• What is generalized anxiety disorder?
• Why do I experience anxiety with my whole body?
• How is it diagnosed?
• What are the causes of generalized anxiety disorder?
• Methods of treatment
What is generalized anxiety disorder?
Anxiety, the Turkish meaning of which is ‘worry’, is a feeling experienced by the person that at any moment something bad could happen, for example the person could receive bad news, or something bad could happen to the person himself or his loved ones.
Often the person experiences an unwarranted high level of anxiety related to everyday matters. His mind is full of disaster scenarios. For example, if his or her child is one hour late in coming home, he responds with anxious thoughts like “a car must have hit the child”, or “someone did something terrible to the child”. The person can respond to an event with anxiety ranging from slight apprehension to panic. The reason why the condition is called generalized anxiety disorder is because anxiety is not just felt in specific situations but in varying degrees in almost every situation (unrelated to a particular place, time or situation). This is what differentiates it from panic disorder.
In fact, anxiety is a psychological state which everyone experiences during their everyday lives. As long as the anxiety does not reach extreme levels, it is useful as a means of encouragement. However when it becomes a problem in itself and affects the execution of daily tasks then it is regarded as a disorder and should be treated.
A person with generalized anxiety suffers extended periods of anxiety which he has difficulty in controlling. The anxiety is accompanied by restlessness, a feeling of being on the alert at all times, forgetfulness, irritability, difficulty in concentrating, sleeping problems, the person may tire easily or suffer from stiff muscles. Either all or some of these symptoms may be present in anxiety disorder and adversely affect the person’s life.
This common disorder generally sets in before the age of 20 and follows a fluctuating course. It can be accompanied by psychiatric conditions like other anxiety disorders, depression or alcohol dependency.
Why do I feel the whole of the stress in my body?
An interesting point is that in addition to anxiety and stress, people with high anxiety levels often complain of tension headaches, generalized body aches, nausea, stomach distension. This is the reason why patients often consult other medical professionals first, before they come to a psychiatrist.
It is thought that there is a connection between the state of anxiety and the fight-or-flight response seen in animals. Similar to the response of an animal who is facing a serious threat, the person perceives a serious threat and responds both psychologically and physically. The person’s autonomous nervous system is activated, circulation and respiration increases. He experiences shaking, unease, muscle tension, shortness of breath, palpitations, cold hands and feet, dry mouth, nausea and stomach distension. As we can see, the brain and the body constantly work together, and symptoms are experienced distinctly through the body.
How is the condition diagnosed?
Generalized anxiety disorder should be diagnosed by a psychiatrist. The aim during diagnostic phase is to distinguish the symptoms from those caused by a physical illnesses or by another psychiatric disease. A detailed physical examination, various blood tests, imaging and, if necessary, consultations with doctors from other fields of medicine may be required.
If a patient presents with stomach distension, headaches and generalized muscle aches and a definite cause cannot be established for these complaints, then anxiety disorder should be the first possibility that comes to mind.
What are the causes of generalized anxiety disorder?
The reason why some people are constantly more anxious than others, is still a subject of research. Alongside hereditary factors, the effects of childhood experiences are undeniable. The feeling of constantly being on the alert seems to also be related to the cognitive schema of the person.
If generalized anxiety disorder is not treated, it will continue for years and lead to a loss competence in the patient. In advanced stages of the disorder the patient can develop depression as a secondary conditions. In order to alleviate the anxiety and tension, patients may turn to alcohol or increase their alcohol consumption because of alcohol’s short-term relaxing effect. It is therefore important that the disorder is treated right from the start.
Furthermore, regardless of whether there are any accompanying physical symptoms or not, treatment of excessive anxiety is an important step towards decreasing the risk of hypertension and heart and circulation problems.
The primary approach in the treatment of generalized anxiety disorder is the use of an appropriately chosen antidepressant. In some cases a short-term therapy with drugs from the benzodiazepine group can be added to the therapy with antidepressants. Drug treatment on its own or, if necessary, together with a cognitive-behavioural therapy has a success rate of up to 90%.
What we need to know about anti-obsessive antidepressants:
• These drugs should only be used under the supervision of a doctor.
• It takes 2-4 weeks before the patient experiences the full effect of the medication. They have no immediate beneficial effect. In fact, in the early stages some complaints may be exacerbated by the medication.
• Your doctor should decide whether the drug is sufficient for the patient’s needs, whether or not to change it, or if additional medication is required in order to strengthen the effect.
• After a certain level of improvement is achieved, you should continue with the treatment for at least 6-9 months. The decision to stop the medication at the end of the treatment should be discussed with your doctor and you should act in accordance with his recommendation.
• Contrary to what is commonly believed, antidepressants do not act by tranquillizing the patient. Your ability to think and decide will not be affected during the use of antidepressants.
• Antidepressants do not cause drug dependency.
• Side effects associated with antidepressants are usually mild and short-term. They usually occur during the first week. The patient may experience nausea, vomiting, headaches or a feeling of confusion. Longer term side effects may be a lack of sexual drive, difficulties in erection and ejaculation. Weight gain is only associated with a certain group of this medication and does not reach extreme levels. Do not refrain from sharing such side effects with your doctor, he will welcome it. If any unexpected side effects occur during treatment you must contact your doctor immediately.
A method of therapy that has been proven to be effective in generalized anxiety disorder, is cognitive-behavioural therapy. Psychotherapy in addition to a drug therapy will help the patient to change his negative thoughts and behaviour patterns and aims at making the patient more active in combating the disorder. The therapy can last 6-12 sessions.
In cognitive-behavioural therapy the patient is firstly educated on the illness and its causes. In addition, with the help of breathing and relaxation exercises, and methods for coping with stress the patient is encouraged to relax. The patient is also given various tasks that help to desensitize the him towards stress-causing situations.