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Anxiety Disorder Generalized - Causes, Symptoms And Treatment

Anxiety is a feeling of apprehension that some describe as an exaggerated feeling of impending doom, dread, or uneasiness. Unlike fear - a reaction to danger from a specific external source - anxiety is a reaction to an internal threat, such as an unacceptable impulse or a repressed thought that's straining to reach a conscious level.

A rational response to a real threat, occasional anxiety is a normal part of life. Overwhelming anxiety, however, can result in generalized anxiety disorder - uncontrollable, unreasonable worry that persists for at least 6 months and narrows perceptions or interferes with normal functioning. Recent evidence indicates that the prevalence of generalized anxiety disorder is greater than previously thought and may be even greater than that of depression. Generalized anxiety disorder can begin at any age but typically has an onset between ages 20 and 39. Anxiety disorder affects about 4 million Americans and about twice as many women than men.

Causes of anxiety disorder generalized

Theorists share a common premise about generalized anxiety disorder:Conflict, whether intrapsychic, social personal, or interpersonal, promotes an anxiety state.

Signs and symptoms of anxiety disorder generalized

Psychological or physiologic symptoms of anxiety states vary with the degree of anxiety. Mild anxiety mainly causes psychological symptoms, with unusual self-awareness and alertness to the environment. Moderate anxiety leads to selective inattention but with the ability to concentrate on a single task. Severe anxiety causes an inability to concentrate on more than scattered details of a task. A panic state with acute anxiety causes a complete loss of concentration, commonly with unintelligible speech.

Physical examination of the patient with generalized anxiety disorder may reveal signs or symptoms of motor tension, including trembling,muscle aches and spasms, headaches, and an inability to relax. Autonomic signs and symptoms include shortness of breath, tachycardia, sweating, and abdominal complaints.

In addition, the patient may startle easily and complain of feeling apprehensive, fearful, or angry. She may also experience difficulty concentrating, eating, and sleeping. Medical, psychiatric, and psychosocial histories of a patient with generalized anxiety disorder fail to identify a specific physical or environmental cause of the anxiety.

Laboratory tests must rule out organic causes of the patient's signs and symptoms, such as hyperthyroidism. pheochromocytoma, coronary artery disease, supraventricular tachycardia, and Meniere's disease. For example, an electrocardiogram can rule out myocardial ischemia in a patient who complains of chest pain. Blood tests, including complete blood count, white blood cell count and differential, and serum lactate and calcium levels, can rule out hypocalcemia.

Because anxiety is the central feature of other mental disorders, psychiatric evaluation must rule out phobias, obsessive-compulsive disorders, depression, and acute schizophrenia.

Treatment anxiety disorder generalized

A combination of drug therapy and psychotherapy may help a patient with generalized anxiety disorder. Benzodiazepines, such as clonazepam and alprazolam, may relieve mild anxiety and improve the patient's ability to cope.

Antidepressants, such as venlafaxine or higher doses of short-acting benzodiazepines, may relieve the patient of severe anxiety and panic attacks. Antihistamines and sedatives medication may also be prescribed. which may pose less risk of physical and psychological dependence than benzodiazepines.

Psychotherapy for generalized anxiety disorder has two goals: helping the patient identify and deal with the cause of the anxiety, and eliminating environmental factors that precipitate an anxious reaction.



The patient can learn relaxation techniques, such as deep breathing, progressive muscle relaxation, focused relaxation, and visualization.


Special considerations

  • Stay with tIle patient when she's anxious, and encourage her to discuss her feelings. Reduce environmental stimuli and remain calm. Additionally, tell the patient to avoid or reduce caffeine intake and other stimulants.
  • Administer anti anxiety drugs or antidepressants, and evaluate the patient's response. Teach the patient about prescribed medications, including the need for compliance with the medication regimen. Review adverse reactions.

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