Generalized Anxiety Disorder - Essay Example

Generalized Anxiety Disorder Generalized Anxiety Disorder Introduction In life, individuals worries about many things. The things worried about may have direct or indirect effect to the involved individual. Some of the worries revolve around health, money, or family problems (National Institute of Mental Health (NIMH), 2014). These worries may come for a short time and then vanish. However, this is not the case in generalized anxiety disorder (GAD). In GAD individuals, the worries are more prominent (NIMH, 2014). In GAD, the person is extremely worried about many things even where there is no need for such alarm (NIMH, 2014). The thought in such individuals is that situations will turn out lousy throughout the day. This extreme worry sometimes makes individuals with GAD to abstain from everyday tasks (NIMH, 2014). Gad has been shown to be associated with certain families, but it is not clear why some individuals would be affected and not others. Moreover, researchers have indicated that several parts of the brains are involved in generation of fear and anxiety (NIMH, 2014). The understanding of the role of the brain in development of the condition may play a significant role in coming up with effective forms of treatments. The condition has attracted significant attention in the United States. This is because of its effect in the general population. The condition has been shown to affect about 3.1% American adults causing them to ravage in fear and uncertainty (NIMH, 2014). The population falls between the age of 18 years and over. The average age of the occurrence of the condition has been shown to be 31 years old (NIMH, 2014). In total, about 6.8 million American adults are affected by the condition (NIMH, 2014). The condition has been shown to be twice as common in women as in men (American College of Physicians (ACP), 2013). The reason for choosing the topic is to gain insight in the disorder. A reflection on the disorder will help understand risk factors, pathology, signs and symptoms, diagnosis, treatment, epidemiology, natural history, care, and future research of the disorder. Associated factors in development of the GAD Various factors are associated with the development of the disorder. Environmental factors have been significantly associated with the development of the disorder (Beesdo, Pine, Lieb & Wittchen, 2010). One of the environmental factors that have been associated with the disorder is unfavorable life events. Researches carried out have established that the exposure of individual to one or more negative life event is correlated with an increase in the development of the disorder (Beesdo, Pine, Lieb & Wittchen, 2010). Some serious problems associated with negative life events are conflicts and abuse. In war-devastated areas, there has been shown to be elevated levels of anxiety disorders. A research carried out established that traumatic events such as war were significantly associated with having one or more anxiety diagnoses (Ayazi et al., 2014). These factors have been shown to induce stress in a person involved. The stress may lead to the development of an excessive worry and hence the disorder (Ayazi et al., 2014). On the other hand, considerable negative events during childhood may lead to an increased level of development of the disorder. Such negative events may include reversed role during the childhood years, lack of healthy social interactions, poor life satisfaction (Ayazi et al., 2014). A research carried out showed that GAD is prevalent on child exposed to various form of maltreatment at their tender age (Liao et al., 2013). These factors raise the chances of an individual developing a disorder. On the other hand, gender plays a significant role in the development of the disorder. For example, being female increases the chances of one developing the disorder. The condition has been shown to be more prevalent in women as compared to women. The condition has been shown to be twice as common in women as in men (American College of Physicians (ACP), 2013). Moreover, certain form of illness a have been shown to increase the chances of developing the disorder (Meng, 2012). Some of the illnesses associated with the disorder are usually chronic or those that affects individuals severely. Such illness may include cancer, obesity, hypertension, and diabetes. The condition makes individual to get worried about the future due to complex treatments and finances involved (Mayo Clinic Staff, 2014). Stressful situation may also make one prone to the disorder. Most of the stressful situations make ones worried for a long time. Genetics has also been shown to contribute significantly in the development of the condition (Mayo Clinic Staff, 2014). As a result, the condition has been shown to occur in the family lineage. Personality also plays a significant role in the development of the disorder. People with some personality types increases the chances of developing anxiety disorders tan those that do not have such personality (Mayo Clinic Staff, 2014). Other personalities disorders may lead to increased prone to GAP. Such disorders may include borderline personality. Additionally, substance abuse may also increase the chances of development of the disorder (CMHA, 2014). Such abused substances may involve drug, alcohol, caffeine and nicotine (CMHA, 2014). Pathology/Pathways Response to stress is associated with the brain. This is usually triggered when the survival of organism is threatened. This may be caused by a physical challenge and human anticipation of any challenge (Shelton, 2014). Hence, when human makes an erroneous assumption that a challenge is about to occur, this leads neurosis, anxiety, and paranoia. The amygdala is the site in the brain associated with the response to fear (Shelton, 2014). The main role is to note the stressful stimuli and create emotional memories. The information is received from neurons in the cortex (Shelton, 2014). The information is generally conscious and involved abstract associations (Shelton, 2014). The site may also be involved with subconscious process when information sidesteps the cortex. The activation of the amygdala result to changes in the brain (Shelton, 2014). It stimulates regions of the midbrain and brain stem leading to hyperactivity (Shelton, 2014). This is related with the physical symptoms of anxiety. Therefore, response to stress is because of activation of the hypothalamic-pituitary-adrenal axis (Shelton, 2014). This association becomes hyperactive in anxiety disorders (Shelton, 2014). The process involves a number of neurotransmitters in the brain. They include serotonin, nor-epinephrine, and gamma-aminobutyric acid (GABA) (CMHA, 2014). Signs and symptoms There are serious symptoms of the disorder. People with the disorder have difficulties in getting rid of their concerns (NIMH, 2014). This occurs even after the affected individual realizing that their anxiety is more pronounced than the situation requires. Such individuals are also unable to relax and have trouble in concentrating. There is also difficulties in falling asleep and spend most of their time being restless. There are also some significant physical symptoms. Some include fatigue, headaches, sweating, and nausea (NIMH, 2014). Diagnosis There are several diagnostic criteria for the condition. One is extreme nervousness and worry for an extended period (ACP, 2013). Such individual finds it difficult to control their worries. The anxiety and worry are linked to major symptoms of the disorder (ACP, 2013). These symptoms include restless, being easily fatigued, difficulty in concentrating, irritability, muscle tension, and sleep disturbances (ACP, 2013). Laboratory tests are not usually used in the diagnosis. However, sometimes clinicians may consider using laboratory test to exclude medical conditions characterized by the existing symptoms (ACP, 2013). Moreover, sometimes the diagnostic process may be a challenge to clinicians. As a result, it is advisable for clinicians to seek opinions from psychologist, psychiatrist, or other mental health specialist (ACP, 2013). Treatment options Treatment of the disorder occurs in two ways. It involves pharmacological or non-pharmacological process. However, sometimes the two processes are used together in the treatment of the disorder. The non-drug therapy is done through the cognitive behavior therapy (CBT). In this case, the individual is subjected to twelve sessions. The sessions may involve education, exposure therapy, relaxation training, and problem-solving techniques (ACP, 2013). The CBT is augmented by other factors. The short-term psychodynamic therapy focuses on revealing and resolving unconscious conflicts that lead to anxiety symptoms (ACP, 2013). This takes place by having an interpersonal relationship between patient and therapist (ACP, 2013). Training employs various techniques. The techniques help a patient to relax and reduce anxiety states (ACP, 2013). In self-examination therapy, the patient is exposed to text or media to mediate anxiety symptoms ((ACP, 2013)). The individual is also exposed to worrying situation. This means exposing a patient to anxiety-provoking situation until the anxiety diminishes (ACP, 2013). This is meant to ensure the individual learns not to react to such a situation. The use of the drug is also common in the treatment of the disorder. This is usually common in the adult population. Drugs are used due to various factors. It may be used when CBT becomes ineffective or is not available. It may also be used when an individual is not interest in nondrug therapy. This leads to use of drugs. The most commonly used antidepressants include serotonin reuptake inhibitors such as benzodiazepines, sertraline, (ACP, 2013). However, patient side effects and preference should be considered in the administration of the drug. Other drugs include alprazolam, diazepam, azapirones, antipsychotic, hydroxyzine, and pregabalin (ACP, 2013). Epidemiology The effect of the disorder has been established in United States. GAD has been noted as the most common mental illness in the country. The disorder affects 40 million adults in the country, which are at the age of eighteen and above (Anxiety and Depression Association of America (ADAA), 2014). The disorder has a high chance of being treated. However, only one-third of the affected individual gets access to treatment. The disorder is also a burden to the healthcare sector in United States. This is due to the heavy burden because of massive spending. In fact, the country spends over $40 billion a year in caring for the patients (ADAA, 2014). People with the disorder have also a high chance of visiting a doctor, or be hospitalized due to the disorder as compared to those that do not suffer from the disorder (ADAA, 2014). There are various risk factors associated with the disorder. They include genetics, brain chemistry, personality, and life events (ADAA, 2014). Moreover, individual suffering from the disorder has more chance of developing other medical conditions. The most significant condition associated with the disorder is depression. The number of adults affected by disorder in United States is worrying. The disorder affects 6.8 million adults (ADAA, 2014). This is over three percent of the country population. The disorder also affects both male and females in different ways. For example, women are as twice most likely to be affected as compared to men (ADAA, 2014). The effect on children is also alarming. It affects one in eight children, in the country (ADAA, 2014). Research indicates failure to treat the disorder in children is associated with poor school performance, reduced social interaction, and high chance of engaging in substance abuse (National Institute of Mental health (NIMH), n.d.). The disorder has also been shown to be more prevalent in certain race as compared to others (NIMH, n.d.). Natural history of GAD The disorder has been shown to respond well to treatment. The treatment involves CBT and use of drugs (ACP, 2013). The two may be used together in some cases. In CBT, the individual is able to reverse the dysfunctional beliefs and through patterns with more rational and realistic views (ACP, 2013). The use of drugs has been shown to be effective in controlling anxiety in patients (ACP, 2013). Consequently, the reversal of the effects makes an individual to lead a normal life. The disorder sometimes is difficult to note and hence mostly goes untreated. This makes an individual not to lead a normal life. Hence, the individual is unable to carry out normal activities in a regular manner. Such individuals also become a burden to the society and families. This is clear based on the symptoms of the disorder (ACP, 2013). Care, Facilities, and research The disorder involves a number of healthcare providers. The disease requires a detailed diagnosis. Hence, the clinicians play a significant role in the process (ACP, 2013). The medics, on the other hand, are most involved in recommending drugs depending on the severity and extent of the disorder. On the other hand, the disorder requires the services of therapist in the CBT (ACP, 2013). Such forms of care may take place in various setups. However, the most common are in hospital and nursing facilities as patients requires extreme forms of care and follow-up. There is a wide area left for research on the disorder. For example, the future research may seek to establish why some people develop the disorder. Conclusion It is clear GAD affects individuals in significant ways. It leads to uncontrollable worries in individuals that affect their life in significant ways. Such individual are unable to interact well, lack sleep, and unable to engage in productive activities, in the society. Various risk factors are associated with GAD. Some of the factors include exposure to unfavorable life condition and traumatic life events. Genetic is also seen to play a significant role in the development of the disorder. Children also seem to be most likely affected by the risk factors. The development of the disorder is seen to result from various abnormalities in the brains. Additionally, there are six factors associated with the diagnosis of the disease. After diagnosis, there are various options of treating the disorder. This involves use of drugs and CBT. This may occur in hospital and nursing facilities, as more attention is needed for proper recovery. Treatment of the disease is seen to be effective and helps the patient returns to normalcy. Failure to treat may lead to complication in an individual. On the other hand, the disorder seems to weigh heavily on American people. This is due to its prevalence in children and adult population. The disease requires further research to establish why it is common in some people and families. This will play a significant role in treatment and elimination of the disorder. References American College of Physicians. (2013). In the Clinic Generalized Anxiety Disorder. Annals of Internal Medicine, pp. 2-12. Anxiety and Depression Association of America. (2014). Facts & Statistics. Retrieved from http://www.adaa.org/about-adaa/press-room/facts-statistics. Ayazi, T et al. (2014). Association between exposure to traumatic events and anxiety disorders in a post-conflict setting: a cross-sectional community study in South Sudan. BMC Psychiatry, 14(6), 1-23. Doi: 10.1186/1471-244X-14-6. Beesdo, K., Pine, D., Lieb, R & Wittchen, H. (2010). Incidence and Risk Patterns of Anxiety and Depressive Disorders and Categorization of Generalized Anxiety Disorder. Arch Gen Psychiatry, 67(1), 47-57. Doi:10.1001/archgenpsychiatry.2009.177. Canadian Mental Health Association. (2014). Anxiety Disorders. Retrieved from http://www.cmha.ca/mental-health/understanding-mental-illness/anxiety-disorders/. Liao, M et al. (2013). Childhood Maltreatment Is Associated with Larger Left Thalamic Gray Matter Volume in Adolescents with Generalized Anxiety Disorder. Childhood Maltreatment and Thalamic Volume, 8(8), 1-8. Mayo Clinic Staff. (2014). Generalized anxiety disorder. Retrieved from http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/basics/risk-factors/con-20024562. Meng, X. (2012). Common and Unique Risk Factors and Commordity for 12-Month Mood and Anxiety Disorders among Canadians. The Canadian Journal of Psychiatry 57(8), 479-487. National Institute of Mental Health. (2014). Generalized Anxiety Disorder (GAD). Retrieved from http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml. National Institute of Mental health. (n.d.). Any Anxiety Disorder among Children. Retrieved from http://www.nimh.nih.gov/statistics/1ANYANX_child.shtml. Shelton, C. (2014). Diagnosis and Management of Anxiety Disorders. Journal of the American Osteopathic Association. Retrieved from http://www.jaoa.org/content/104/3_suppl_1/S2.full. Read More