1. GENERALIZED ANXIETY DISORDER
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Research Summary
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In partial fulfilment
of the requirements in Introduction to Psychology B
at
Cornerstone Institute
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by
Leeandri Smith 32156
27 August 2012
3. 1
Introduction
“Psychological disorders, also known as mental disorders, are patterns of behavioural or
psychological symptoms that impact multiple areas of life. These disorders create distress for
the person experiencing these symptoms.”
(http://psychology.about.com/od/psychotherapy/tp/psychological-disorders.htm). Here are some
examples of psychological disorders: anxiety disorders, cognitive disorders, developmental
disorders, dissociative disorders, eating disorders etc. The topic our group had to do was
generalized anxiety disorder. I summarized some of the researched I did for our group
presentation. I will try to explain what generalized anxiety is, as well as the symptoms, some
of the classifications, the causes of generalized anxiety, the diagnoses and the treatment for
generalized anxiety.
Understanding Generalised Anxiety
While worrying and feeling nervous is something that all human beings experience, as with
anything, too much of something can be bad for you. Normal anxiety can become a problem
when it is: excessive, feels uncontrollable, is experienced as intrusive in your life, is
persistent – seeming to always be around, and causes you significant distress, or impairs your
ability to go about your day-to-day life. This is when normal anxiety becomes generalised
anxiety. Some common things people have told us they experience when they have
generalised anxiety are: Chronic worries running through their head. They occur over and
over again like a broken record uncontrollable anxiety. Having a strong desire to be in
control of their emotions, yet feeling as if the anxiety and worry has taken control over them
and there is nothing they can do to stop it. This can be like intrusive thoughts. No matter how
much they try not to worry, not to think about things that make them nervous, these thoughts
keep popping back into their mind against their will, hating uncertainty, wanting to know
what is going to happen in the future and finding the experience of ‘not knowing’ very
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difficult indeed, feeling restless, keyed up, on edge and unable to relax, being physically
tense. Feeling nervy or uptight, and having tightness or stiffness in the muscles of their body.
Sleep disturbance, having trouble falling asleep, maintaining sleep, or experiencing unsettled
sleep, because their mind is constantly ticking over with worry. You can have problems
concentrating and focusing on a task. You are procrastinating about getting things done.
Putting things off because it all feels too much and too overwhelming. Avoiding situations in
which they worry or get anxious and nervous. (Wells, A: 50-55). One of the important
features of generalised anxiety is that the anxiety is spread across a number of different areas
such as health, work, interpersonal relationships, finances, and so on. This makes it different
from other anxiety problems, such as social anxiety or phobias, where nervousness and
worrying are more specific to particular situations. (Wells, A: 12-20). You may think that
generalised anxiety is not as serious as other problems, such as social anxiety, phobias or
panic, where the anxiety may appear to be more intense. However, generalised anxiety,
nervousness, or worrying can significantly interfere in a person's life because it is long-term
and chronic. In this way, it can be likened to having a condition like asthma or diabetes.
Unfortunately, people who have problems with generalised anxiety often do not seek
treatment, as they might feel embarrassed to be seen as someone who cannot control their
nerves. They may also believe that because they "have always been like this", they just have
to live with it. Having these views may mean that they don't seek help for their worrying and
nervousness, but it is important to remember that there are ways to break the worry habit. It is
also not uncommon for people experiencing generalised anxiety to also experience other
types of anxiety disorders, or to experience mood disorders, such as depression, at the same
time. Often when people do seek treatment it is for these other problems, rather than for their
tendency to worry excessively.(Heimberg, R.G., Turk, C.L., & Mennin, D.S:15-18)
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What Causes Generalised Anxiety?
So, how does one become a chronic worrier? There’s no simple answer, of course, as
everyone is different. However, there are some important factors that have been identified.
These factors can generally be divided into biological and psychological causes.
Biological Factors
No single gene has been associated with generalised anxiety. Based on twin and family
studies, it does seem that individuals may inherit a vulnerability to develop an anxiety
disorder. These studies have reported a general vulnerability to develop an anxiety disorder,
and interestingly, also a mood disorder. Notice that the researchers tell us that this is a general
vulnerability, rather than a specific vulnerability for a specific type of disorder. In addition, it
has been found that people born with a particular ‘anxious’ type of temperament, may be
more likely to develop an anxiety disorder later in life. (Barlow, D.H:33-36)
Psychological Factors
However, it is important to remember that while our biology may make us vulnerable to
developing an anxiety disorder, not all people with this vulnerability go on to develop
problematic anxiety. A great deal depends on the lifestyle of that person, the types of life
stressors they have encountered, and how they cope with such stressors. Stressful, traumatic,
and often uncontrollable life events may contribute to the development of generalised
anxiety. When such events occur, some people may come to believe that life is dangerous
and unpredictable, and that worrying about possible future negative events is a way of coping
with the uncertainty of life. (Barlow, D.H., Raffa, S.D., Cohen, E.M:55-60) They may think
that worrying helps they achieve a greater sense of certainty and control, because they would
be better prepared for anything. Anxiety may also develop when the people around you give
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you information about what is threatening and how to cope with those threats. For example,
a child may have seen a parent constantly worrying about current circumstances and
potentially negative future events, and may learn to follow the parent’s behaviour.
Alternatively, you may have been told that “Worrying is good and shows that you are a
conscientious and prepared person”. These sorts of indirect and direct messages may
increase your chances of developing generalised anxiety. Finally, anxiety is made worse
when one begins avoiding things they have some concern about. Avoidance will quickly
make something that is initially a slight concern for a person, become a source of anxiety. If
the people in your life (i.e., parents, siblings, peers, spouses/partners) support your avoidance
of various things, this may make your anxiety worse in the long run. People usually support
a person’s avoidance because they don’t want the person to feel any distress. However,
experiencing a small amount of distress and learning how to solve or cope with the problem
is likely to stop more severe anxiety in the long run. (Barlow, D.H:70-74)
Generalized Anxiety Disorder Symptoms
Generalized anxiety disorder symptoms can vary. They can include the following symptoms:
Constant worrying or obsession about small or large concerns, restlessness and feeling keyed
up or on edge, fatigue, difficulty concentrating or your mind "going blank", irritability,
muscle tension or muscle aches, trembling, feeling twitchy or being easily startled, trouble
sleeping, sweating, nausea or diarrhea and shortness of breath or rapid heartbeat. There may
be times when your worries don't completely consume you, but you still feel anxious even
when there's no apparent reason. For example, you may feel intense worry about your safety
or that of your loved ones, or you may have a general sense that something bad is about to
happen. (http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders)
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Diagnosis of generalized anxiety disorder:
Excessive anxiety and worry about several events or activities most days of the week, for at
least six months, difficulty controlling your feelings of worry, anxiety or worry that causes
you significant distress or interferes with your daily life and anxiety that isn't related to
another mental health condition, such as panic attacks, substance abuse or post-traumatic
stress disorder (PTSD). Generalized anxiety disorder often occurs along with other mental
health problems, which can make diagnosis and treatment more challenging. Some disorders
that commonly occur with generalized anxiety disorder include the following: phobias, panic
disorder, depression, substance abuse and post-traumatic stress disorder.
(http://www.medicinenet.com/anxiety/page2.htm)
Treatment
The two main treatments for generalized anxiety disorder are medications and psychotherapy.
You may even benefit more from a combination of the two. It may take some trial and error
to discover exactly what treatments work best for you. There are several different types of
medications that are used to treat generalized anxiety disorder. Antidepressants are
medications that influence the activity of brain chemicals (neurotransmitters) thought to play
a role in anxiety disorders, examples of antidepressants used to treat generalized anxiety
disorder include Paroxetine (Paxil), sertraline (Zoloft) and venlafaxine (Effexor).
Buspirone is anti-anxiety medication may be used on an ongoing basis. As with most
antidepressants, it typically takes up to several weeks to become fully effective. A common
side effect of buspirone is a feeling of light headedness shortly after taking it. Less common
side effects include headaches, nausea, nervousness and insomnia. Benzodiazepines in
limited circumstances your doctor may prescribe one of these sedatives for short-term relief
of anxiety symptoms. Examples include lorazepam (Ativan), diazepam (Valium),
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chlordiazepoxide (Librium) and alprazolam (Xanax). Benzodiazepines are generally only
used for relieving acute anxiety on a short-term basis. They can be habit forming and can
cause a number of side effects, including drowsiness, reduced muscle coordination, and
problems with balance and memory. In some cases, medications not specifically approved for
generalized anxiety disorder may be tried. Off-label use is a common and legal practice of
using a medication to treat a condition not specifically listed on its prescribing label as an
FDA-approved use. Psychotherapy are also known as talk therapy and psychological
counselling, psychotherapy involves working out underlying life stresses and concerns and
making behaviour changes. It can be a very effective treatment for anxiety. Cognitive
behavioural therapy is one of the most common types of psychotherapy for generalized
anxiety disorder. Generally a short-term treatment, cognitive behavioural therapy focuses on
teaching you specific skills to identify negative thoughts and behaviours and replace them
with positive ones. Even if an undesirable situation doesn't change, you can reduce stress and
gain more control over your life by changing the way you respond.
(http://gad.about.com/od/symptoms/a/dsmiv.htm)
Conclusion
Generalized anxiety disorder is a relatively common problem that leads to considerable
personal and social costs. Although individuals with GAD suffer from excessive and
uncontrollable worry and anxiety, they often wait many years before seeking help because
they mistakenly assume that worry is an immutable part of their personality. This is
unfortunate given that there are a number of effective pharmacological and psychological
treatments for GAD. But I believe with God anything is possible, and He will help you and
lead you in any problem or illness.
Word Count: 1788 words
9. BIBLIOGRAPHY
Barlow, D.H., Raffa, S.D., Cohen, E.M. (2002) Psychosocial treatments for panic
disorders, phobias, and generalized anxiety disorder. In P.E. Nathan & J.M. Gorman (Eds.),
A Guide to Treatments that Work (2nd ed., pp. 301-335). New York: Oxford University Press.
Barlow, D.H. (2002). Anxiety and Its Disorders: The Nature and Treatment of Anxiety and
Panic (2nd ed.). London: Guilford Press.
Heimberg, R.G., Turk, C.L., & Mennin, D.S. (2004). Generalized Anxiety Disorder:
Advances in Research and Practice. New York: Guilford Press.
Wells, A. (1997). Cognitive Therapy of Anxiety Disorders: A Practice Manual and
Conceptual Guide. Chichester, UK: John Wiley & Sons Ltd.
Wells, A. (2008). Metacognitive Therapy for Anxiety and Depression. New York: Guilford
Press.
http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders
http://gad.about.com/od/symptoms/a/dsmiv.htm
http://www.medicinenet.com/anxiety/page2.htm
