Generalized Anxiety Disorder (Gad) Essay, Research Paper
Generalized Anxiety Disorder Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience from day to day. GAD is more than the normal nervous response in stressful situations. Such as, the sweaty palms, a racing heart and the butterflies in the stomach one feels before a big test, a board meeting, or addressing a group for the first time. However, people with GAD can’t seem to shake their concerns and are unable to relax. An individual that has this disorder is always anticipating disaster and they worry excessively. The psychiatric diagnosis of GAD is chronic, exaggerated worry and tension that lasts for more than six months. They may worry excessively about health, money, family, or work, even when there is no sign of difficulty. They also have trouble relaxing and they often have insomnia. Many live from day to day with distressing physical symptoms such as trembling, sweating, muscle tension, stomach pains, or headaches that tend to worsen when they face even mild stress (Harvard Health Letter, 1998) In 1994, generalized anxiety disorder (GAD) became an identifiable mental disorder with a DSM-IV diagnosis. The diagnostic criteria for GAD are: A. Unrealistic or excessive anxiety and worry about life circumstances for a period greater than 6 months, during which this person has been bothered by these concerns for more days than not. B. The person has difficulty controlling the anxiety and worrying. C. The anxiety and worry are associated with at least 3 of the following symptoms: 1) Restlessness or feeling keyed up or on edge 2) Being easily fatigued 3) Difficulty in concentrating or mind going blank 4) Irritability 5) Muscle tension 6) Sleep disturbances D. If another psychiatric disorder is present, the focus of the anxiety and worry is unrelated to it. E. The anxiety, worry, or physical symptoms cause significant distress or impairment in social, occupational, or some other important aspect of functioning. F. The disturbance is not due to the direct effect of a substance, medication, or general medical condition, and does not occur only during the course of a mood disorder, a psychotic disorder, or a pervasive development disorder. (Diagnostic and Statistical Manual of Mental Disorders “IV”, 1994). One case study of a patient diagnosed with generalized anxiety disorder, is a young person whom I’ll call Sarah. Sarah has been feeling emotionally tense, scared, constantly on edge, and jittery inside. Cognitively, Sarah worries that something terrible is going to happen but doesn’t know what it is. She says that she is frightened but doesn’t know why. She can’t put her finger on what exactly is making her so scared. Physically, Sarah has experienced headaches, nausea, stomach pains, heart races, and periods of feeling cold or hot with sweats. She states she wants to go to sleep and not wake up or she wants to run away but can’t express what from. Treatment for generalized anxiety disorder is varied and a number of approaches work equally well (Mental Health, 1998). Usually the most effective manner of treatment is to incorporate both psychopharmacological and psychological approaches. The models used in Sarah’s treatment were biomedical, cognitive and behavior. The approach of the multi-modal therapy plan has worked well for Sarah.
Biomedical therapy is medication. After careful consideration of the medications available for treatment of GAD, Sarah was given BuSpar (buspirone HC1, USP). BuSpar works differently than other anti-anxiety medications with fewer side effects. If side effects do occur, they are usually mild and often decrease or disappear as treatment continues. The more commonly observed side effects are dizziness, nausea, headache, nervousness, lightheadedness, drowsiness and excitement. There seems to be no potential for abuse, dependency, or withdrawal syndrome when therapy is discontinued. BuSpar works on the serotonin system in the brain to bring serotonin levels back to normal (Bristol-Myers, 1996). BuSpar was administered with a gradual increase to 15 mg in the morning and 15 mg in the evening. After 3 to 4 weeks of biomedical therapy, there was an improvement of Sarah’s anxieties and her feelings of well-being. Cognitive therapists believe that distorted thinking causes disordered behavior and that correcting the distorted thinking will alleviate and even cure the disordered behavior (Rosenhan, Seligman, 1995). Cognitive therapy essentially involves helping an individual think in more effective ways. By changing one’s thought or thinking processes, it is possible to change resulting feelings as well. Through therapy sessions, Sarah has shown positive growth in her thinking processes. Sarah was given workable tools that helped to change her irrational thinking patterns. She has a noticeable improvement in dealing with her problems. Behavior therapists view disorder behavior as learned from past experience and attempt to alleviate the disorders by training the patient to use new, more adaptive behaviors (Rosenhan, Seligman, 1995). Among the behavioral techniques employed are training in both assertiveness, relaxation, and gradual desensitization to the fearful objects. Sarah has the classical learned conditioning symptoms of a child reared in an environment of conflict between her parents. Sarah has been given the ability to be assertive in dealing with the things that make her anxious. Sarah was taught techniques of deep rhythmic breathing to relieve her symptoms of the anxiety. By using the method of systematic desensitization, Sarah was able to imagine the more stressful and anxious times then what she had suffered. This method brought about the partial alleviation of Sarah’s symptoms. Taken together, the cognitive and behavioral strategies create a balanced approach to understanding and treating common life problems. This approach provides a means of examining not only the manner an individual views themselves and their environment (cognition), but also the way in which they act on that environment (behavioral). Ultimately effecting a positive and lasting change in maladaptive thoughts and/or behaviors. REFERENCE PAGE American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, D.C.: Author. Bristol-Myers. (1996). Your Path to Relief of Persistent Anxiety. BuSpar Starter Kit. Princeton. Harvard Health Letter. (1998, July) Chronic Anxiety: How to Stop Living on the Edge. (anxiety disorders). [On-Line]. web1.infotrac-college.com. Article: A53367589. Mental Health Net. Generalized Anxiety Disorder Treatment. (1999, April 4). [On-Line]. mentalhelp.net/disoreders/sx24t.htm. Rosenhan, David L., Seligman, Martin E.P. (1995). Phobia, Panic, and Anxiety Disorders. Abnormal Psychology. (3rd ed.). New York: W.W. Norton and Company, Inc.