Generalized Anxiety Disorder: symptoms, causes and treatment
The generalized anxiety disorder it is characterized by exaggerated and excessive worry and anxiety about any day-to-day event with no apparent reason for this concern.
People who suffer from this disorder they always expect things to go wrong and they can not stop worrying about their health , money, family, work or university.
What is generalized anxiety disorder?
This fear or worry is irrational, unreal and disproportionate, and daily life becomes a constant concern. Therefore, anxiety ends up dominating the individual's life, which negatively affects their normal functioning in different areas of their lives, 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 the negative sensations that are perceived in the present.
We must differentiate GAD from other anxiety disorders
Anxiety is a normal reaction of individuals facing situations of stress and uncertainty. Now, when several anxious symptoms cause anguish or some degree of functional deterioration in the life of the individual who suffers it, the anxiety disorder is diagnosed. There are different types of anxiety disorders: panic disorder, phobic disorder, obsessive-compulsive disorder (OCD) ...
All of them, including the TAG, have in common that hinder the functioning in different areas of your life of the person who suffers . For example: social and family relationships, work, school. But among the different types of anxiety disorders, there are differences.
In the case of generalized anxiety disorder, anxiety 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 air (panic disorder), feeling humiliated in public (social phobia), suffering from contamination (obsessive-compulsive disorder), or having a serious illness (hypochondria). But, unlike the previous ones, the main characteristic of generalized anxiety disorder (GAD) is having excessive and irrational worry and anxiety, persistent (at least half of the days for at least 6 months) and difficult to control over A number of events or activities such as work, school, friends and family.
In addition, according to the DSM-V, to diagnose GAD, the disorder it must not be due to the direct physiological effects of a substance (drug, drug) or disease (for example, hyperthyroidism) or occur exclusively during an affective disorder, a post-traumatic stress disorder, a psychotic disorder or a 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 concern are associated with three (or more) of the following six symptoms . In the case of children, only one of the items is required.
- Restlessness or feeling restless
- Easily fatigued
- Difficulty concentrating or having a blank mind
- Muscle tension
- Sleep disorders (difficulty to reconcile or maintain, sleep little or restless)
In addition, anxiety, worry or physical symptoms cause clinically significant discomfort or deterioration in social, occupational, or other important areas of functioning.
Unlike the DSM-V, according to the Diagnostic Criteria of the ICD-10 (World Health Organization, WHO) it is not necessary that the concerns are excessive and difficult to control. In addition, it requires the presence of the following symptoms:
- Autonomic symptoms : palpitations or tachycardia, sweating, tremor or shaking, dry mouth (not due to medication or dehydration).
- Related to chest and abdomen : shortness of breath, feeling of choking, pain or discomfort in the chest, nausea or abdominal discomfort.
- Related to the mental state: feeling dizzy, unstable or fading; derealization or depersonalization; fear of losing control, going crazy or losing consciousness; affraid to die
- General symptoms : hot flashes or chills; stun or tingling sensations; muscle tension, pain or discomfort; restlessness or inability to relax; feeling of being on the edge or under pressure, or of mental tension; feeling of lump in the throat or difficulty swallowing.
- Other non-specific symptoms : exaggerated response to small surprises or surprises; difficulty concentrating or "blank mind" due to worry or anxiety; persistent irritability; difficulty falling asleep due to worries.
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 be from the autonomous group. Despite the differences between the DSM and the CIE, the degree of agreement between the two is quite high: a study by Andrews, Slade and Peters (1999) concluded that in 77% of the subjects diagnosed by one of these systems had a positive diagnosis in the other also.
The neurological basis of generalized anxiety disorder
Little is known about the neurological basis of generalized anxiety disorder, beyond having recorded evidence that is associated with a lower than normal activation in the prefrontal cortex and the cortex of the anterior cingulate. It is necessary to reealizar many more investigations on the matter to get to understand well this disorder.
Examples of generalized anxiety disorder
To illustrate this pathology better, some examples are shown below:
- A doctor who is continuously worried about not diagnosing patients correctly . Every time they call him on the phone he thinks he is a superior to tell him that he is working badly. In addition, he is continually concerned about whether his new patient will be a former patient who has relapsed.
- A woman who is always worried if her partner is going to leave her , they will fire you at work and if someone in your family is going to become seriously ill.
- A father who is always worried if his 4-month-old son is going to drown while eating , of if you will not hear him cry at night if he needs help, and if he could become seriously ill and die.
Treatment for this psychological maladjustment
Like the rest of anxiety disorders, the TAD can be treated effectively 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.
- 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.