Definition
Generalized anxiety disorder (GAD) is primarily distinguished by extreme worry and anxiety. The patient must find it problematic to manage these anxieties, which must generate notable distress or negatively influence their capacity to perform in social and professional contexts. These concerns must cover a spectrum of occasions and activities and should be present most days for at least six months (Oltmanns & Emery, 2019). GAD is distinguished from other anxiety disorders: a person with GAD should not worry about contamination (as with obsessive-compulsive disorder), social embarrassment (as in social anxiety disorder), or panic attacks (as with panic disorder).
Symptoms
Individuals with GAD frequently display a span of upsetting and incapacitating manifestations. The most noticeable symptom is worry that is exaggerated and uncontrollable. Even though patients are cognizant that their level of worry is out of proportion to the real threat, some are always preoccupied with several concerns. Undue worry can result in restlessness or an ongoing feeling of unease.
People with GAD often report having trouble concentrating, being chronically fatigued, and experiencing “blackout” moments (Oltmanns & Emery, 2019). They may become restless, which could result in disputes with others. Another recurring symptom that adds to physical discomfort is muscle tension. Finally, GAD is denoted by sleep disorders such as difficulty falling asleep, staying asleep, or experiencing disturbed, unsatisfactory sleep.
Diagnosis
Clinicians use the criteria documented in the DSM-5 to diagnose GAD. The essential features include excessive worry, its uncontrollability, the accompanying distress or impairment, the duration of more than six months, and the variety of worry topics that are not narrowly concentrated on particular phobias or panic attacks (Oltmanns & Emery, 2019). Furthermore, to distinguish GAD from other anxiety disorders, at least three accompanying symptoms from above must be present.
Course and Outcome
It is commonly observed that most individuals with anxiety disorders, including GAD, have severe issues over a protracted period of time. As one of the anxiety disorders, GAD frequently shows a chronic course. According to long-term follow-up studies, many people experience anxiety symptoms and related social and occupational impairments years after their initial diagnosis (Oltmanns & Emery, 2019).
Nonetheless, the outcomes of GAD are not uniform and can be unpredictable. Over time, patients with GAD may start to share complaints about physical manifestations rather than anxiety itself. A younger age of onset and inadequate care are frequently linked to worse outcomes. Therefore, early intervention and reasonable treatment can define the course and outcome of GAD, possibly enhancing the projection in the long run.
Frequency, Causes, and Gender Differences
It is observed that anxiety disorders are among the predominant mental health conditions. Roughly 3 percent of people in the US suffer from GAD (Oltmanns & Emery, 2019, p. 150). GAD has a complex etiology that incorporates both hereditary and environmental elements. Anxiety disorders, such as GAD, are thought to have an inborn component, with genetic characteristics accounting for 20–30% of the variance in GAD transmission (Oltmanns & Emery, 2019, p. 153). Two distinct genetic factors have been found, one connected to specific phobias and the other to GAD, panic disorder, and agoraphobia.
In addition, the development of GAD is influenced by environmental aspects. An augmented risk of GAD is seen in those who believe they have no control over external circumstances. This sense of uncontrollability is tied to the persistent anxiety that defines GAD. The lifetime prevalence of different anxiety disorders varies by gender. GAD concerns women twice as often as men, making them more liable to the disorder (Oltmanns & Emery, 2019). Furthermore, women with anxiety disorders relapse at higher rates; these gender distinctions also apply to other anxiety disorders, such as agoraphobia, panic disorder, and specific phobias, which are more standard in women.
Treatment
Clinically significant improvements have been seen in GAD treatment due to cognitive therapy. Cognitive therapy aids patients in recognizing and reframing their unhelpful thought patterns, thus focusing on the cognitive elements essential to the persistence of GAD (Oltmanns & Emery, 2019). Relaxation methods have also been beneficial in treating GAD.
Pharmacological treatment is an additional option: in particular, benzodiazepines have demonstrated efficacy in the short term for treating GAD (Oltmanns & Emery, 2019). An alternative class of antianxiety drugs for serotonin transmission includes azapirones, such as buspirone (Oltmanns & Emery, 2019). Research with controlled outcomes has demonstrated that buspirone is a valuable treatment for GAD. Despite having less side effects, buspirone might not offer the same quick relief from severe anxiety symptoms as benzodiazepines.
Reference
Oltmanns, T. F. & Emery, R. E. (2019). Abnormal psychology (9th ed.). Pearson.