Generalized Anxiety Disorder

Abstract

Generalized Anxiety Disorder is one of the most common mental health problems in America on and off of college campuses. GAD affects approximately 6.8 million adults in the United States in any given year, with women being twice as likely as men to be affected by GAD. A diagnosis of GAD can be made when a patient has experienced intense feelings of anxiety more days than not over a six month period. Other symptoms include fatigue, digestion problems, sweating, rapid heartbeat, restlessness and even depression. The onset of Generalized Anxiety Disorder is most likely to occur between childhood and middle age and is most prevalent between the ages of 15 and 24. GAD is a chronic disorder that is generally regarded as a lifelong issue for most patients, but luckily it is treatable by various psychotherapy treatments, including cognitive-behavioral therapy, as well as the prescription of certain drugs including Benzodiazepines and Buspirone.

Prevalence

Anxiety disorders are one of the most common mental health concerns in the United States and they tend to be among one of the most frequently reported mental health concerns on college campuses around the country. There are several types of anxiety disorders including: Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, Posttraumatic Stress Disorder, Social Anxiety Disorder and specific phobias. According to Baez's article, Evidenced-Based Practice for Anxiety Disorders in College Mental Health, over forty million American adults suffer from some type of anxiety disorder (Baez, 2005). Of those forty million Americans, seventy-five percent reported that they experienced their first episode of anxiety by the age of twenty-two (Baez, 2005). GAD affects approximately 6.8 million adults in the United States in any given year, with women being twice as likely as men to be affected by GAD ("Adaa").

Syndrome Description

DSM IV-TR Criteria

The Diagnostic and Statistical Manual of Mental Disorders diagnoses GAD when the patient experiences, "At least 6 months of "excessive anxiety and worry" about a variety of events and situations and when there is significant difficulty in controlling that anxiety and worry (American Psychiatric Association, 2000)." Generalized Anxiety Disorder is characterized by persistent, unwarranted, and unrealistic worry about everyday matters ("Adaa"). According to the Anxiety and Depression Association of America, "People who suffer from GAD experience exaggerated worry and tension, often expecting the worst, even when there is no apparent reason for concern ("Adaa")." Mostly, GAD sufferers anticipate disaster at all times and are excessively troubled by thoughts about money, health, family matters and work related or other various issues. The constant worrying that is associated with GAD generally occurs every day, possibly all day, to the point that it interferes with daily life including work, school and family, as well as causing disruptions to regular social activities and events.

Syndrome Epidemiology

Generalized Anxiety Disorder is diagnosed when a person worries excessively about a variety of different problems for at least six months, generally on a daily basis. In the article by Lizeretti and Extremera, the authors conclude that anxiety disorders can develop at any point in a person's life, but the onset of GAD is most likely to occur between childhood and middle age. Most clinically diagnosed cases of GAD occur during the patient's high school and college years, or between the ages of 15 and 24. (Lizeretti & Extremera, 2011)

Other symptoms, besides chronic every day worrying accompany GAD. Muscle tension and discomfort are two of the most common symptoms that coincide with the presence of Generalized Anxiety Disorder. Fatigue, restlessness and also difficulty sleeping are also common symptoms. Not only these symptoms, but also irritability and edginess are often experienced by GAD sufferers. Gastrointestinal discomfort, such as stomach aches and pains and diarrhea also afflict those with Generalized Anxiety Disorder as well.

Syndrome Treatment

Assessment of Syndrome Description

Social anxiety disorder remains under-recognized in primary care practice, with patients often receiving treatment only after the onset of complications, such as clinical depression or substance abuse disorders (Baez, 2005). No specific tests are run on patients who are believed to have GAD, but instead a comprehensive check is done to make sure that any symptoms the patient is experiencing are truly related to Generalized Anxiety Disorder. In some cases, physicians use psychological questionnaires to help with the diagnosis process. Doctors may also execute a physical examination to look for potential underlying medical conditions that may be causing the patients' anxiety. Commonly, patients complain mostly about feelings of anxiety and have a tendency to be startled easily and jumpy, restless, shaky, experience a pounding heartbeat, indigestion and cramps, feelings of lightheadedness and even exhaustion (Roemer et. al, 1995). Usually when a patient complains about having three or more of these symptoms and can explain in detail how often they occur and their severity, a doctor will be able to accurately diagnose them as having GAD according to the DSM IV-TR criteria (American Psychiatric Association, 2000).

Course and Prognosis

GAD is a chronic disorder that is generally regarded as a long-term condition that may become a lifelong problem in which the symptoms may appear off and on during the course of its presence, with some symptoms being worse than others at any given time (Ginsburg et. al, 2011). Although Generalized Anxiety Disorder can be debilitating for many sufferers by interfering with their everyday routine, it is treatable. With the right treatment plan and the use of medications, GAD patients are capable of returning to their everyday lives with the ability to function normally without their intense feelings of anxiety.

Psychosocial TX

One treatment that has proven to be quite beneficial is cognitive-behavioral therapy (CBT). CBT is commonly used to treat a wide range of disorders, including phobias, addiction, depression and anxiety. Cognitive-behavior therapy is an effective type of treatment because it aids patients in understanding their personal thoughts and feelings and how they impact their anxiety (Ladouceur et. al,