Emotional Disorders - Research Paper Example

Running head: GENERALIZED ANXIETY DISORDER Generalized Anxiety Disorder Jada could be suffering from a combination ofgeneralized anxiety disorder or specific phobia. Jada has a good record in her school life. Being sixteen years of age, she is enrolled as a junior in one of the public schools at her local setting. The record track of Jada is exceptional after having won several honors in her high school education. Her joy is in music especially playing of the piano and singing in her church choir. The vocal instructor has seen the talent, and he sees the potential talent of music in the young lady. With this in mind, Jada hopes to attend a music school in New York after graduating from the school. Some of the symptoms that Jada has led to two mental conditions entailing the fears and anxiety the lady has after joining the music school. From the definition, generalized anxiety disorder is a condition in which it becomes difficult to control worry that occurs persistently (Clark & Beck, 2011). On the other hand, specific phobia is unreasonable fear or anxiety connected to specific situations or objects and people tend to avoid them. The pressure of the upcoming audition at school has made Jada wallow in a huge deal of stress. One of the symptoms that characterizes the two conditions is a great worry. She worries about missing her family and the cost of paying for the school. Jada is in the great deal of stress due to the pressure from the upcoming audition (Doctor, Kahn, & Adamec, 2008). Jada experiences fear of the uncertainty with the financial reasons being the prime cause of worry. The huge deal of stress has already begun affecting her day-to-day activities (Doctor, Kahn, & Adamec, 2008). Generalized anxiety disorder is an abnormal worry about something or even specific situations. It is normal to worry about health, family, and finances, but extreme worry of these situations leads to this condition. The signs of generalized anxiety disorder include having trouble with sleep or sleeping for long hours (Doctor, Kahn, & Adamec, 2008). Furthermore, patients with this disorder lose appetite and due to this reason, there is weight loss. Physical symptoms include muscle tension, trembling, twitching, and headaches. In the same case, Jada is having problems with sleeping that is she is experiencing insomnia (Heimberg, Turk, & Mennin, 2004). Furthermore, the lady has lost weight, as a result, of decreased appetite. With all these symptoms, the lady has become hopeless and worries what the future beholds for her. In the extreme pressure, the daily functioning of the lady has been affected. The situation is catastrophic and the friends describe Jada as irrational. The anxiety is taking toll on Jada and she is melancholic and tearful. As an escapist tendency, the lady has resulted to drinking of alcohol. While admitting the abuse of the drug, she reveals to her parents that she has been using alcohol in dealing with stress (Heimberg, Turk, & Mennin, 2004). Specific phobia, on the other hand, is intense or irrational fear about the specific situations, places, or things. These fears make it difficult or hamper some of the activities in life. They make a person unable to accomplish certain tasks or goals in life. As a specific phobia, Jada has the fear of upcoming auditions that will make her enroll for music studies. The fear puts strain on the relationship of Jada with her friends and parents (Morris & March, 2004). The parents all along understand their daughter to be exceptional in her education but it is shocking to see her indulge in alcohol abuse. The specific phobia of Jada culminates in anxiety responses. Jada experiences panic attacks, and she often cries. The distress interferes with her normal routine and the social relationships. With intense nervousness, specific disorder results to anticipatory anxiety. She fears the outcome of the upcoming auditions (Morris & March, 2004). The main fears for the young lady are whether she will be accepted or not and the finances to pay for music education. By extension of extreme nervousness, the lady experiences difficulty in sleeping and eating and thus losing weight. With pessimism characterizing her fears, Jada has wishful thoughts of dying so she would not have to encounter with the stress. In addition to death wishes, Jada has opted to drinking as temporary solution to her problems (Heimberg, Turk, & Mennin, 2004). Generalized anxiety disorder and specific phobia are both DSM-IV-TR diagnoses for the adolescent. Both disorders have similar symptoms with the anxiety forming the common denominator. Despite the presence of situational fear, specific phobia is characterized by frightening moments of objects in the life of a human being (Heimberg, Turk, & Mennin, 2004). High places or some animals bring the frightening experiences in life. This fear makes it difficult for one to work and reduces self-esteem. The case of Jada gives a life situation in which the lady fears the outcome of the auditions. Being the main cause of worry, it culminates into anxiety about her upkeep. Most of the specific phobias are experienced during childhood while others arise during adolescent. This concurs with situation of Jada since she is experiencing the situational fear of the auditions at the age of sixteen. Situational fear as a specific disorder is rare with the phobia focusing on animals, insects, thunder, flying, and certain medical procedures (Doctor, Kahn, & Adamec, 2008). With the commonality in these events and situations, generalized anxiety disorder remains the main diagnosis for the condition facing Jada. Generalized anxiety disorder is a condition that is multifactorial in nature. It arises from various situations and conditions affecting the life of the individual (Doctor, Kahn, & Adamec, 2008). The prime cause of worry for Jada is the upcoming audition that will define and shape her musical career. To make the matters worse other worries crops up in relation to the musical career. She is worried that she may be rejected and upon acceptance, she will be incapable of raising the necessary fees to meet her education. As a common feature of the disorder, she experiences insomnia and loss of appetite (Clark & Beck, 2011). Furthermore, Jada loses weight due to lack of eating and the stress. The pressure Jada experiences is great with the thoughts of dying becoming rife at her weakest point. As an escapist tendency, Jada results to drinking of alcohol with her friends. All these symptoms make general anxiety disorder be the diagnosis result for Jada. It complements with the symptoms the young lady experiences (Clark & Beck, 2011). According to various research studies, conducted GAD is one of the anxiety disorders with other in this class including panic disorder, specific phobia, and acute stress disorder. Most of the anxiety disorders can occur in isolation, however, in some cases the disorders occur together with depressive conditions. GAD is a common disorder with the central feature being excessive worry and a number of events that are associated with heightened tension (Heimberg, Turk, & Mennin, 2004). A formalized diagnosis using the DSM-IV classification identifies two major symptoms these are: excessive anxiety and worry of related or unrelated events. Furthermore, patients experiencing this condition have difficulty in controlling their worries. Jada in our vignette has extreme thoughts of committing suicide due to the pressure and anxiety she is experiencing. The symptoms could be present for a period of 6 months and could lead to impairment in terms of social and occupational responsibilities (Heimberg, Turk, & Mennin, 2004). It is important to note that being and feeling anxious is normal. It assists individuals to escape harm where possible and even prepare for important events in our daily life. Feeling anxious forewarns individual in areas needing immediate action. On the flipside, having the anxiety that is persistent and irrational culminates to GAD and other anxiety disorders (Doctor, Kahn, & Adamec, 2008). An individual having GAD has constant and unsubstantiated worries that lead to significant levels of stress. The stress levels disrupt the social activities interfering with work, academic performance, or even family life. In addition to the above symptoms, individuals with GAD are restless, have irritability, experience insomnia and loss of appetite. With the loss in appetite, the individual experience sudden drop in weight (Doctor, Kahn, & Adamec, 2008). Lack of sleep makes the individual become irritable with poor concentration. Physically, the patient becomes restless and have muscle pain. Insomnia complicates the life of the individual trickling to fatigue. The different levels of anxiety lead to physical conditions such as trembling, twitching, hot flashes, sweating and headaches and feeling out of breath. GAD develops gradually from childhood to adolescent although it can arise in adulthood. The condition is common in women compared to men. Diagnosis for the condition is appropriate when the individual spend at least six months while in worry (Clark & Beck, 2011). Researchers have not pinpointed the exact cause of GAD but many suspects an imbalance in neurotransmitters in the brain to be the main cause. Neurotransmitters in the brain serve the role of regulating the body neuronal responses to various situations such as emotions. Neurotransmitters serve an important role in cell signaling pathways thus acting as the channels for communication. With this in mind, these chemicals regulate the person moods, perception, alertness, and sleeping patterns. When the neurotransmitters are off the balance, they affect the individual both physically and mentally. Researchers point to the fact that the imbalance makes the individual become ready to act or respond to an emergency even when none is in existence. GAD may arise from a developmental factor or it can be multifactorial. Research regarding the condition indicates that it can develop from childhood to adolescent (Clark & Beck, 2011). Childhood experiences could be the major reason contributing to GAD and its progression. Poor upbringing and negligence while one is young could predispose to GAD. In this situation, the condition initiates while the person is a child and progresses on to teenage life. Lack of early intervention for the condition leads to further progression to adulthood (Heimberg, Turk, & Mennin, 2004). The condition is multifactorial with causes being the environmental stress, biochemistry, psychological profile, and personal history. A person diagnosed with GAD is vulnerable to stress than the rest of population. As aforementioned, imbalance in neurotransmitters such as gamma-aminobutyric acid, dopamine, and serotonin may contribute to GAD (Heimberg, Turk, & Mennin, 2004). Serotonin, for instance, plays a significant role in pleasure ad feelings of well-being. Deficiencies in serotonin in this case, lead to anxiety and depression. Hormones that regulate stress such as cortisol play a significant role in contributing to the anxiety when they are off balance. Researchers have identified brain structures to be a major cause of GAD (Doctor, Kahn, & Adamec, 2008). With the principle focus on amygdala, sometimes known as the fear center, evidence suggests that people with GAD experiences high responses to the unfamiliar and novel situations. Genetic factors contribute to GAD with individuals who have had persons with the condition having a high likelihood of contracting the disorder. Researchers are making good progress in identifying genes that could predispose an individual to the inherited risk. Treatment of GAD is promising with the individuals with the condition experiencing relief after the first few weeks of therapy. The approach used in the treatment of GAD can be single or multi-faceted. Successful treatment of the condition includes medication such as the use of benzodiazepines and other antidepressants. Moreover, other useful treatments include cognitive-behavioral therapy, biofeedback to control muscle tension, relaxation techniques among others (Clark & Beck, 2011). Throughout the therapy sessions, individuals are capable of identifying the unrealistic patterns in their thinking process and substituting them with helpful thoughts. In addition, the health professional helps the patient in understanding the disorder and its effects on the family and social relationship (Clark & Beck, 2011). The three most effective treatments for GAD include psychotherapy, pharmacotherapy, and self-management strategies. Psychotherapy session realizes the fact that patients with GAD have cognitive abnormalities, which hinder their abilities to deal with their symptoms and other aspects in the environment. Under this realization, patients with GAD have a higher likelihood of incorrect interpretation of external stimuli in comparison to healthy individuals. Psychotherapy helps the patients to have behavioral and cognitive strategies that assist in the management of symptoms impeding their normal functioning (Doctor, Kahn, & Adamec, 2008). Early psychosocial therapies aim at the somatic manifestation of GAD such as muscle tensions through the use of relaxation techniques. When cognitive behavioral therapy is used in conjunction with relaxation therapy, it reduces the need for medication. Apart from psychotherapies, GAD is treatable using pharmacotherapies. Recent drugs have been shown to be effective in treating the condition and tolerable than the earlier medications such as benzodiazepines. Some of these drugs include Buspirone, Benzodiazepines, and antidepressants. Antidepressants such Serotonin Selective Re-uptake Inhibitors are useful in the retention of serotonin in the brain thus preventing the imbalances in this neurotransmitter (Heimberg, Turk, & Mennin, 2004). In addition to the two approaches, self-management or self-care may eliminate the need of seeing a therapist or taking the drugs. Some of the self-care strategies recommended by the doctors include reduction in consumption of caffeine, exercising and getting enough rest and sleep. It is appropriate for the patient having the disorder to join a support group (Olatunji, Deacon & Abramowitz, 2009). Sharing with other individuals having the same experiences may help in coping up with the adverse effects of GAD. Although not a substitute for talk therapy or medication, they are supplementary for achieving the overall effect (Olatunji, Deacon & Abramowitz, 2009). The treatment of GAD is compounded with ethical issues. Despite the theoretical and empirical support that the therapy has, psychotherapy and other interventions evoke serious public relations problems (Laura Weiss Roberts & Shaili Jain, 2014). Some of the physicians engaging in the treatment of the condition have negative view of the method. Several studies indicate that the treatments leads to distress rather than ameliorate the condition. Some claim that the patients are better off experiencing the disorder rather than undergoing the treatment. In the same light, practitioners have been blamed for the lack of training in the field (Laura Weiss Roberts & Shaili Jain, 2014). With lack of adequate training, the practitioners do not utilize the technique while working with the patients. Ethical concerns about the safety and the tolerability of the exposure based therapies have been central to the objection of the treatment. Intolerability during the therapy session result in high attrition rates or dropout before the completion (Olatunji, Deacon & Abramowitz, 2009). Another issue of ethical concern is the preferences for the patient with some of them experiencing heightened anxiety during the therapy sessions. In the same context, the therapist is likely to experience litigation for inadequate or incompetent therapy. Some therapists proceed without obtaining the informed consent as per the requirements of APA (Olatunji, Deacon & Abramowitz, 2009). In summary, ethical issues compound the use of psychiatric medication. The use of this medication has evoked serious societal and ethical concerns (Laura Weiss Roberts & Shaili Jain, 2014). Studies show that children taking antidepressants face a high risk of suicidal behavior relative to those taking the placebo. Atypical psychotropic are blamed for other conditions such as diabetes and hyperglycemia. In the recent past, there has been widespread application of these medications making it issue is of ethical concern (Laura Weiss Roberts & Shaili Jain, 2014). With the pharmaceuticals, trying to reap huge profits, over prescription of psychotic drug has become a common feature. The use of psychotropic that have stimulating effects on the body can give rise to addiction of the medication. Developers of these drugs argue that they lead to cognitive performance among the individuals (Laura Weiss Roberts & Shaili Jain, 2014). Poor diagnostic evaluation have resulted in unethical prescriptions of the drugs. It is important for the therapist to evaluate the patient history in order to curb the rising cases of unethical medication. References Clark, D. A., & Beck, A. T. (2011). Cognitive therapy of anxiety disorders: Science and practice. New York: Guilford Press. Doctor, R. M., Kahn, A. P., & Adamec, C. A. (2008). The encyclopedia of phobias, fears, and anxieties. New York: Facts on File. Heimberg, R. G., Turk, C. L., & Mennin, D. S. (2004). Generalized anxiety disorder: Advances in research and practice. New York: Guilford Press. Laura Weiss Roberts, M., & Shaili Jain, M. (2014). Ethical Issues in Psychopharmacology | Psychiatric Times.Psychiatrictimes.com. Retrieved 2 June 2014, from http://www.psychiatrictimes.com/articles/ethical-issues-psychopharmacology Morris, T. L., & March, J. S. (2004). Anxiety disorders in children and adolescents. New York: Guilford Press. Olatunji, B., Deacon, B., & Abramowitz, J. (2009). The cruelest cure? Ethical issues in the implementation of exposure-based treatments. Cognitive And Behavioral Practice, 16(2), 172--180. Read More