Generalized Anxiety Disorder

Psychological disorders are malfunctions in the mind that involve one’s thoughts, behaviors, or emotions that cause an individual significant distress and dysfunction over a period of time. Psychological disorders may interfere with a person’s ability to function in everyday life; they may be unable to meet their own personal needs, and/or be a danger to themselves or others. Generalized anxiety disorder is not considered to a dangerous disorder, however, it can cause some severe dysfunction in patients’ lives. In this paper, I will discuss generalized anxiety disorder from a neurobehavioral perspective.

Generalized Anxiety Disorder

According to the Diagnostic and Statistical Manual, Fifth Edition, (DSM-V), generalized anxiety disorder is characterized by excessive worry and apprehension that last longer than six months and pervades every aspect of the person’s life, or nearly every aspect, and the individual finds it difficult to control these thoughts (DSM-V, 2013). This anxiety causes a variety of symptoms of which three or more must be present for more days than not over the six-month period; restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and/or sleep disturbances. These disturbances in a person’s life cannot be explained by either an addiction, such as a drug or alcohol addiction, or by another psychological disorder (DSM-V, 2013).

Biopsychosocial Theory

Generalized anxiety disorder is a disease that is caused by a variety of factors. Anxiety is generally considered to be a disorder that people are genetically predisposed too. Research has shown that generalized anxiety disorder has a heredibility factor, however, one’s environment will contribute a great deal to rather or not one develops generalized anxiety disorder (Brown, O’Leary, & Barlow, 2001). Although one may be predisposed to develop generalized anxiety disorder, evidence shows that stressful life events in childhood may play a contributing factor, events such as child abuse, the loss of a parent, or insecure attachments to caregivers (Brown, O’Leary, & Barlow, 2001). It is a comorbid disorder often occurring along with other disorders such as; autism, depression, sleep disorders, or substance abuse.

Evidence shows that the amygdala and areas of the forebrain are involved in generalized anxiety disorder. The basolateral amygdala complex (BLA), and centromedial amygdala complex, receive information about potentially negative emotions, activating the GABA neurotransmitters, leading to somatic manifestations of anxiety (Nuss, 2015).

Epidemiology

Generalized anxiety disorder is not a rare disease. In fact, it’s prevalence in the US may range as high as five percent of the population. It is found to be more prevalent in low income families, white, adult, women, and within those social groups of people who are widowed, separated, or divorced (Weisberg, 2009).

Complications

Generalized anxiety disorder is more than just excessive worrying. It can impair one’s ability to think clearly, and concentrate on a task. It can sap a person’s energy, and make it hard for them to sleep. It can lead to a worsening of, or be the cause of other psychological disorders such as; depression, substance abuse, insomnia, digestive problems, headaches, and may even cause heart problems. Generalized anxiety disorder has also been linked to suicidal tendency, and some people who suffer from the disorder to manage to carry out their suicide (Mayo Clinic Staff, 2016).

Treatment Options

The two main treatment options for generalized anxiety disorder are psychotherapy, or medication; usually a combination of both. Cognitive behavioral therapy is the most effective therapy for generalized anxiety disorder, as it involves teaching the patient how to respond better to stress and negative emotions. Several different medications are used to treat generalized anxiety disorder including antidepressants, antianxiety, and benzodiazepines (Mayo Clinic Staff, 2016).

Antidepressants such as selective serotonin reuptake inhibitors (SSRI’s), and serotonin norepinephrine reuptake inhibitor (SNRI), are usually the first choice of physicians when treating anxiety disorders. Antidepressants and antianxiety medications take up to several weeks to work, and the side effects can be drastic, to include suicidal thoughts; physicians are advised to carefully monitor patients, changing medications if severe side effects do occur. Benzodiazepines are only used on short term basis for patients who are suffering from acute anxiety attacks, and should not be used for patients with a history of substance abuse because they can be addicting (Mayo Clinic Staff, 2016).

Conclusion

Generalized anxiety is a psychological disorder that is quite prevalent in the population of the United States. People who suffer from this disorder are likely to stress and worry over the smallest thing in an uncontrollable manner, and this stress is likely to affect their personal life increasing the likely hood of them developing another psychological disorder. But, anxiety can be controlled with the assistance of a physician, through the use of psychotherapy, and medications. I believe Juliana Hatfield described anxiety, and its symptoms, best when she said, “Sometimes I feel like a human pincushion. Every painful emotion hits me with ridiculously exaggerated force. And, the anxiety feels like hands inside of me, squeezing my guts really hard.”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Nuss, P. (2015). Anxiety disorders and GABA neurotransmission: a disturbance of

modulation. Neuropsychiatric Disease and Treatment11, 165–175.

http://doi.org/10.2147/NDT.S58841

Brown, Timothy A., O’Leary, Tracy A., & Barlow, David H.(2001). Clinical Handbook of

            Psychological Disorders, Third Edition: A Step-by-Step Treatment Manual, Chapter

Four. Retrieved from:

http://commonweb.unifr.ch/artsdean/pub/gestens/f/as/files/4660/21992_121827.pdf

Weisberg, Risa B. (2009). Overview of Generalized Anxiety Disorder: Epidemiology,

Presentation, and Course. Journal of  Clinical Psychiatry 2009;70(suppl 2):4-9. Retrieved

from: http://www.psychiatrist.com/jcp/article/Pages/2009/v70s02/v70s0201.aspx

Mayo Clinic Staff. (2016). Generalized Anxiety Disorder, Complications. Retrieved from:

http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-

disorder/basics/complications/con-20024562

Juliana Hatfield. Retrieved from: https://www.brainyquote.com/quotes/keywords/anxiety.html

Three Techniques to Cope with Anxiety

I am an introvert. In our extroverted society, just making that statement can be anxiety provoking. People assume the worst about introverts; that we’re cold, reserved, don’t like people, like to be alone, etc. But, the truth is, most introverts just like meaningful conversation with people who make them feel good about themselves. Introverts have a hard time with small talk, and may talk too much when nervous or stressed; causing awkward situations for both the introvert and the people around them. As a result of this, introverts often suffer from social anxiety, or, occasionally, generalized anxiety disorder. For this post, I will discuss social anxiety, as that is the type of anxiety I suffer from, and therefore, have the most experience with.

Social anxiety involves fear of social situations, or situations where an individual may be exposed to the judgement of others. These unreasonable fears are usually accompanied by thoughts such as, “everybody is thinking how much better this place would be without you,” “you always make a fool of yourself,” “you can’t do anything right,” or “nobody is ever going to like you, you might as well give up.” These can be debilitating thoughts, and the fear they cause can have physical manifestations. For instance, when I am experiencing an anxiety attack, my hands get sweaty, my heart starts to race, and my stomach starts to twist and turn. This is the body’s sympathetic nervous system; your flight, fight, freeze, or submit system, and it is automatic. While you cannot control this system, you can control your responses.

Three responses, or coping mechanisms, one can employ when having an anxiety attack, rather social or otherwise, include changing one’s thoughts, breathing and relaxation exercises, and distraction exercises.

Changing one’s thoughts is probably the hardest thing to do, however, the benefits of realized that not everyone hates you, are extremely beneficial. Some coping sentences one can use when facing an anxiety provoking situation include: “It is better for me to think about my positive qualities than my negative qualities, or think about what I can do, rather than what I cannot do.”  Focusing on your positive qualities can have an uplifting feeling, and give you the confidence you need to forge ahead, or enter that party, or family get together.

“If I plan what I will do or say, I will feel more confident.” Planning the situation, and an initial conversation you have be beneficial, as long as you do not let your negative thoughts overcome your rational thoughts. Conversations rarely go as bad in real life as they do in your head, or even close to what you rehearse, but planning how to say, “hello, how are you?” may benefit your nervous system and help you to realize that your fears of being hated by everyone are unreasonable.

“I can do this.” Simple, yet, effective. You can do it. Just keep repeating that to yourself while doing some deep breathing. Everything will be fine. People like you. You are a likeable person. Try it.

Breathing and relaxation exercises are extremely beneficial in calming the sympathetic nervous system. The progressive relaxation exercises, developed by Edmund Jacobson, involves tensing each part of your body, starting with your toes and working your way up, for five seconds, without straining, followed by ten seconds of relaxing each part of your body, consecutively. One could also practice mediation, which I have found to be extremely helpful in calming my nerves. While practicing these relaxation exercises, try to employ some distraction exercise.

Distraction exercises are great when you are placed in an unexpected social situation (the fear of all introverts). Some thought distraction exercises I personally employ, are naming items in the room that start with a given letter of the alphabet – just pick a letter. Conjure up images in your mind’s eye of your favorite place, and then walk down all the paths located there. Remember the words to your favorite song, and sing it to yourself, until the fear has passed. Some physical distraction exercises, especially for when you are at a large gathering, include offering to do the dishes, play with or babysit the children, or offer to hand out beverages or food.

Remember that having social anxiety is manageable, and that often your fears are worse than reality. Question your fears. Is it reasonable to assume that everyone hates you? Is it reasonable to assume that you always mess things up? Of course, the answer to both those questions is: no!  Be careful of black and white thinking that places everything and everyone into either or categorizes. Everybody is human and has good and bad days, experiences high and low emotions, and have good and bad moods, just because you are around for a low, doesn’t mean that low has anything to do with you. In fact, it probably doesn’t.

If you suffer from past trauma, or abuse, these techniques will work for you in the short run, but I recommend consulting a psychologist for further techniques in handling anxiety, especially if it interferes with your daily living. Anxiety is a psychological disorder that is manageable by a variety of therapy techniques, and it does not have to rule your life!