Generalized anxiety disorder

Generalized anxiety disorder: description

A hallmark of Generalized Anxiety Disorder is that those affected are worried about most of the day. They are afraid of illness, accidents, to come too late or work can not cope. The negative thoughts rock up. They play through the feared scenarios in the head again and again, without finding a solution to the problem. The longer the process lasts, the stronger the fears become. If those affected do not seek help, the fears will affect more and more areas of life over time. The constant tension also affects the body. Physical complaints are therefore part of the appearance of Generalized Anxiety Disorder.

How widespread is Generalized Anxiety Disorder?

About four to seven percent of the population suffer from Generalized Anxiety Disorder once in their lives. Generalized anxiety disorder is one of the most common anxiety disorders. Generalized anxiety disorder is more common in women than in men. The onset of the disease is usually in young adulthood. However, it also occurs more often between the ages of 50 and 60 years. Children and adolescents are less likely to suffer from the mental disorder. However, the number of younger patients is increasing.

The Generalized Anxiety Disorder rarely occurs alone

In addition to generalized anxiety disorder, most sufferers suffer from other mental health problems. Often, the specific and social phobia as well as depression and physical ailments are without organic cause (somatoform disorders).

Generalized anxiety disorder: symptoms

Generalized anxiety usually refers to everyday things. Everybody knows worries and the fear of negative events that could possibly happen in the future. However, people with Generalized Anxiety Disorder can not control these concerns. They track those affected most of the day and severely limit their quality of life. They are much more worried than people without this disorder. Sometimes little things are enough to scare them.

Generalized anxiety disorder: worry about worries

The constant worries take over at some point so overhand, that those concerned are afraid of the worries themselves. They fear that they could harm them, for example, could cause harm to their health. One then speaks of so-called “meta-worries”. As a result, they try to suppress the worried thoughts. By constantly dealing with the fears, they are no less, but always in the center of attention.

Generalized Anxiety Disorder: Physical Symptoms

A very characteristic feature of Generalized Anxiety Disorder is the physical symptoms. These can be very different. Frequently, patients suffer from muscle tension, sleep disorders, difficulty concentrating, shaking, heavy sweating, rapid heartbeat or dizziness. Also, stomach and intestinal problems are often the reason for a visit to the doctor. Fear is rarely recognized as the cause behind these complaints.

Generalized anxiety disorder: prevention and reinsurance

Patients try to reduce their worries by, for example, frequently contacting family members to hear that they are well. They often look to other people for reassurance that everything is alright and they do not have to worry. Some also avoid listening to news to protect themselves from further fears. This behavior reinforces the problem in the end. Because reinsurance and avoidance behavior reinforce their belief that there is cause for concern. Even trying to suppress negative thoughts makes the situation worse. Who should not think of a pink elephant, will inevitably have a pink elephant in mind.

Generalized anxiety disorder: difference to depression

People who suffer from depression have similar negative thoughts as patients with Generalized Anxiety Disorder. However, unlike depression, worries about Generalized Anxiety Disorder are focused on the future. In depression, thoughts are more about past events.

Generalized anxiety disorder: causes and risk factors

As with many other mental disorders, evidence of a genetic basis has also been found in generalized anxiety disorder. However, the genetic material is not solely responsible for the development of the disorder. Only when further circumstances are added will a generalized anxiety disorder develop.

Important influencing factors are the parents’ parenting style and the experiences that a person made at a young age. Children learn early on from their parents how to deal with threats. Very anxious parents promote the fears of their children. People from less educated backgrounds develop the disorder more frequently.

Many people with Generalized Anxiety Disorder have experienced loss in childhood, such as the death of a parent. Strong risk factors for an anxiety disorder are abuse and neglect.

Currently stressful events are often the trigger for a generalized anxiety disorder. Among other things, there is a connection between the beginning of the disorder and the loss of the partner through divorce, separation or death, and unemployment.

Also the messenger substances in the brain are probably involved in the development of a generalized anxiety disorder. The exact procedures are still unknown. The positive effects of drugs that act on the messenger serotonin are an indication of dysfunction in the brain.

Generalized anxiety disorder: examinations and diagnosis

Very often people with generalized anxiety disorder turn to a general practitioner. But they do not make the fear the topic, but seek help for physical complaints such as headache or abdominal pain and sleep disorders. Since patients rarely report their fears, many family doctors overlook the mental causes.

If you notice your thoughts and find that they are often negative and often ponder you, you should discuss this with your doctor. He can then refer you to a psychosomatic clinic or psychotherapist. The therapist can determine an accurate diagnosis with the aid of special questionnaires. The therapist could ask the following questions:

• How many times have you felt nervous or tense lately?
• Do you often feel restless and unable to sit still?
• Do you have a lot of worries in your head that you can not control?
• Are you often worried that something bad could happen?

According to the ICD-10 classification of mental disorders, the following criteria for the diagnosis of generalized anxiety disorder apply:

For at least six months, sufferers experience tension, anxiety, and fears about everyday events. In addition, at least four of the following symptoms must apply. Of these at least one of the symptoms 1 to 4.

1. Palpitations, palpitations or increased heart rate
2. sweats
3. Fine or coarse tremor (trembling)
4. dry mouth
5. difficulty breathing
6. tightness
7. Thorax pain and sensations
8. Nausea (nausea) or abdominal sensations (eg tingling in the stomach)

To exclude organic causes, a doctor will also perform a physical examination and create a blood count. Symptoms similar to a generalized anxiety disorder can also occur due to hyperthyroidism. Also, the side effects of some drugs and the withdrawal of drugs can cause fears.

Generalized anxiety disorder: treatment

Is the Generalized Anxiety Disorder curable? Only rarely do the symptoms disappear on their own. For many patients, Generalized Anxiety Disorder solidifies after some time and becomes a constant companion. A therapy helps those affected to recognize and reduce the symptoms of anxiety. This allows them to pursue their professional and social life again. The quality of life improves.

Generalized anxiety disorder: therapy and medication

Treatment for generalized anxiety disorder is usually a combination of psychotherapy and medication. As a form of therapy, experts recommend cognitive behavioral therapy (CBT) or psychodynamic therapy. Relaxation techniques according to Jacobson are often used to support therapy.

Generalized Anxiety Disorder: Cognitive Behavioral Therapy

Cognitive behavioral therapy focuses primarily on the behavior and thoughts of the patient. First, the affected person is explained the mechanism of anxiety disorder. The worries are mutually reinforcing and growing. Persons with generalized anxiety disorder are also looking for reasons for their worries. An important starting point is therefore to divert attention from negative stimuli. The patient learns to question and replace him with realistic thoughts.

A major problem with Generalized Anxiety Disorder is that thoughts jump from one concern to the next and are not really processed. In the CBT the affected person should intensively deal with a fear with the help of the therapist. The mental confrontation with disquieting events serves to accustom the patient to the negative ideas. The intensity of anxiety decreases with time.

Generalized anxiety disorder: psychodynamic therapy

The psychodynamic direction assumes that unresolved conflicts are responsible for the fears. The therapy deals with current and past conflicts from childhood. Outpatient therapy often extends over several years.

Generalized anxiety disorder: medications

Selective serotonin reuptake inhibitors, such as escitalopram, are used for drug treatment. Selective serotonin norepinephrine reuptake inhibitors, such as venlafaxine or duloxetine, have also shown to be very effective against generalized anxiety disorders. The effect occurs only a few weeks after the start of drug therapy. To prevent relapses, the remedies are prescribed over a longer period of at least a few months.

Generalized anxiety disorder: disease course and prognosis

Generalized anxiety disorder is often chronic. The sooner the disease is treated, the better the chances of recovery. Compared to other anxiety disorders, the prognosis is worse. In many cases, the Generalized Anxiety Disorder is not recognized and not treated therapeutically. This is sometimes because the Generalized anxiety disorder rarely occurs alone and is usually obscured by other problems.