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Generalized Anxiety Disorder

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Generalized Anxiety Disorder What is the difference between fear and anxiety? Fear is when someone seems to face a serious threat to his or her well-being, the person may react in immediate state of alarm. With fear, the cause of the state of alarm is usually known or thought to be known. However, anxiety is “vague sense of being in danger” that cannot always be pin pointed to a definite cause (Comer, 2014). Anxiety disorders are the most common psychiatric disorder in the United States. Between 15 - 19% of the population suffers from this disorder, which impairs the quality of life and functioning (NIMH, 2016). Sigma Counseling Services describes on their website that anxiety as “an adaptive emotion that helps us plan and prepare for a possible theat,” and also that, “worrying about many different aspects of life becomes chronic, excessive, and unreasonable.” This is also known as generalized anxiety disorder or GAD (Sigma Counseling, 2015). DSM 5 specifies that GAD is a worry that occurs more days then not for at least 6 months, and that it must be experienced as difficult to control (APA, 2013). 25% of those that suffer from this disease are treated, leaving a large group in the population with anxiety without treatment. Although there is a high correlation of those with anxiety that use health facilities to treat the additional symptoms that anxiety causes (NIMH, 2016).
The subjective worrying, that is the foundation for anxiety, must also be accompanied by three of the six other symptoms. These symptoms include restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension & sleep disturbance (Comer, 2014). Twice as common in women, then it is in men, and at the age that it is said to occur is unknown due to reports that clients with GAD presume that they have had it all their lives. GAD has a high correlation with other anxiety and mood disorders such as panic disorders, social phobias, specific phobias, PTSD, and major depressive disorder. Those with GAD will also experience spotty panic attacks but do not meet the requirements to be diagnosed with panic disorder. It is also common to for GAD clients to excessively use substances like tranquilizers, sleeping pills, and alcohol (Mayo Clinic, 2014).
What causes all of these symptoms? Anxiety is known as a physiological or behavioral change that causes the formation of symptoms and affects the coping mechanism that affects a person’s everyday reaction to a stressor (Web MD, 2016). These changes occur at the autonomic nervous system, which influences the parasympathetic and sympathetic nervous systems which are in turn responsible for body processes. The sympathetic nervous system is responsible for the “fight or flight” defense system which is what causes anxiety. Anxiety is perceived by the cortex of the brain which sends a stimuli to the adrenal glands which then release epinephrine, which causes you to breathe harder and your pulse and blood pressure to increase. Blood moves away from the stomach and intestines where it was used to digestion and it shifts towards the heart, CNS, and muscles to replenish resources used during flight or fight. GABA and Serotonin are also both responsible for the cause of anxiety. GABA which is affects the amygdale and hippocampus which is the center for emotions such as fear, arousal, and rage. Dysregulated Serotonin is likely play a role in the cause of anxiety (NIMH, 2016).
Anxiety disorders have been proven in to run in families, they have also been shown to be common in different forms and types amongst families. The chance of heritability is 40% for those that have a family history of anxiety. The chances that an individual is to also develop PTSD after a traumatic event, is 3 times higher. No specific genes have been identified to be the precipitating factor for anxiety because environment also plays a critical role in its development (NIMH, 2016). It is also believed that anxiety is a product of frustration. An example would be a client losing his job, which interferes with his life goals such as financial security, work pride, and perception as family provider. When these goals are threatened, clients are likely to experiences feelings of failure, insignificance, and growing anxiety (Folk, 2015).
Some theorists believe that those that were exposed to periods of intense fear are more likely to develop anxiety later in life. Children that are exposed to parents that respond to anxiety via anxiety are likely to develop anxiety themselves. The opposite reaction from parents which would include unmoved by potentially stressful situation, children that feel alone and lack emotional support from their families will cause anxiety later on. Psychoanalytic theory believes that those with a low self esteem are also more likely to experience anxiety (ACCG, 2014).
Family physicians are the normal medical help that those with anxiety will usually go to for treatment. In most occasions a doctor will prescribe an anti-anxiety medicine, such as benzodiazepines like Xanax or Klonopin. These drugs are both used and abused to help relieve stress via the autonomic nervous system. These meds are also cause dependency, and withdrawal. SSRIs will usually be used to prevent a dependency and withdrawals but may take 2-4 weeks to reach a therapeutic level of effectiveness (Web MD, 2016). Other than medications, there are some other cognitive and behavioral treatments for anxiety. Training to relieve anxiety includes muscle relaxation techniques, cognitive restructuring, and reducing the minor events that will cause anxiety (Comer, 2014).
If left untreated, anxiety can have very serious consequences, up to and including suicide. "Both depression and anxiety carry a high risk of suicide," says Mark Pollack, MD, ADAA President and Grainger Professor and Chairman, Department of Psychiatry at Rush University Medical Center. "More than 90 percent of those who die by suicide have a diagnosable illness such as clinical depression, and often in combination with anxiety or substance use disorders and other treatable mental disorders." (ADAA, 2016).

References

ACCG Counselling Services (ACCG). (2014). Anxiety. Retrieved March 26, 2016, from http://accg.net/anxiety.htm.

American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.

Anxiety and Depression Association of American (ADAA). (2016, January). Suicide and Prevention. Retrieved March 26, 2016, from http://www.adaa.org/understanding-anxiety/suicide.

Comer, R. J. (2014). Fundamentals of Abnormal Psychology (7th ed.). New York, NY: Worth.

Mayo Clinic. (2014, September 25). Generalized anxiety disorder. Retrieved March 24, 2016, from http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/basics/definition/con-20024562.

NIMH. (2016). Any Anxiety Disorder Among Adults. Retrieved March 24, 2016, from http://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml.

Sigma Counseling Services (2015). Mental Health Program- Retrieved March 24, 2016, from http://www.sigmacounseling.com/index.php/services/mental-health-program.

Web MD. (2016). Generalized Anxiety Disorder. Retrieved March 26, 2016, from http://www.webmd.com/anxiety-panic/tc/generalized-anxiety-disorder-topic-overview.

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