an individual plays a key role in theoccurrence of GAD. Abnormal functioning in some pathways of nervecells, especially in the regions that are involved in emotion andthinking, is highly associated with the occurrence of GAD (WebMD LLC,2015). The connection of these nerve cells is facilitated byneurotransmitters, which are some of the chemicals that influence thefunctioning of the human brain. Neurotransmitters are responsible fortransmission of information from cell to cell. Inefficient running ofpathways that connect different regions of the brain leads to changesin mood and anxiety. This has a significant implication in thetherapeutic approach that a psychologist selects because behavioralapproaches may not be effective for clients with ineffectivepathways.
Thethird type of risk factor is environmental. Stressful events increasechances for the affected person to suffer from GAD. For example,people who abuse substances are at a higher risk of suffering fromGAD compared to the general population (WebMD LLC, 2015). GAD alsobecomes worse when one is changing a job or school, death of familymembers or friends, and when one is divorced.
Symptomsas well as the clinical features of GAD vary from one patient to theother. This implies that the psychologist should understand a largenumber of symptoms for easy diagnosis and the determination ofappropriate therapeutic approach. Some of the general symptoms of GADinclude obsession with concerns that are not proportional to theexpected impact of a given event, inability to set aside worries,restlessness, difficulty in concentrating, fear of making wrongdecisions, and indecisiveness (WebMD LLC, 2015). Apart from thepsychological symptoms, the affected person may express physicalsymptoms, especially when GAD has intensified. Physical symptoms mayinclude irritability, fatigue, sweating, headaches, trembling, muscletension, and troubled sleeping among others. In addition, somepatients suffering from GAD complain of cramping and indigestion. Inthe worse cases of GAD, patients experience frequent urination,develop a lump in the throat, and clammy skin (Waters, Donaldosn &Zimmer-Gembeck, 2010). A patient may have a combination of symptoms,which is a challenge for psychologists who have to distinguish GADfrom other types of anxiety.
Diagnosisfor generalized anxiety disorder
TheDSM-5 criteria are the most common approach used by psychologists todiagnose GAD. The criteria have five major elements that indicatewhether the client is suffering from GAD or other types of anxiety.First, a person with GAD suffers from excessive anxiety, and feelsworried about different events in most of the days of a week, whichruns for at least 6 months (Mayo Clinic, 2015). Secondly, secondly,the criteria help psychologists to conclude that a client issuffering from GAD if they find it difficult to control theirfeelings of worry. Third, a GAD patient expresses at least three ofthe major symptoms that include fatigue, restlessness, irritability,trouble concentrating, sleep problems, and muscle tension (MayoClinic, 2015). Fourth, clients experience anxiety that culminates insignificant distress that in turn interferes with their daily life.Lastly, the anxiety that the clients suffers from should not beassociated with other mental conditions, such as post-traumaticstress disorder and panic attacks. However, an experiencedpsychologist should understand that GAD co-occurs with other mentalconditions that complicate the process of diagnosis. Some of themajor mental disorders that co-occur with GAD include PTSD, phobias,depression, panic disorder, and substance abuse. Therefore, apsychologist should understand the criteria for diagnosing otherconditions in order to make a clear distinction between GAD and othermental problems.
Therapeuticalternatives for GAD
GADcan be treated using the psychotherapeutic and pharmaceuticalapproaches. However, the combination of the two types of therapyenhances the treatment outcome. The psychotherapeutic approach, alsoknown as the psychological counseling involves the establishment of arelationship between the client and the therapists, who worktogether, to reduce the symptoms of anxiety (Mayo Clinic, 2015). Thecognitive behavioral therapy is the most effective psychotherapeuticapproach for the treatment of GAD. A therapist who is delivering CBTbegins by providing the client with a general idea of the nature ofdifferent anxiogenic conditions, such as situation-specific anxiouspredictions and the idea of automatic thoughts (Brown, O’Leary &Barlow, 2001). The therapist focuses on equipping patients with theskills that they need to return to the activities that they haveavoided because of their anxiety. In essence, CBT involves theempowerment of the clients with the objective of helping them addresstheir own conditions, but with the close guidance of a professionaltherapist.
Inmost cases, therapists combine psychotherapy with medications inorder to enhance the treatment outcome. There are three types ofmedications that are commonly used to treat GAD. The first categoryof medication is antidepressants (such as escitalopram) that improvethe functioning of serotonin reuptake inhibitors and norepinephrinereuptake inhibitor (Mayo Clinic, 2015). Secondly, buspirone is ananti-anxiety prescription that is administered to clients on anongoing basis and may take several weeks before its effectiveness canbe realized. Third, benzodiazepine is an anxiety relieving medicationthat is offered in limited circumstances because of its side effects(Mayo Clinic, 2015). Therapists select the combination of therapythat depending on the severity of GAD.
Strategiesfor prevention of GAD
Althoughthere is no exact methods can be used to predict the occurrence ofGAD, one can take several measures to prevent or reduce the impactsof anxiety. The first measure is to get health early, which is basedon the notion that it is easy to address anxiety at early stages thanin late stages (Mayo Clinic, 2015). Secondly, keeping a journal helpspeople track their personal experiences, which can help them or theirproviders identify the cause and effective measures of reducing theimpact of anxiety. Third, one can reduce the chances for theoccurrence of GAD by prioritizing issues in life. This involves aproper management of one’s energy and time. Fourth, avoiding theuse of substance abuse can also reduce the risk of suffering fromGAD.
Achange in lifestyle is also an effective method of enhancing thewellbeing and preventing the occurrence of GAD. For example, a personwho develops a routine for physical activity every day and every weekis less likely to suffer from GAD than physically unfit individuals(Fricchione, 2004). This is because excise is an effective stressreducer that enhances mood and the overall well-being of anindividual. In addition, healthy eating behaviors (such as eatingless fatty foods and eating fruits and vegetables) have beenassociated with less chances of suffering from anxiety (Mayo Clinic,2015). Moreover, adopting relaxation techniques (such as yoga) andallocating enough time for sleeping eases anxiety. Therefore, thereare many strategies that can be used singly or in combination toprevent GAD.
Generalizedanxiety disorder is the most common type of anxiety that affectspeople in the modern world. The excessive worries that one encounterwhen suffering from GAD interferes with the normal functioning. Thisis because people with GAD anticipate disaster and remains overlyconcerned about daily matters, including the work difficulties,challenges arising from interpersonal relationships, family, andfriendship problems. The relationship existing between GAD andsubstance abuse predisposes people who are addicted to drugs andalcohol to higher risks of GAD than the general population. Thegenetic predisposition and brain chemicals are significant riskfactors, but they are difficult to prevent compared to environmentalfactors. However, GAD can be treated using pharmaceutical orpsychotherapeutic approaches or a combination of the two treatmentstrategies. A change in lifestyle (such as physical exercise) plays acritical role in preventing the occurrence of GAD.
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