Generalized anxiety disorder

- So, think about the last time you took a big exam. You probably got pretty nervous about it, right? Anxious, maybe right before the exam. Well, this is completely normal and might even be useful in some situations because it could make you more alert and more careful. After the test though, you might kick back and breathe a sigh of relief, and stress goes away, right? For some people, about 3% of the population, that stress doesn't go away, and at this point, the stress is considered to be anxiety. This anxiety also might get worse over time and cause things like chest pain or nightmares. It might even cause you to not want to leave the home. At this point, where it starts to interfere with your daily life like work, school and relationships, we might even call it an anxiety disorder. Now, one particular type of anxiety disorder is Generalized Anxiety Disorder, or GAD. This type is characterized by anxiety about everyday things, things like money, health, family, work and relationships. Sometimes, even the thought of getting through the day produces anxiety, and it's this anxiety as opposed to normal anxiety that everybody feels has three main pieces. The first is that it's persistent, meaning that it doesn't seem to go away. The second is that it's excessive, so it's usually way more than someone else might have given that situation. And third, it's typically pretty unreasonable. As in, there really isn't any reason to worry about whatever you're worrying about. Now, people with GAD might even be aware that these worries are excessive and unreasonable, but they don't know how to stop feeling like this or feel like it's completely beyond their control. Some people with mild GAD might be able to function socially and hold down a job. But others with severe GAD might have trouble with the simplest of daily activities. So, what causes one person to have GAD and one person to not have GAD? Ultimately, as is the case with many psychological disorders we don't know. Genes, though, are thought to play a role since sometimes, it runs in families. Also, the environment you're in, especially if high levels of stress are involved. Also, several parts of the brain have been linked to fear and anxiety, and continued research into these areas may provide some clues in the future about GAD. All right, so how might we know that someone has GAD? What are the signs and symptoms? Well, the main symptom is frequent worry and tension or stress, for little to no reason. Other symptoms might include things like edginess or restlessness, or an impaired concentration or feeling like your mind just goes blank. Then also, irritability. These psychological symptoms can even be severe enough to lead to physical symptoms like difficulty sleeping, and this is one of the biggest physical complaints of people with generalized anxiety disorder. Our bodies need to recharge when we sleep, right? With that said, insomnia can take this serious toll on your physical health, which means your body isn't functioning at its optimal levels, is it? Besides insomnia though, another physical symptom might be digestive problems. Chronic stress may lead to eating more or less than normal, and many people even experience diarrhea or constipation as a result. Finally, muscle aches and soreness is also a pretty common symptom of GAD. This happens from increased muscle tension, because people with anxiety carry around this tension in their bodies, which can lead to tense shoulders, back, jaws and muscles. This can even manifest as clenched jaws or teeth grinding. Overall, these physical and mental symptoms usually come about gradually. Typically starting in the teen years or young adulthood, but over time, they have this serious impact on your well-being. Additionally, there might be periods where symptoms seem to get worse, or they might get worse during periods of high stress. Unfortunately, there aren't any tests that will tell you whether you have GAD or not, and a proper diagnosis will be based on a medical professional's questions about your symptoms. So, from the Diagnostic and Statistical Manual for Mental Disorders, the Fifth Edition, or DSM5, the following criteria given for a diagnosis of GAD. Excessive anxiety and worry is present and occurs more often than not for at least six months, and is clearly excessive. The other one is anxiety and worry is associated with at least three of the symptoms that we went through and in children, only one symptom is needed for a diagnosis. Once it's been diagnosed, we're going to look to treatments. GAD will often be treated with psychotherapy, medication or both. Specifically, within psychotherapy, we'll often try something called Cognitive Behavior Therapy, which is really useful for treating GAD, since it tries to teach you different ways of thinking, behaving and reacting to situations that reduce your feelings of anxiety and worry. The other form of treatment is medication, and there are two types they are usually focused on. The first, are anti-anxiety medications. These tend to slow down our central nervous system, so our brain. So they have this, kind of, relaxing and calming effect. Typically, anti-anxiety medications are benzodiazepines. Apart from those, though, antidepressants can also be prescribed. These are approved for depression, but have also been found to be effective for treatment of anxiety as well. The most commonly prescribed antidepressants are Selective Seratonin Reuptake Inhibitors, or more commonly just called SSRIs. These guys work to regulate seratonin levels in our brain and elevate your mood. Knowing that these treatments exist, some people respond better to cognitive behaviour therapy alone, and some respond better to medications alone. While still, others respond best when both are used together. It totally depends on the patient, and so it needs to be tailored on a case-by-case basis.