Generalised Anxiety Disorder

‘Now on the 5th of April 2018, and the 9th off August 2018. As well as the 12th of September and the 31st of October. I was diagnosed by my GP as having this mental Health condition. Which sometimes rears its ugly head, while I try to go about my everyday routine. As per normal. At present it’s not intensely prevalent, but has been more so in the past. After seeking a brief time of therapeutic intervention currently, then I may edit this. (Which I acknowledge isn’t typical of publishing of blogs)’

Below is a medical/clinical description of the condition, for your perusal:

“Generalised anxiety disorder is one of the most common anxiety disorders

Generalised anxiety disorder (GAD) is one of the most common anxiety disorders seen in primary care.7 It is characterised by excessive and inappropriate worrying that causes significant distress or impairment. Recovery from GAD can be less likely than recovery from major depression.1

Diagnosis of generalised anxiety disorderThe DSM-IV diagnostic criteria are used for a formal diagnosis of GAD (see sidebar). The Generalised Anxiety Disorder Scale (GAD7, Figure 2) can be used to assess severity.

Anxiety and depression often coexist

Approximately 35 to 50% of people with major depression also meet the criteria for GAD.9 When there is a diagnosis of both depression and anxiety, or if depression follows an anxiety disorder, this usually indicates a more severe anxiety disorder with a poorer prognosis.1 If anxiety symptoms arise as a consequence of depression, effective treatment of the depression will often relieve the anxiety symptoms.1

Suicide risk

Anxiety disorders are associated with a significantly increased risk of suicidal behaviour. Rates of suicide and suicide attempts are reported as being ten times higher in people with anxiety disorders, than in the general population. Co-existing mental disorders further increase this risk.6

Treating generalised anxiety disorder

Treatment is indicated for most people with GAD. Less intensive interventions are required for those with fewer or less severe symptoms.

The decision whether to treat may be based on:1▪ Severity and persistence of symptoms

▪ Level of disability and impact on social functioning▪ Co-existing mental or physical disorders
▪ Current medications

Which treatment?

Treatment of GAD may involve psychological therapy, drug therapy or a combination of both. Psychological and drug therapies are equally effective in the treatment of GAD. However the relapse rate for psychological therapies may be lower.10 It is recommended that initially, either psychological or drug therapy are used alone as there is no evidence that using them together is more effective.10

Several factors determine which treatment is chosen:5, 6,10

▪ Patient’s preference and motivation
▪ Patient’s response to any previous treatments▪ Availability and cost of psychological therapy

▪ Patient’s ability to engage in treatment (e.g. certain cognitive-behavioural therapies may be unsuitable for patients with significant cognitive impairment)

▪ Adverse drug effects▪ Onset of efficacy

Psychological therapies for generalised anxiety disorder

A wide range of behavioural and problem solving psychological approaches can be effective for patients with anxiety disorders.11 Cognitive behavioural therapy (CBT) is the most widely used and may be useful for some patients with GAD.6, 7, 10

22 | BPJ | Issue 25

DSM-IV diagnostic criteria for GAD

  1. Excessive anxiety and worry about a number of events or activities, occurring more days than not for at least six months, that are out of proportion to the likelihood or impact of feared events.
  2. The worry is pervasive and difficult to control
  3. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past six months):
    • ▪  Restlessness or feeling keyed up or on edge
    • ▪  Being easily fatigued

4.

▪ Difficulty concentrating or mind going blank

▪ Irritability

▪ Muscle tension

▪ Sleep disturbance (difficulty falling or staying asleep or restless unsatisfying sleep)

The anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.”

Source: https://mentalhealth.org.nz/assests/A-Z/Downloads

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