Generalized Anxiety Disorder: symptoms, causes and therapy

The generalized anxiety disorder It is characterized by exaggerated and excessive worry and anxiety about any day-to-day event for no apparent reason for this concern. In fact, it is one of the anxiety disorders with the most annoying and disabling symptoms, since they appear in many different situations.

People with this disorder they always wait for things to go wrong and can't stop worrying about their health, money, family, work or college.

What is generalized anxiety disorder?

East afraid or worry is irrational, unreal and disproportionate, and daily life becomes a constant worry. Therefore, anxiety ends up dominating the life of the individual, which negatively affects their functioning normal in different areas of your life, such as social activities, work, or relationships interpersonal. Additionally, generalized anxiety disorder also affects the ability to vividly imagine possible future situations, making the attention focus more on the negative sensations that are perceived in the Present.

Differences between GAD and other anxiety disorders

The anxiety It is a normal reaction of individuals in situations of stress and uncertainty. Now, when various anxiety symptoms cause distress or some degree of functional impairment in the life of the individual who suffers, 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 make it difficult for the person who suffers to function in different areas of his 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 happens better than that of generalized anxiety disorder, the mental health expert will rule out the TAG.

So, let's see some keys to differentiate diagnostic categories, taking into account that the diagnosis can only be made by psychologists or psychiatrists duly licensed and trained to it.

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 air (panic disorder), feeling humiliated in public (social phobia), suffer contamination (obsessive compulsive disorder), or have a serious illness (hypochondria). Unlike the previous ones, the main characteristic of generalized anxiety disorder (GAD) is having excessive and irrational worry and anxiety, persistent (at least 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 worry 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 agitated.
• Easily fatigued.
• Difficulty concentrating or having a blank mind.
• Irritability.
• Muscle tension.
• Sleep disorders (Difficulty reconciling or maintaining, sleeping little or restless).

Also, anxiety, worry, or physical symptoms cause clinically significant discomfort or impairment in social, occupational, or other important areas of functioning.

Unlike 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:

• Autonomous symptoms: palpitations or tachycardia, sweating, trembling or shaking, dry mouth (not due to medication or dehydration).
• Related to chest and abdomen: shortness of breath, shortness of breath, chest pain or discomfort, nausea or abdominal discomfort.
• Related to mental state: feeling dizzy, unsteady, or lightheaded; derealization or depersonalization; fear of losing control, going crazy, or losing consciousness; affraid to die
• General symptoms: hot flashes or chills; lightheadedness or tingling sensations; muscle tension, aches, or pains; restlessness or inability to relax; feeling of being on edge or under pressure, or of mental tension; feeling of a lump in the throat or difficulty swallowing.
• Other non-specific symptoms: exaggerated response to small surprises or shocks; 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 from the autonomous group. Despite the differences between the DSM and the ICD, the degree of concordance between the two is quite high: a study by Andrews, Slade and Peters (1999) concluded that 77% of the subjects diagnosed by one of these systems had a positive diagnosis in the other. also.

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

Causes

GAD is not different from other psychological disorders with regard to the multicausal origin that initiates it. There is no single cause of generalized anxiety disorder in 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 have GAD more frequently.

The neurological bases of generalized anxiety disorder

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

Much more research is needed to get a good understanding of this disorder.

Examples of generalized anxiety disorder

To better illustrate this pathology, some examples are shown below:

• A doctor who is continually concerned that he is misdiagnosing patients. Every time they call him on the phone he thinks he is a superior to tell him that he works badly. Furthermore, you are continually concerned about whether your new patient will be an old one who has relapsed.
• A woman who is always worried about whether her partner is going to leave her, you will be fired at work and if someone in her family is going to become seriously ill.
• A father who is always worried that her 4-month-old son is going to choke while he eats, whether she won't hear him cry at night if she needs help, and whether she could become seriously ill and die.

Treatment for this psychological maladjustment

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

The 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 the yoga, may be beneficial in combination with CBT.

Specific, the use of self-instruction and the technique of systematic desensitization They are common, and so are Mindfulness sessions, the objective of which is to help the person direct their attention to the present.

Bibliographic 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.