General Anxiety Disorder Treatment

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INTRODUCTION: Generalized Anxiety Disorder (GAD)

"I always thought I worried about everything. I was alarmed and unable to relax. Sometimes, the feeling came and went and sometimes was constant. Could last several days. I worried about what was going to make for dinner or what would be a good gift for someone. I just could not stop worrying about any details. "

"When I touched my back problems, missed work and I felt terribly bad about this situation. Then I worried about losing work. My life was miserable until I got treatment. "

"She suffered serious sleep problems. There were times when I woke up startled in the middle of the night. I had trouble concentrating, even reading the newspaper or a novel. Sometimes I felt a little dizzy. My heart was racing or pounding. And that worried me even more. I always imagined worse than reality. If I had a stomachache, I thought it was an ulcer. "

People with generalized anxiety disorder (GAD) spend the day filled with exaggerated worry and tension, even when there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. Sometimes the mere thought of getting through the day produces anxiety.

GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least six months. People with GAD seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They can not relax, startle easily and have difficulty concentrating. They often have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out air and hot flashes.

When their anxiety level is mild, people with GAD can function socially and hold down a job. Although not avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out simple activities of daily living if your anxiety is severe.

GAD affects about 6.8 million adults and affects estadounidenses1 twice as many women as men. The disorder develops gradually and can begin at any point in the cycle of life, although the years of highest risk are between childhood and middle age.2 There is evidence that genes play a modest role in trastorno.13

Other anxiety disorders, depression, or abuse of sustancias2, 4 often accompany GAD, which rarely occurs alone. Normally, the GAD is treated with medication or cognitive-behavioral therapy, but also coexisting conditions should be treated with appropriate therapies.

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Classification according to ICD-10
F41 Other anxiety disorders
F41.1 Generalized anxiety disorder
ICD-10 online (WHO version 2011)
Generalized anxiety disorder (GAD), according to ICD-10 (F41.1) is a form of "other anxiety disorders." It becomes independent of the fear and lose their relevance and relation.
Contents [hide]
1 Symptoms
2 development and maintenance
3 Therapy
4 Literature
5 Sources
Symptoms [Edit]

The patient experienced a generalized and persistent fear that is not (as in the phobic disorders) are restricted to certain environmental conditions, but rather floats freely.
Contents of fear is in most cases an unfounded concern and fears of future accidents or illnesses that affect one or even relatives, as well as a large number of other worries and forebodings. The patient has to cope with little or unable to perform routine tasks. He has anxiety, which can hardly force for a normal lifestyle. The anxiety occur in many situations. The person concerned gets panic of crowds, elevators, public transportation, in simple and everyday situations in which the fear of the person concerned for the average citizen does not understand. The lifetime prevalence of 4-5%, the disease usually begins between the 20th and 30 Age, women are affected more often than men, often associated with stressful life circumstances. The course is variable, but tends to fluctuate and become chronic. Concerns are:
Family / social relationships
Work and power
Health concerns
The fear manifests itself in patients by physical symptoms such as tremors, palpitations, dizziness, derealization and depersonalization, nausea, anxiety, relax inability to hot flashes, muscle tension, impaired concentration, nervousness, insomnia, tension headaches, dizziness, tingling.
After the ICD-10 criteria, the following symptoms for at least several weeks, usually to be met for several months on most days:
Concerns (concerns about future calamity, nervousness, difficulty concentrating, etc.)
motor tension (physical restlessness, tension headaches, tremors, inability to relax)
autonomic hyperarousal (dizziness, sweating, tachycardia and tachypnoea, abdominal pain, dizziness, dry mouth, etc.)
Psychological symptoms (feeling of dizziness, uncertainty and lightheadedness, derealization and depersonalization, fear of losing control, fear of dying)
There must be no organic cause or match the criteria for a depressive episode, phobic disorder, obsessive compulsive disorder or panic disorder, although depressive symptoms may occur temporarily with a generalized anxiety disorder. After the ICD-10 research criteria, generalized anxiety disorder can therefore occur simultaneously with a major depressive episode. In this case, only the criteria for panic disorder, phobias, obsessive-compulsive disorder, or a hypochondriacal disorder no longer be met.
People suffering from a generalized anxiety disorder studied, mostly because of his physical ailments to the doctor. Often it takes many years to recognize is that behind its physical symptoms of chronic anxiety. The physical symptoms of those affected are usually the result of their negative thoughts, their concerns and thoughts. The disease has been underestimated before. Today we know that it is associated with severe impairment of quality of life.
Development and maintenance [Edit]   Click here for General anxiety disorder treatment

The basic cause for the emergence of generalized anxiety disorder, genetic and social factors are assumed. The GAS is inherited but not specific, it seems to exist rather an inherited biological vulnerability to the development of pathological anxiety. This biological vulnerability to the experience of anxiety can lead to stress which is caused by social factors. Stress-generating social factors are most critical life events. The experienced stress can lead to the characteristic of GAS anticipatory anxiety (worry). This anticipatory anxiety is characterized by negative feelings associated with "related to the perceived inability to predict upcoming events in control conditions or desired results, or to achieve" [1]. This leads mainly to a shift of attention to internal, self-evaluative content and excessive vigilance against anxiety-provoking stimuli. Vigilance in turn leads to many different life circumstances are perceived as threatening. The GAS seems to be maintained by the concerns: By Borkovec and colleagues [2] concerns are a form of mental avoidance. The process of caring dampens the emotional processing of fear-inducing stimuli and also leads to somatic Suppressionseffekten: the anxiety-provoking stimuli (due to cognitive processing) and streamlines the people are peaceful by self-concern. This short-term improvement of the emotional and physical being, reinforcing a negative effect: The fear is maintained.
Further discuss cognitive factors are inter-dimensional and ExternalEmailAddress misperceptions arising from the result from the patient to himself observed changes such as reduced concentration and disruption of working memory: I'm not up to the task, possess little control or ability damage to master difficult situations, the concerns me. Due to the negative control experiments Metasorgen can arise that increase the frequency of worry and even trigger avoidance behavior and reinsurance. But also positive Metasorgen as "preventive care is the same" can reinforce the worry process. Through the control, prevention and reinsurance can not take place so that habituation and no end of worry process, and the cycle swings up.
Therapy [Edit]    Click here for General anxiety disorder treatment

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In psychodynamic psychotherapy, both the psychic structure, as well as the fears and anxiety-inducing situations is associated processes. Here, the "fear-preserving conditions," an equally great attention is given to how the contents of the fears or the triggering conditions in the life of the affected. Also biographical contexts can be vermittlet during therapy, these are, in contrast to other anxiety disorders, but never in the foreground. At the height of the transfer of security needs of the person concerned is at the center. This is followed by the address of the therapist's interventions. Themes can also be binding in therapy come into play. There are also short-term psychodynamic psychotherapy that have proven in the treatment of GAS as effective as cognitive-behavioral therapy programs. [3] [4]
In a cognitive-behavioral therapy is the first objective is that the patient experienced a behavioral analysis and mediation of a specific fault model, an understanding of his disorder, and this creates a willingness to behavioral interventions such as the confrontation with the fear in sensu (mentally) or in vivo (in real life, ie in the specific situation) to participate. In this way he can learn new behavior patterns by himself and his anxiety is experienced in practice that he feared the inevitable consequences. Through cognitive therapy elements, such as cognitive restructuring, reality testing, or the processing of the Entkatastrophisieren Metasorgen the patient to acquire a new outlook on life and a new perspective on their own abilities. The effectiveness of cognitive behavior therapy has increased sharply, while improved since the researchers used clinical techniques.
Another important element is the Applied relaxation therapy, represents but in severe cases that are not otherwise able to benefit from psychotherapy, because their fears and tensions are too large, a drug therapy offers with antidepressants, especially SSRIs or SNRI, in order to produce a treatment capacity at all. However, this negative can be expected with additional anxiety and discontinuations due to side effects or the fear of stopping the medicine.
Many clients with generalized anxiety disorder to seek primary care physicians to seek treatment for their anxiety and somatic complaints. In this case, are often wrongly prescribed benzodiazepines to relieve nervousness. However, there are fast habituation effects. Benzodiazepines also produce quickly dependence, which makes it difficult to discontinuation of medication [5].

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