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Case Study on Generalized Anxiety Disorder

Alicia doesn’t like giving to or accepting from strangers a drink or cup of tea or coffee. The first time this happened was when she was nineteen and was taken home by her boyfriend to meet his parents. Both this relationship and a succeeding one failed. She found her fears gradually spreading and affecting her work as a secretary. “At one time I found it difficult to take notes and type it back if it was given to me just before I was due to leave the office or if the work was need urgently and my boss were waiting for it; I would panic and my fingers would cramp up….. I know everybody has some dread of something, but people accept somebody who has an aversion to mice or flies. If you don’t like giving somebody a drink, though, they think you are antisocial hand, if your hands shake, that you must either be drunk or crazy”.

Alicia always feels tensed and edgy causing her to lose many nights of sleep. As a result, she finds it incredibly hard to concentrate and cannot handle the stress. However, the stress she is undergoing is due to her worrying and not to any real outside pressure.

Why is Generalized Anxiety Disorder

The first reason why we think Alicia having the generalized disorder is because she is experiencing anxiety about her job. She will always feel panic when her boss asking her to do some work that is urgent and she also feel difficult to take notes and type it back if the work was given to her just before she was due to leave the office. When she feels panic, her fingers will cramp up, just like what the symptoms of the generalized anxiety disorder. People who facing this disorder will feel tense and edgy and they also experience the sleep problems. Alicia has the same symptoms as they.

Besides that, the stress that she undergoing is due to her worrying and not to any real outside pressure. For the generalized anxiety disorder patient, the problem is the stress comes from their own worry rather than from any real external source.

Because of Alicia having all these symptoms, we found out that Alicia is facing the generalized anxiety disorder.

History of generalized anxiety disorder (GAD)

Start form year 1980, generalized anxiety disorder, or GAD, has been well-know form any other anxiety disorder. The American Psychiatric Association classified the anxiety disorder into 3 types which are panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. GAD is a chronic anxiety that is sustained for a long period of time. The person who suffers from the GAD has excessive worry for at least six months, and has been diagnosed in more and more people during the last 30 years. A century ago, Freud noted that chronic, free-floating anxiety occurred frequently in the general population. In this day, there is limited information available about the natural history of the generalized anxiety disorder.

Definition of generalized anxiety disorder (GAD)

According to National Institute of Mental Health (NIMH), Generalized Anxiety Disorder is a condition characterized by 6 months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. They worry excessively about money, health, family, or work, even when there are no signs of trouble. Sometimes the source of the worry is hard to pinpoint. GAD most often strikes in childhood or adolescence, but can also begin in adulthood. It affects women more often than men, may run in families, and may also grow worse with stress. 

Symptoms of generalized anxiety disorder (GAD)

Generalized anxiety disorder often begins at an early age, and the signs and symptoms may develop more slowly than in other anxiety disorders. The symptoms can vary in combination and severity. Not all of the patients with generalized anxiety disorder will have the same symptoms although most of them will experience a combination of a number of the physical and psychological symptoms.

The physical symptoms of GAD are muscle aches, sleeping problem, stomach problems, headaches, chest or muscle pains, trembling, grinding the teeth or dry mouth, nausea, sweating, dizziness, rapid heartbeat and shortness of breath, unsteadiness, restlessness and easily tired. On the other side, the psychological symptoms of GAD are impatience, annoyed easily, feelings of dread, unable to control anxious thoughts, unable to relax, difficulty concentrating and fear of losing control or being rejected. It often coexists with depression, Irritable bowel syndrome, substance abuse, and other anxiety disorders.

In addition, the children and adolescents suffering from GAD will also have a few specific symptoms. They will have excessive worries about school performance, punctuality, earthquakes, nuclear war or other catastrophic events. Other than that, a child with the disorder may also feel overly anxious to fit in, be a perfectionist, lack of confidence and strive for approval.

A person should consult a doctor when one feel like worrying too much and it's interfering with one’s work, relationships or other parts of one’s life. One will also feel depressed, have trouble with drinking or drugs, or have other mental health concerns along with anxiety. Meanwhile, one who has suicidal thoughts or behaviors should really seek a doctor immediately.

Causes of generalized anxiety disorder (GAD)

Biological and psychological factors play a role in the cause of generalized anxiety disorder. GAD occurs somewhat more often in women than in men.

For biological and genetics factors, generalized Anxiety Disorder may be due to an imbalance of certain neurotransmitters such as dopamine and serotonin which affect and regulate our moods and behaviour. When these chemicals are imbalanced, they can cause Generalized Anxiety Disorder.

GAD can also develop through environmental factors which a person are exposed to on a daily basis. A child will learn from their parents by observation and direct interaction on how to deal with stress anxiously. There is also evidence that being in an unsafe environment or experiencing abuse can also lead to GAD.

Another cause of GAD is integrative perspective which meant the disorder is likely caused by a combination of biological and environmental factors. The biological factor has been mentioned about the chemical imbalances which may have a genetic component that caused the disorder can be passed from parent to child through observational learning.

Lastly, generalized anxiety disorder can lead to social phobias especially those who suffer greatly.

The Impact of Generalized Anxiety Disorder

The impacts of GAD are quite similar to its symptoms such as nausea, vomiting, shaking, and fatigue either in terms of physical or mental. Due to mental fatigue, the person will have difficulty concentrating. A person with generalized anxiety disorder will easily get annoyed causing to harm relationships, jobs and make life miserable for the sufferer and those around him or her. Thus, this can make finding a job, keeping a job, making friends, forming romantic relationships and other things more difficult. People with this disorder live in a constant state of fear and worries. Their worrying leads to all kinds of unfounded conclusions in their heads, and they seldom or never talk about what is in their mind. Therefore, they will miss out lots of opportunities in life. Other than that, people with generalized anxiety disorder, or GAD, will be less able to regulate negative emotions.

Another impact of GAD is lack of connectedness in relationships. As these people always in a state of worry and fear, they are often not in mind and spirit. In a conversation, they may not really hear what is being said to them but wondering in their own world. As a result, people will lose patience with these people as they do not seem paying any attention. When someone is in a state of fear and worries, they have very high possibilities to encounter accidents because their minds are not on the roads.

For those who suffer from severe GAD, they will isolate from the world and people. The reason is that their fear is too great that they choose to avoid things. These people will stop their normal life routines because they come up with all kinds of things that might go wrong. Such isolation sadly only gives them more time to worry, which make the situation worse. When a person with such disorder is stuck with never ending worries and fear, he or she will use alcohol or drugs to self-medicate without realizing that these substances will actually increase their anxiety. Lastly, generalized anxiety disorder can lead to social phobias especially those who suffer greatly. They may start to think they are not good enough or something bad is going to happen to them or their loved ones. This may end in a fear of going to public places and leaving the house

Treatment of generalized anxiety disorder (GAD)

Consist of a combination of medication and cognitive-behavioral therapy. Tranquilizers such as Xanax, Librium, Valium and Ativan are often used to treat this disorder. Moreover, Antidepressants such as Paxil, Effexor, Prozac, Lexapro, and Zoloft, are also being used to treat GAD.

Cognitive-behavioral therapy (CBT) is very useful in treating anxiety disorders. The cognitive part helps people change the thinking patterns that support their fears, and the behavioral part helps people change the way they react to anxiety-provoking situations.

http://www.medscape.com/viewarticle/431268

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