Generalized Anxiety Disorder Epidemiology and Treatment

Introduction

Generalized anxiety disorder is characterized by excessive anxiety and significantly affects the patient’s personal life, family, and work. People with generalized anxiety disorder feel excessive concerns about typical everyday activities. A generalized anxiety disorder differs from normal anxiety because the degree of disturbance is higher; it lasts longer and is frequently irrelevant to any particular topic. Thus, the affliction’s epidemiology, causes, symptoms, and treatments should be explored.

The Epidemiology of the Disease

Generalized anxiety disorder is the most common anxiety condition, often combined with other mental and behavioral disturbances, complicating diagnosis. Generalized anxiety disorder affects 3.7% of the population worldwide. The disease is more prevalent in high-income countries (5.0%) than in low-income countries (1.6%). Most individuals diagnosed with generalized anxiety disorder are middle-aged, but symptoms can occur at any age (Rutter & Brown, 2017). Generalized anxiety disorder is twice as standard in females as in men. A global study by the World Health Organization (WHO) found that 51% of individuals with generalized anxiety disorder have severely impaired local functioning, affecting personal relationships and social life. On average, patients miss eight workdays per year due to the disorder (Rutter & Brown, 2017). People with generalized anxiety disorder have lower income and quality of life than healthy individuals.

The Reasons of Generalized Anxiety Disorder

It is essential to mention that the exact origin of this condition is still unknown, but experts have identified the main accelerants of the disease. This disorder often occurs in people who, under their character, are cautious. They are reserved, frequently re-examine everything before deciding, and attempt to avoid risky situations maximally. Females are in the risk group, as according to statistics, they have this disorder two times more often than males. Genetic prerequisites for GAD are observed in 30% of cases (Rutter & Brown, 2017). If relatives have this diagnosis, it can appear in the heirs under certain circumstances.

Provocative factors that can lead to the development of painful nervousness also include alcoholism, prolonged psychoactive substance use, or head trauma. The disease may also be caused by a sudden and acute stressful situation, such as the death of a family member and excessive demands from the environment. The condition is also based on the person’s shifted focus of attention, concentrating on a probable threat. The consciousness is flooded with anxiety and does not permit adequate adaptation to the new circumstances of life. In generalized anxiety disorder, the preconditions are often associated with a negative psychosocial factor in the past; for example, education in conditions of hyper protection care or reception of solid emotional trauma in childhood (Rutter & Brown, 2017). The pathogenetic mechanisms of generalized anxiety disorder remain incompletely understood.

The Symptoms of Generalized Anxiety Disorder

Patients with generalized anxiety disorder experience anxiety most of the time. For instance, the person may worry about their work, home routine, or being late for a meeting. The person cannot control their feelings; if one anxiety disappears, the patient switches to worry about a second issue. In addition to excessive worries, patients with generalized anxiety disorder suffer from difficulty concentrating, feeling “on edge,” quick fatigue, and irritability (Huang & Zhao, 2020). Autonomic disturbances always accompany the anxiety: palpitations, shortness of breath or shortness of breath, shivering, sweating, feelings of heat or chills, and fluctuations in blood pressure. Often “irritable bowel” symptoms are added: abdominal pain, constipation or diarrhea, nausea, and vomiting (Huang & Zhao, 2020). If the serious condition of generalized anxiety disorder is severe, sleep and appetite are disrupted.

Due to the fact that somatic symptoms of anxiety are key in GAD, in the presence of somatic diseases, people suffering from this condition consult primary care physicians. They may emphasize somatic symptoms and sleep disturbances rather than excessive anxiety or psychological signs of distress (Huang & Zhao, 2020). Symptoms of generalized anxiety disorder can occur and persist throughout life because it is a chronic illness, and few people manage to resolve their symptoms completely.

The Diagnosis of the Illness

Generalized anxiety disorder develops gradually, which is why patients first begin to notice vegetative symptoms caused by mental stress. They consult internists, cardiologists, and neurologists, complaining of pain, chest discomfort or abdomen discomfort, shortness of breath, nausea, and dizziness. By the time of referral to a psychiatrist, patients undergo many diagnostic procedures and symptomatic therapy by specialists of different profiles (Huang & Zhao, 2020). In order to make a diagnosis, the psychiatrist uses clinical methods of examination, such as interviews, observation, and history taking.

Generalized anxiety disorder is confirmed in the presence of these symptoms. The excessive concern and worry are related to several areas of life and have been present for six months or longer. At the same time, the physician establishes that the anxiety is uncontrollable, and the disturbances are combined with three or more signs and symptoms for six months or more (Huang & Zhao, 2020). The primary criterion in establishing a diagnosis of generalized anxiety disorder is the subjective severity of the feelings or manifestations encountered.

Methods of Treatment

Patients with generalized anxiety disorder are indicated psychotherapy and medication correction of the emotional state. Hospitalization is unnecessary, and all therapeutic measures are performed on an outpatient basis. Among psychotherapeutic directions, rational psychotherapy, cognitive-behavioral psychotherapy, and breathing techniques are the most effective. It is significant to emphasize that by using rational psychotherapy, the specialist shapes the patient’s perception of anxiety as a natural reaction of the body, which has positive and negative functions Huang & Zhao, 2020). The psychotherapist stresses that all signs are reversible, which helps change attitudes toward possible future events and switch attention from alarm to events in the present.

At the same time, the professional assists in dealing with destructive thought patterns that affect perception, emotions, and behavior using cognitive-behavioral psychotherapy. Observing the process of thought formation, the emergence of anxiety and restlessness enables the patient to begin to control the disorder’s symptoms. Additionally, breathing techniques reduce the frequency and severity of autonomic feelings and bouts of heightened anxiety by teaching breathing techniques and muscle relaxation. Purposeful restoration of an even calm rhythm of inhalations and exhalations and conscious relaxation of all muscle groups Huang & Zhao, 2020). Therefore, it leads to a change in the emotional state; that is, anxiety decreases, and the person begins to perceive better what is occurring in the present moment.

The primary component of drug therapy for generalized anxiety disorder is tranquilizers. Medications in this group reduce manifestations of anxiety and eliminate emotional tension and fears. Benzodiazepine tranquilizers effectively relieve symptoms but have many side effects and, after withdrawal, may provoke a resumption of stress with greater severity Huang & Zhao, 2020). Additionally, antidepressants from the group of selective serotonin reuptake inhibitors are used; they also have anxiolytic properties. Generalized anxiety disorder occurs in a chronic form, requiring long-term medication and psychotherapy.

Conclusion

Therefore, an anxiety disorder is a special psycho-emotional condition in which a person may experience feelings of worry under certain circumstances; anxiety arises for no apparent reason or aggravating factors. However, there are essential preconditions for stress, somatic diseases, or the reception of narcotic drugs and strong medications. The primary manifestation of generalized anxiety disorder is the presence of primary anxiety, which manifests as constant tension, apprehension, wariness, or inadequate anxiety. Breathing techniques and rational and cognitive-behavioral psychotherapy are used for treatment.

References

Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: A web-based cross-sectional survey. Psychiatry research, 288, 112954.

Rutter, L. A., & Brown, T. A. (2017). Psychometric properties of the generalized anxiety disorder scale-7 (GAD-7) in outpatients with anxiety and mood disorders. Journal of psychopathology and behavioral assessment, 39(1), 140-146.

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