A Report On General Anxiety Disorder

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Anxiety has been around for along time but didn’t really have a certain name for the disorder until the 19th century. In the 20th century generalized anxiety disorder was beginning to be known as panophobia. Which is close to what some were calling it earlier on, some referred to it as pantophobia. Over time it was argued whether it should be called panophobia or pantophobia. In addition many people came up with different symptoms of what would happen to a person when they were experiencing panophobia or pantophobia.

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Neurasthenia was the next disorder that was not technically the name for generalized anxiety disorder but kind of combined what the symptoms for (GAD) were into its description. It wasn’t until Sigmund Freud came along and published an article that created a separation between the two. Sigmund Freud also gave generalized anxiety disorder a new name as well. He called it anxiety neurosis, of course if you know anything about Sigmund Freud his definition was going to be sexual. Freud believed that anxiety neurosis was caused by the accumulation of sexual excitation.

Interestingly enough Sigmund Freud did have a list of symptoms that went with his theory. One still remains in as criteria for having generalized anxiety disorder in the DSM-5, which is known as anxious expectation. Symptoms that are not criteria today are general irritability, anxious expectations, anxiety attacks, equivalents of anxiety attacks, attacks of sweating, attacks of hunger, tremors, vertigo, paresthesias, pavor nocturnus, typical phobias and agoraphobia, nausea, diarrhea, and rheumatic pains. Freud also believed that people who suffered from rheumatic pains were just experiencing anxiety neurosis. Freud’s idea of anxiety neurosis was actually accepted too. Most thought there was something to his theory except his idea of how it related to sexuality.

In the DSM 2 manual generalized anxiety was not called generalised anxiety. In fact, in the manual it was listed under anxiety neuroses. One of the characteristics was being over concerned with something until it turned into a panic attack. The manual also stated that it could be felt directly or controlled unconsciously be various symptoms. In 1980 generalized anxiety disorder was finally separated from all other categories into its own. The DSM 3 manual was the first time that this had happened. Now generalized anxiety has been in its own category for almost 40 years. It has been revised but is still in its own category in the new DSM 5 manual that was published in 2013.

Criteria for general anxiety disorder

Excessive anxiety and worry that occur throughout a six month period and throughout that time period the anxiety happens more often than not of those six days. The anxiety must also occur about a number of events. The next symptoms to meet the criteria are that the person must find it hard to control there worry. The third part of the criteria that the individual must meet is experiencing at least three of these next few symptoms for most of the days throughout a six month period. For children they must only have to experience one of these symptoms for most of the days throughout a six month period of time. Feeling keyed up on the edge or restlessness, being easily fatigued, having your mind go blank or difficulty focusing, irritability, muscle tension, sleep disturbance having trouble falling asleep staying asleep experiencing restlessness or unsatisfying sleep. The anxiety, worry, and physical symptoms must cause clinically significant distress in social, occupational, or other important areas. The fourth part of the criteria is that these symptoms that the individual is feeling must not be caused from the use of substances or other medical problems. For instance the individual cannot be abusing drugs, alcohol, or other medications. Lastly to be diagnosed with generalized anxiety disorder the disturbances happening in the individuals life must not be better explained by another medical disorder.

Generalized Anxiety Treatment

Many treatment methods exist for (GAD) and many new ways of treatment are being invented. A common method of treatment that we use today is psychotherapy. It has been proven that this type of therapy can help and is meant to help with making it easier to help the individual experiencing (GAD) cope with the stress that comes with this disorder. It can also have the effect of minimizing the persons general anxiety level. Therapy should be conducted by a qualified psychotherapist and different types of therapy should also be conducted by a qualified psychotherapist. For example group therapy has been proven to be effective and is a great way to make the individuals social skills better. Having better social skills has also been shown to be a positive way of helping the individual cope with stress. Individual therapy should be used for treatment of (GAD) to help the person change the way that they think and in result help treat the anxiety. Another type of therapy that can be used is cognitive behavior therapy. The reason why this can be effective is because it can change how the person thinks about the things that are causing them anxiety. Relaxation techniques can also have a positive effect on a person with anxiety by making it so a person can reduce their anxiety regularly when they are struggling to cope.

Medications are also used in the treatment of generalized anxiety disorder benzodiazepines are used regularly. The problem with this type of medication is that it can only be used for a short amount of time only about three to six weeks. Anxiety isn’t something that usually just clears up over time. It is a chronic illness so being able to be on this type of medication for a limited amount of time doesn’t make much sense. Also this type of treatment is debatable that it should even be used because this type of medication can become an addiction forming drugs. In addition to all of these problems it has the potential of making the anxiety of the individual even worse.

The most common and recommended type of medication for generalized anxiety is selective serotonin reuptake inhibitors. This has been proven to make the individual experience a quicker improvement in their psychosocial functioning. Combining psychotherapy and SSRI medication has been shown to be very effective in combating the symptoms of generalized anxiety disorder.

Cognitive behavioral therapy is a major form of therapy used for treating generalized anxiety disorder. Cognitive behavioral therapy also has many components that are broken down to help in the treatment of (GAD). Nonspecific effects are used in therapy and during this part of therapy the main focus isn’t the symptoms of the disorder. It is when there is just a discussion about the patient’s life story.

Psychoeducation is the next step in the list of components of CBT therapy the patient is informed about the disorder. More information that is given to the patient is why a person can develop anxiety. In addition to telling the patient different types of treatment that can be used and why they are used, they can also be given some brochures or self help information about their disorder.

The third component used is cognitive strategies, the first thing that is used is helping the patient understand the disadvantages of what they are worrying about. They need to be able to realize how unrealistic the things that they are worrying about actually are. The next thing that needs to happen is that they should develop a realistic idea of the things that they are worrying about. Putting the individuals worries in perspective for them, it is important to help them realize that what they are worrying about is something that many people worry about. Helping them think about the different ways that other people cope with these worries makes it easier for them to calm down about the situation and cope themselves. Then you want to help them look at events that they might perceive to be catastrophic and them let them make predictions of what might come next in these catastrophic events. Another thing that seems to be helpful is letting them think about what happens when they have positive or negative thinking and the opportunities that can go with each type of thinking. The person should practice controlling their worries. They need to be able to have these worries but then have the ability to think about them in a positive way. This can help them deal with problems that they struggle with caused be perfectionist qualities and the inability to deal with the uncertain. Also working on being able to stop worrying about what effects worrying is going to have on them physically. The last thing in this component is that the person should be able to recognize areas of their life where they don’t worry about things.

Exposure is an important part of cognitive behavioral theory. The patient should not participate in what you could call safety behavior. This means that not doing activities that they believe have a tendency to be dangerous for example traveling. Doing the things that scare them is a good way to make their fear about that certain area less.

Relaxation is another component to cognitive behavioral therapy. The person need to be able to calm down physically and emotionally when they get in an intense situation that they do not like.

The last component of CBT therapy is problem solving techniques. The importance of having these problem solving techniques is to lessen the likelihood of the individual to have the wrong reaction to a stimulus. They need to be able to work through a problem without having their first reaction to worry. The next part of this component is that the person needs to have some sort of life goals established. They need to be involved in different activities in their life and increase their emotional well being that way.

The next thing that is used to treat anxiety is pharmacology, like anything some of the medications used to treat generalised anxiety disorder work better than others. There is also so first choices that should be used before some of the second choice medications. This is due to everyone not being the same and not all medications work the same way for everyone. Also the side effects of each of these medications need to be taken into account as well because they will not affect everyone in the same way either. So I have found that for the first choice of medication they are Selective serotonin reuptake inhibitors, and selective norepinephrine reuptake inhibitors. These two have some of the same advantages and disadvantages they will not cause dependency in the patient and are safe in the case if there was an overdose that occurred. The disadvantage of these medications though is that they take a while to start working and can cause more nervousness in the beginning. The last medication of the first choice is Pregablin this medication has an immediate effect and helps the person sleep. The biggest problem of this medication is that it can make the person have less concentration and be drowsy. The second choice of drugs there are five in this category and they all basically have the same side effects. The main problem is that there has not been enough testing with them and so what data there is tends to not have as great of results and the three medications in the first choice.

How do we know though that treatment is actually working for the individual? There are different scales that are used to determine if treatment is even lessening the symptoms of generalized anxiety disorder. There is a scale used called the Hamilton anxiety scale which is a 14 item instrument. The three types of scales are self report measure the state trait anxiety inventory, the Beck anxiety inventory, and the Penn state worry questionnaire.Treatment response is usually defined as having been reduced by 50% from the baseline score. It can differ for each of the different measures used.

Related or similar disorders

There are many related or similar disorders that can either look like generalized anxiety disorder or just have some of the same symptoms. There are so many different branches of anxiety that could have the same symptoms as generalized anxiety because it is just a general anxiety you could have worries about many things. Where there are more specific list of anxiety in their own separate categories with their own separate worries. For instance the commonalities between generalized anxiety disorder and social anxiety disorder. A study was conducted between three types of kids. Kids without any specific type of anxiety, kids with social anxiety, and kids with generalized anxiety. It was predicted that the kids diagnosed with anxiety disorders would score higher when they measured how much they worried about things. They also thought that the kids with social anxiety disorder would score the highest out of the three groups. When the data was all collected it showed that kids with no diagnosis of anxiety scored the lowest when measured for how much they worry. The interesting thing that was found though is that the kids with social anxiety and generalized anxiety disorder scored the same for the amount in which they worried. So I feel like that shows there is some similarities between the different types of anxiety. The can also present themselves the same way in certain situations. It is important that we have the DSM 5 that is the most up to date with what we know how to diagnose generalized anxiety disorder.

Notable people with generalized anxiety disorder

Notable people that I found to have suffered generalized anxiety disorder in their lifetime was Abraham Lincolon. Abraham Lincolon had many traumas occur in his life from an early age as well. He lost many people that were close to him from his mother, sister, and children. As we know things like this have a big potential to manifest themselves into anxiety problems. One particularly interesting attributor to Abraham’s anxiety was how he felt he was being judged. He felt like he was being judged while he was serving as president because of the inadequacies that he felt he had because of his lack of education. Historians believe this because of the journals and letters that he left behind.

16 August 2021

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