Generalized Anxiety Disorder: Symptoms, Causes and Treatment

What is GAD and which people are most likely to suffer from it?

The generalized anxiety disorder is characterized by exaggerated and excessive worry and anxiety about any day-to-day event without any apparent reason for this worry. In fact, it is one of the anxiety disorders with the most annoying and disabling symptoms, as they appear in many different situations.

People suffering from this disorder always expect things to go wrong and can't stop worrying about their health, money, family, family, health and safety.money, family, work or school.

What is generalized anxiety disorder?

This fear or worry is irrational, unrealistic and disproportionate, and daily life becomes a constant worry. Therefore, anxiety ends up dominating the individual's life, which negatively affects normal functioning in different areas of life, such as social activities, work or interpersonal relationships. In addition, generalized anxiety disorder also affects the ability to vividly imagine possible future situations, causing attention to focus instead on perceived negative sensations in the present.

Differences between GAD and other anxiety disorders

Anxiety is a normal reaction of individuals to situations of stress and uncertainty. However, when several anxious symptoms cause distress or some degree of functional impairment in the sufferer's life, anxiety disorder is diagnosed. There are different types of anxiety disorders: panic disorder, phobic disorder, obsessive-compulsive disorder (OCD)...

All of them, including GAD, have in common that they make it difficult to they make it difficult for the sufferer to function in different areas of his or her life.. For example: social and family relationships, work, school. But between the different types of anxiety disorders, there are differences. And knowing how to distinguish between these different phenomena is important, because if there is another diagnostic category that explains what is happening better than generalized anxiety disorder, the mental health expert will rule out GAD.

So, let's look at some keys to differentiating diagnostic categories, keeping in mind that the diagnosis can only be made by properly qualified and trained psychologists or psychiatrists.

Persistent anxiety

In the case of generalized anxiety disorder, worry and anxiety reactions are not limited to what is typical of other disorders; for example, the possibility of having a panic attack and running out of breath (panic disorder), feeling humiliated in public (social phobia), suffering from contamination (obsessive-compulsive disorder), or having a serious illness (hypochondriasis). In contrast to the above, the main characteristic of generalized anxiety disorder (GAD) is having excessive, irrational, persistent (at least half of the days for at least 6 months) and difficult to control worry and anxiety about a number of events or activities such as work, school, friends and family.

In addition, according to the DSM-V, in order to diagnose GAD, the disorder must not be due to the direct physiological effects of a substance (drug, medication) or illness. (e.g., hyperthyroidism) or occur exclusively during an affective disorder, post-traumatic stress disorder, psychotic disorder, or pervasive developmental disorder.

Symptoms of generalized anxiety disorder

Following the diagnostic criteria for GAD as defined by the Diagnostic and Statistical Manual of Mental Disorders DSM-V, anxiety and worry are associated with three (or more) of the following six symptoms. For children, only one of the items is required.

• Restlessness or feeling agitated.
• Becoming easily fatigued.
• Difficulty concentrating or having a blank mind.
• Irritability.
• Muscle tension.
• sleep disturbances (difficulty falling or staying asleep, poor sleep, or restlessness).

In addition, anxiety, preoccupation or physical symptoms cause clinically significant discomfort or impairment in social, occupational, or other important areas of functioning.

Unlike the DSM-V, according to the ICD-10 Diagnostic Criteria (World Health Organization, WHO) it is not necessary that the worries are excessive and difficult to control. In addition, it requires the presence of the following symptoms:

• Autonomic symptomsAutonomic symptoms: palpitations or tachycardia, sweating, tremor or shaking, dry mouth (not due to medication or dehydration).
• Chest and abdominal related: shortness of breath, choking sensation, chest pain or discomfort, Nausea or abdominal discomfort.
• Related to mental status: sensation of dizziness, unsteadiness, or fainting; derealization or depersonalization; fear of losing control, going crazy, or losing consciousness; fear of dying
• General symptomsOther non-specific symptoms: flushing or chills; lightheadedness or tingling sensations; muscle tension, aches or pains; restlessness or inability to relax; feelings of being on edge or under pressure, or of mental tension; lump in the throat or difficulty swallowing.
• Other non-specific symptomsOther non-specific symptoms: exaggerated response to small surprises or startles; difficulty concentrating or "blank mind" due to worry or anxiety; persistent irritability; difficulty falling asleep due to worry.

The ICD-10 specifies the presence of 4 of the 22 symptoms for the diagnosis of this pathology, and it is necessary that at least one of the symptoms is of the autonomic group. Despite the differences between the DSM and ICD, the degree of concordance between the two is quite high: a study by Andrews, Slade and Peters (1999) concluded that 77% of subjects diagnosed by one of these systems had a positive diagnosis in the other as well.

In any case, the symptoms of generalized anxiety disorder must be present almost constantly for a period of at least 6 months in a row.

Causes

GAD is no different from other psychological disorders in terms of the multi-causal origin that gives it its onset. There is not a single cause that produces the appearance of the generalized anxiety disorder in the person, but many. in the person, but many. The main ones are the following:

• Genetic predispositions to experience stress.
• Having experienced traumatic experiences.
• Personality factors: shyness and fear of the image that is given.
• Gender factors: women present GAD more frequently.

The neurological basis of GAD

Little is known about the neurological basis of generalized anxiety disorder, beyond evidence that it is associated with lower than normal activation in the prefrontal cortex and anterior cingulate cortex. On the other hand, alertness emotions such as fear are related to the functioning of the cerebral amygdala.

Much more research is needed to understand this disorder.

Examples of generalized anxiety disorder

To better illustrate this pathology, here are some examples:

• A physician who is continually concerned that he or she is not diagnosing patients correctly.. Every time he gets a phone call he thinks it is a superior telling him that he is doing a bad job. In addition, she is continually worried that her new patient will be a previous patient who has relapsed.
• A woman who is always worried about whether her partner is going to leave her, whether she is going to be fired from her job, and whether someone in her family is going to become seriously ill.A woman who is always worried that her partner is going to leave her, that she is going to be fired from her job and that someone in her family is going to become seriously ill.
• A father who is always worried about whether his 4-month-old son is going to choke to death while eating, whether he will not hear him cry, whether he will not be able to hear him cry.A parent who is always worried about whether his 4-month-old child will choke while eating, whether he won't hear him cry at night if he needs help, and whether he might become seriously ill and die.

Treatment for this psychological maladjustment

Like all other anxiety disorders, TAD can be effectively treated with psychotherapy and medication.

Cognitive behavioral therapy (CBT) allows patients to acquire tools to manage and control anxiety and worry. In addition, alternative treatments such as relaxation techniques, meditation or yoga can be beneficial in combination with CBT.

Specifically, the use of self-instructions and the technique of systematic desensitization are common. are common, as well as Mindfulness sessions, whose objective is to help the person to orient his or her attentional focus towards the present.

Bibliographical references:

• Mochcovitch, M. (2014). A systematic review of fMRI studies in generalized anxiety disorder: Evaluating its neural and cognitive basis. Journal of affective disorders, 167, pp. 336 - 342.
• Solomon, C. (2015): Generalized Anxiety Disorder. The New England Journal of Medicine, 373(21), pp. 2059 - 2068.
• Wu, J. (2015): Episodic future thinking in generalized anxiety disorder. Journal of anxiety disorders, 36, pp. 1 - 8.