Generalized anxiety disorder is a mental disorder in which a person has general, persistent anxiety that is not associated with certain objects or situations. This disease is quite common, according to statistics, every year about 3% of the world's population reveal signs of generalized anxiety disorder: constant nervousness, tremors throughout the body, muscle tension, sweating, tachycardia, dizziness, discomfort and discomfort in the solar plexus area. A person lives with a constant feeling of anxiety, anxiety, fear for himself and for the health of his loved ones, a presentiment of trouble, illness, death.
This mental disorder most often occurs in women and is usually associated with severe traumatic situations or is a consequence of chronic stress. Generalized anxiety disorder has a wavy nature of the course and most often takes on a chronic form.
Causes
There are several reasons for the development of generalized anxiety disorder: chronic alcohol dependence, chronic stress, the presence of panic attacks in patients. It may also be one of the symptoms of depression.
The development of constant anxiety in humans has a neurophysiological mechanism.
A. Beck developed a cognitive theory of the onset of generalized anxiety disorders. He believes that anxiety is a person's response to perceived danger. People who constantly suffer from disturbing thoughts have a distorted reaction to the perception and processing of information, as a result of which they consider themselves powerless in the face of the prevailing life problems. The attention of patients with constant anxiety is selectively directed precisely to the probable danger. On the one hand, this mechanism allows a person to adapt to external circumstances, and on the other hand, anxiety arises constantly and is not controlled by a person. Such reactions and manifestations create a "pathological circle" of the disease.
The patient, as a rule, is not aware of the excessiveness of his fears, but they give the person discomfort, poison his life. A person with generalized anxiety disorder may miss college or stop going to work. This disease is manifested not only in adults; symptoms can occur in children and adolescents. Generalized anxiety disorder in a child can occur because of separation from the mother, unexpected or frightening circumstances, or because adults deliberately bully children "for the purpose of parenting." Children often have a fear of going to kindergarten or school after a frightening situation or conflict with peers or teachers has arisen there.
Risk factors
Clinical manifestations
For a diagnosis of generalized anxiety disorder, a patient must have symptoms of anxiety for several weeks to several months.
Patients with symptoms of this disease look pale, tired, their torso is tense, their eyebrows are frowned and drawn together, their hands and head tremble. When talking, they show autonomic reactions: spilled red spots on the chest, vascular white spots on the upper and lower extremities, sweating of the palms, feet, armpits. The patient is crying and depressed.
Usually, a person cannot articulate exactly what scares him. There is no such area of his life that would not bother him. Students may have a fear of passing exams or an important test, although there are no objective reasons for such a pronounced concern (the student prepared, taught and always has good grades).
A woman with generalized anxiety disorder constantly worries about the life and health of her children, if she returns home and sees an ambulance near the entrance, then she has only one thought that something terrible happened to her child. A woman's consciousness paints a picture of a terrible illness or even death. Arriving home, and making sure that all her close and dear people are alive and well, and the ambulance arrived at the unfamiliar neighbor, a woman can throw out all her emotions and experiences on unsuspecting children. In family life, such people bring discord and constant nervous tension with their violent reactions, anxieties and experiences.
People with generalized anxiety disorder show insufficient emotional involvement in interpersonal contacts and social aspects of life.
A distinguishing feature of patients with symptoms of this disease is that they are excruciated by a state of uncertainty.
Most often, patients do not assess their increased anxiety as a mental disorder and turn to doctors with complaints of problems of the digestive, respiratory, cardiovascular systems, insomnia.
Diagnostics
The psychiatrist examines the patient, collects anamnesis, finds out the hereditary predisposition to mental illness, bad habits (chronic nicotine intoxication, the use of alcohol, drugs, caffeine-containing drinks, drug addiction). In a patient with generalized anxiety disorder, it is necessary to exclude somatic pathology, including thyrotoxicosis. It is also necessary to carry out differential diagnostics with panic attacks and psychopathies, social phobias, hypochondria, obsessive-compulsive disorder, depression.
Increased anxiety requires timely diagnosis and treatment, since it affects the course and prognosis of concomitant somatic pathology.
Therapy
The main goal of the treatment of generalized anxiety disorders is to relieve the main symptoms of the disease - chronic anxiety of the patient, reduce muscle tension, autonomic manifestations and normalize sleep. The main methods of therapy for this disease are psychotherapy and drug treatment. It is necessary to exclude the patient from chronic caffeine intoxication, alcohol consumption, smoking, drug dependence.
The main drugs for the treatment of generalized anxiety disorders are anxiolytics and antidepressants. To eliminate unpleasant symptoms from the cardiovascular system, beta-blockers are prescribed. Drug treatment is prescribed to the patient in the case when the symptoms of increased anxiety do not allow a person to live, study, and work.
Anxiolytics and antidepressants must be prescribed under the supervision of a physician; the dosage must be effective but safe.
Of antidepressants, drugs from the group of selective serotonin reuptake inhibitors (paroxetine), tricyclic antidepressants (imipramine) are mainly prescribed. Very often, drugs from the benzodiazepine group (clonazepam, phenazepam, diazepam, alprozalam) are used in the treatment of generalized anxiety disorders. With prolonged use of these drugs, dependence is formed, the sensitivity of the receptors to them decreases (to achieve a therapeutic effect, an increase in the dose of the drug is required) and side effects appear.
Some patients with symptoms of constant anxiety begin to independently use corvalol and valocardin in the treatment, these drugs contain phenobarbital, you can buy them in the pharmacy without a doctor's prescription. But some time after the use of these drugs, barbitur dependence occurs (one of the most severe forms of drug dependence).
Generalized anxiety disorder is a chronic mental disorder. In most cases, patients complain of constant anxiety, which is not associated with any events or objects, aggravated at night and in the evening. But the disease has many symptoms, it can disguise itself as depression and chronic fatigue.
Pathology has an undulating character - attacks of anxiety and fear recede for a while, then appear again without any provoking factors. If untreated, generalized anxiety disorder becomes chronic and can lead to personality distortion and severe mental syndromes.
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Description of pathology
Generalized anxiety disorder is a mental disorder accompanied by persistent anxiety that is not associated with any objects, events, or people. It can be accompanied by a number of conditions - mental and physical.
Usually, the disorder occurs against the background of constant stress, neurosis, but it also occurs in those people who do not experience constant stressful situations in life.
Anxiety persists for several months, significantly impairing the patient's quality of life. Pathology is almost always combined with other disorders, for example:
- neurosis;
- panic disorder;
- phobia;
- depression;
- obsessive states.
Differences from normal anxiety
Feeling anxious is a normal part of human psychological behavior. The feeling of anxiety and tension accompanies important events, but does not cause pathological changes.
Normal alarm characteristic:
- it does not interfere with everyday life;
- easy to control;
- does not cause severe stress;
- has a clear rationale;
- passes in a short time.
Characteristics of the state of GAD:
- anxiety interferes with work and daily functions;
- not controlled;
- causes panic attacks;
- felt all the time, every day.
At the same time, it is almost impossible to overcome the state of excitement, a person considers only the worst development of any situation and is not able to control his feelings.
Causes
The causes, predispositions and impulses for the development of generalized anxiety disorder are not fully understood. But psychologists have classified the most common characteristics found in patients with GAD.
Internal conflict
According to the first researcher of the psychology of anxiety, Sigmund Freud, the cause of GAD is the conflict between human instincts and the norms of behavior laid down from childhood. Freud's followers supplemented this concept and concluded that the cause was internal conflict. It arises against the background of any threat to the future person or due to chronic failure to meet basic needs.
Features of information perception
A predisposition to GAD is considered to be selective assimilation of information - only that which has a negative character.
If a loved one complains of a headache, a person with anxiety pathology will think about his imminent death, and not about the fact that a pill can be offered to a loved one for a headache and a visit to a doctor is advised.
Character traits
Characteristics are also considered a predisposition to GAD. Anxiety disorder often affects impressionable, vulnerable people who hide their experiences or are unable to express them. GAD is often found in people who have experienced any type of violence: physical, psychological, or sexual.
Long-term poverty, lack of ambition and prospects, unsolvable problems and pressure from society can be a factor contributing to the development of GAD. It is rooted in the dissatisfaction of a basic need: the less financial opportunities, the more a person limits himself and suffers from this.
Parenting mistakes
Most researchers are inclined to believe that anxiety disorder is partly congenital, partly acquired. The tendency to chronic anxiety is further complicated by mistakes in upbringing since childhood:
- constant criticism;
- overstated requirements;
- non-recognition of the child's achievements;
- lack of parental support;
- belittling of dignity.
All of these reasons lead to the fact that a person cannot adapt to difficult situations.
The subconscious mind gives signals that he cannot cope with such a situation, and he worries about his failure and the worst events, not trying to believe in himself. Self-esteem also suffers, because of which a person cannot achieve anything and, as a result, worries about himself even more.
Symptoms
The symptoms of the disease can vary widely. At some time of the day, patients feel better, in the evening, causeless fear and anxiety are exacerbated, interfere with everyday tasks, sleep and even contact with loved ones. Any little thing that the average person does not pay attention to, brings patients with GAD to an anxiety-phobic state.
Emotional
These are the very first symptoms that signal the development of generalized anxiety disorder. Emotional symptoms are characterized by:
- constant nervous excitement, anxiety;
- lack of a clear cause of the problem - the person does not understand what exactly bothers him;
- obsessive thoughts about the worst outcome of any situation;
- increasing fear.
The patient expects terrible events that are unlikely to take place in reality. When viewing the news, the patient sees only the prerequisites for a world war, poverty, disease and death, begins to think about his own fate and the fate of his loved ones.
Behavioral
Behavioral symptomatology develops after the emotional one and is already noted by the people around. Behavioral symptoms:
- inability to relax;
- fear of being alone even for a couple of hours;
- constant postponement;
- avoiding any contact with people.
A person tries to withdraw into himself, but feels the need for someone to be near. Alone, almost all patients immediately develop a panic attack.
Physical
Physical signs appear already in the case of seizures and exacerbations in generalized panic disorder of moderate severity.
Most often, the physical symptoms of GAD occur in people who consider mental disorders demeaning. They do not go to a psychotherapist, considering it shameful, and they try to treat the physical symptoms.
Physical symptoms:
- increased muscle tone;
- body aches;
- difficulty falling asleep;
- daytime sleepiness;
- cardiopalmus;
- excessive sweating;
- disturbances in the digestive tract, nausea;
- headache.
The state of mind at the time of seizures significantly worsens physical well-being. Individual symptoms are also not excluded, since each person's response to stress can be different: increased appetite or weight loss, hand tremors, difficulty breathing.
The genitourinary system responds with symptoms such as a decrease in libido, a violation of the menstrual cycle, and the disappearance of an erection. Physical disorders come to the fore and force patients to seek help from specialists of different profiles.
Diagnostics
The diagnosis is carried out by a psychotherapist. Usually, the Spielberger anxiety scale is used for this, according to which the specialist determines the psychoemotional state in adults. Symptoms for diagnosis must be followed for at least a week - long-term emotional disturbances characterize GAD. Symptoms of reactive depression may appear and then disappear again - in this case, GAD cannot be ruled out and depression diagnosed.
For diagnosis, the following studies are assigned:
- general analyzes;
- examinations of the cardiovascular system;
- consultations with a urologist, sex therapist;
- consultation and examination by an endocrinologist.
These measures make it possible to exclude the organic causes of the disease and differentiate generalized anxiety disorder from diseases of the internal organs.
Treatment methods
To get rid of obsessive anxiety, both psychotherapy methods and drug treatment tactics are used.
The choice of the method depends on the severity of the course of the disease, the characteristics of the character, personality and body of the patient.
Cognitive Behavioral Psychotherapy
Aimed at identifying misconceptions in human values and correcting them. They prevent a person with GAD from perceiving information rationally, therefore, in different ways, cognitive-behavioral psychotherapy is replaced by more adaptive and adequate ones.
The patterns of catastrophization - the constant representation of the worst development of events and their consequences - are eliminated. An example of such a pattern is a situation when a person leaves the house and is sure that he will lose consciousness on the roadway or get into a car accident.
Mindfulness method
This technique is applicable both at home and under the supervision of a specialist. It helps to cope with the situation and reduce inner feelings thanks to a simple principle: allow yourself to worry, but consider the reasons for these feelings.
If a friend is late for an appointment, the person with GAD will pretend that the late person had an accident or had a heart attack along the way. You should not try to relieve the alarm, just ask yourself: how often is he late, does he have heart problems, does he drive carefully? Answering these questions, the patient is not only distracted from focusing on anxiety, but also realizes that it is unfounded.
Imaginary method
This technique is used only under the supervision of a specialist and is situational. The patient shares his strongest fears and thoughts that cause panic and anxiety, describes the situations in which he feels the greatest fear. The psychotherapist is interested in what a person thinks during anxiety attacks.
After collecting information, the therapist helps to look at the situation in a different way and respond to it correctly. Situational correction is recorded on a dictaphone and listened to at home by the patient, facilitating his condition.
Suggestion and hypnosis
Hypnosis is used to focus on the most important information that the therapist gives. With its help, the specialist instills in a person more adaptive, adequate beliefs and the ability to assess the situation.
The advantage of the method is that it allows you to remove obsessive anxiety for a long time, if not forever, since it builds new beliefs not only on the level of the conscious, but also the unconscious.
Group, family treatment
Psychotherapy in the family circle allows the patient not to be afraid of his thoughts and share them simultaneously with a specialist and with his relatives, since usually these thoughts are hidden from them.
A person's relatives learn to properly support him during anxiety attacks, and the patient himself stops hiding his feelings and thoughts, his fears, thereby allowing himself to rethink them together with loved ones.
Drug therapy
As part of a comprehensive treatment, drugs can also be prescribed to overcome the physical and behavioral symptoms of generalized anxiety disorder.
Drugs for the treatment of GAD:
- anxiolytics: Bromazepam, Diazepam;
- antidepressants: Clomipramine, Miaser, Tianeptine;
- medications: Sedasen, Gelarium Hypericum.
Only a qualified specialist should prescribe drugs. Self-administration of pills can worsen the health condition.
In the early stages of anxiety disorder, when anxiety develops frequently but is still controlled, home remedies can be effective. Psychotherapists give the following advice:
- To add variety to your life - to do something new at your leisure, visit old friends, the places where you spent your childhood.
- Try to let go of the situation and convince yourself that gloomy thoughts attract similarly gloomy events.
Generalized anxiety disorder (F41.1) is a mental disorder characterized by persistent anxiety against a background of everyday events in daily life and accompanied by recurrent restlessness, muscle tension, symptoms of anxiety and suspicion.
Prevalence: 7% in the adult population. Women suffer 2 times more often than men. Generalized anxiety disorder is more likely to appear during childhood or adolescence, but it can develop into adulthood.
Predisposing factors: genetic predisposition (cases of similar diseases in relatives), psychological trauma and stress, drug use and alcohol abuse.
Clinical picture
Patients have long-term anxiety and fears that are difficult to control. Motor tension may also manifest (expressed in the form of muscle tension in the muscles of the back and shoulder girdle, tremor, inability to relax, headache). Some patients develop hyperactivity of the autonomic nervous system (increased sweating, increased heart rate, dry mouth, epigastric discomfort, dizziness). There may also be irritability, impaired concentration. In the case of generalized anxiety disorder, patients may complain of sleep disturbance.
On external examination, a tense face with frowning eyebrows, a tense posture / anxiety, trembling all over the body, and tearfulness may attract attention. The skin is often pale, distal hyperhidrosis is noted.
The presence of persistent anxiety (at least 6 months), generalized (expressed anxiety, anticipation of troubles and problems), unfixed (not limited to certain circumstances) are the criteria for making a diagnosis.
Diagnosis of Generalized Anxiety Disorder
- Conducting general clinical laboratory blood and urine tests, instrumental research methods to exclude somatic pathology.
- Neuropsychological testing.
Differential diagnosis:
- Organic mental disorder.
- Obsessive-compulsive disorder.
- Endocrine diseases (hyperthyroidism, hypoglycemia, pheochromocytoma).
Treatment for Generalized Anxiety Disorder
- Drug therapy (benzodiazepines, antidepressants).
- Cognitive Behavioral Therapy.
- Relaxation techniques.
- Breathing exercises.
- Biofeedback.
Treatment is prescribed only after the diagnosis has been confirmed by a specialist doctor.
Essential drugs
There are contraindications. Consultation of a specialist is required.
- (antidepressant). Dosage regimen: inside, in the morning at a starting dose of 20 mg 1 time per day.
- Venlafaxine (antidepressant). Dosage regimen: inside, with meals, at an initial dose of 37.5 mg once a day.
- Imipramine (antidepressant). Dosage regimen: inside, 25-50 mg 3-4 times / day. Within 10-14 days, the dose is gradually increased to 150-250 mg per day, after achieving the effect, it is gradually reduced to a maintenance dose of 50-150 mg.
- Buspirone (anxiolytic). Dosage regimen: inside, at an initial dose of 5 mg 2 or 3 times a day. If necessary, it can be increased by 5 mg every 2-3 days. The average daily dose is 20-30 mg. The maximum single dose is 30 mg, the daily dose is 60 mg.
Symptoms
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Generalized anxiety disorder (GAD) is a mental disorder characterized by general persistent anxiety that is not associated with certain objects or situations.
Causes of occurrence
The cognitive theory of the origin of generalized anxiety disorder, developed by A. Beck, interprets anxiety as a reaction to perceived danger. Persons prone to the development of anxious reactions show a persistent distortion of the process of perception and processing of information, as a result of which they consider themselves unable to cope with the threat and control the environment. The attention of anxious patients is selectively directed precisely at the possible danger. Patients with this disease, on the one hand, are firmly convinced that anxiety is a kind of effective mechanism that allows them to adapt to the situation, and on the other hand, they regard their anxiety as uncontrollable and dangerous. This combination, as it were, closes the “vicious circle” of constant worry.
Generalized Anxiety Disorder Symptoms
Generalized anxiety disorder (GAD) is characterized by anxiety:
- persistent (period of at least six months);
- generalized (pronounced tension, anxiety and a sense of impending troubles in everyday events and problems; various fears, worries, forebodings);
- non-fixed (not limited to any specific circumstances).
There are 3 characteristic groups of symptoms of generalized anxiety disorder:
- Anxiety or apprehension that is difficult for the patient to control and that lasts longer than usual. This anxiety is generalized and does not focus on specific issues, such as the possibility of an anxiety attack (as in panic disorder), being stranded (as in social phobia), or contaminated (in obsessive-compulsive disorder).
- Motor tension, which can manifest itself in muscle tension, tremors, inability to relax, headache (usually bilateral and often in the frontal and occipital regions).
- Hyperactivity of the autonomic nervous system, which is expressed by increased sweating, tachycardia, dry mouth, epigastric discomfort and dizziness.
Other mental symptoms of generalized anxiety disorder are irritability, poor concentration, and sensitivity to noise. Some patients, when tested for their ability to concentrate, complain of poor memory. If memory impairment is indeed detected, then a thorough psychological examination must be carried out to exclude a primary organic mental disorder.
Other motor symptoms are aching muscle pain and muscle stiffness, especially in the back and shoulder region.
Vegetative symptoms can be grouped by functional system as follows:
Diagnostics
The patient should have primary symptoms of anxiety most days for a period of at least several weeks in a row, and usually several months. These symptoms usually include:
- fears (anxiety about future failures, a feeling of excitement, difficulty concentrating, etc.);
- motor tension (fussiness, tension headaches, tremors, inability to relax);
- vegetative hyperactivity (sweating, tachycardia or tachypnea, epigastric discomfort, dizziness, dry mouth, etc.)
Children may have a pronounced need to be sedated and recurrent somatic complaints.
The transient appearance (for several days) of other symptoms, especially depression, does not exclude generalized anxiety disorder as the main diagnosis, but the patient should not meet the full criteria for a depressive episode, phobic anxiety disorder, panic disorder, or obsessive-compulsive disorder.
Patient actions
If you experience the symptoms described above, you should consult a psychiatrist. For effective treatment of GAD, it is important to identify the disease as early as possible, as this can reduce the risk of severe psychological complications.
Treatment for Generalized Anxiety Disorder
The goal of treatment for generalized anxiety disorder is to eliminate the main symptoms - chronic anxiety, muscle tension, autonomic hyperactivation, and sleep disturbances. Therapy should begin with explaining to the patient that the physical and mental symptoms he has are a manifestation of increased anxiety and that anxiety itself is not a "natural response to stress", but a painful condition that can be successfully treated. The main treatments for generalized anxiety disorder are psychotherapy (primarily cognitive-behavioral and relaxation techniques) and drug therapy. For treatment, antidepressants from the SNRI group are usually prescribed; if unresponsive to this therapy, the addition of atypical antipsychotics may help.
Complications
There is a risk of severe psychological complications.
Prevention of Generalized Anxiety Disorder
It is almost impossible to prevent the development of generalized anxiety disorder, but there are some fairly simple tips, adherence to which will help reduce the risk of developing the disease. First of all, it is recommended to minimize the consumption of caffeine-rich foods, among which are cola, tea, coffee and chocolate. Before taking the medicine, be sure to study the annotation on it. The fact is that some drugs contain substances that increase the level of anxiety. It is also recommended that you exercise regularly and eat balanced, healthy foods. After severe stress, you should not neglect the help of specialized psychotherapeutic consultations. Relaxation methods such as meditation or yoga are quite effective in combating anxiety disorders.
Generalized anxiety disorder (synonyms: GAD, anxiety neurosis, anxiety reaction, anxiety state) is a mental pathology caused by chronic persistent anxiety, which does not depend in any way on the patient's living conditions and is not associated with a specific situation surrounding him.
All the signs of classic anxiety are inherent in anxiety neurosis: constant nervousness, persecution mania, tachycardia, diarrhea, excessive sweating, increased muscle tone of skeletal muscles, dizziness, uncomfortable feeling in the solar plexus area. Patients often develop an overwhelming fear of their own illness, death, including for their loved ones.
GAD is one of the most common conditions, the disorder is observed in 3-5% of the population, and the female part is susceptible to this pathology 2 times more often.
With regard to age categories, generalized anxiety disorder is more common in childhood or adolescence, and in adults who have suffered from the disorder in childhood, relapses are very frequent, when manifestations of neurosis persist throughout life.
Etiology of Anxiety Disorders
Modern psychiatrists have developed several models to explain the onset and further development of the disorder in patients.
- Sociocultural model. The modern world is dynamic, diverse and cruel, not every person is able to adapt to it and take his place without humiliating his own dignity. According to the sociocultural model, people who believe that they live or often find themselves in conditions that are dangerous to their health and life are susceptible to generalized anxiety disorder.
- Psychodynamic model. An anxious state arises at the peak of the depletion of the protective mental forces of the body, which, under the influence of constant stress and moral anxiety, do not withstand, and a person begins to perceive the world around him too subjectively.
- Humanistic model. A person gives up under the onslaught of the problems and adversities of those around him. The patient believes that his physical strength and health are no longer enough to provide himself with an independent state, the phenomenon of self-denial arises.
- Existential model. Panic fear of the imminent end of the life cycle leads to a reassessment of life values, the calculation of the remaining days before death and emotional experience based on a sense of unfulfilled duty and previously set tasks.
- Cognitive model. A psychopathological disorder based on a displacement of logical thinking due to any dysfunctions in the brain (clouding of consciousness).
Symptoms of anxiety disorder
For GAD, anxiety will be a mandatory symptom, which is characterized by the following symptoms:
- Persistence. The anxiety state lasts at least six months and periodically changes its tension, sometimes increasing, then weakening.
- Generalization. The causes of anxiety are necessarily localized, acquiring a completely laconic look. The patient can always specifically say what he fears or is afraid of panic.
- Non-fixedness. The feeling of anxiety does not in any way depend on the surrounding circumstances, the strength and number of stimuli - it arises spontaneously and for no reason, regardless of the time of year and day.
Common symptoms of anxiety disorder can be divided into three characteristic groups:
- Mental manifestations, expressed in difficult to control long-term phenomena of anxiety and fear. This type of anxiety is clearly generalized by the specifics of the reasons.
- Musculo-motor tension, pronounced in tremors, convulsive manifestations, inability to relax, often with the presence of headaches in the frontal and occipital regions.
- Hyperactivity of the autonomic nervous system, which is characterized by increased sweating, increased heart rate, hyposalivation (decreased salivation), a pressing condition in the solar plexus region and dizziness.
The manifestation of symptoms of GAD of the third group most often occurs before the age of 5 years and often degenerates into a separate disease - in children.
Hypererkinetic disorder of conduct in children is characterized by a lack of perseverance, persistence in cognitive activity. The child often proceeds to the next task without completing the first, as a result, without completing any of them. Children with this disorder exhibit excessive but unproductive activity.
In modern psychiatry, 22 symptoms of generalized anxiety are clearly identified; it is believed that if a patient has at least four of them, then there is every reason to diagnose GAD. Thanks to this list of symptoms, the genesis of anxiety disorder can be successfully localized:
Vegetative symptoms:
- tachycardia,
- increased sweating,
- muscle tremors (eyelid twitching, shaking hands)
- dry mouth, saliva viscosity.
Respiratory and Digestive System Symptoms:
- dyspnea,
- chronic lack of air
- regular pain and heaviness behind the breastbone, recurring at the same time of day,
- nausea, burning, or stomach pain.
Psychosomatic symptoms:
- dizziness, body instability when standing, fainting,
- derealization of surrounding objects, the patient has a clear feeling that he sees himself from the outside,
- fear of loss of self-control or loss of mind,
- fear of imminent death.
Common symptoms:
- feeling fever or chills
- numbness of some parts of the body, more often - asymmetric, "goosebumps".
Stress symptoms:
- increased skeletal muscle tone,
- inability to relax
- a chronic feeling of mental stress,
- difficulty swallowing.
Other symptoms:
- hyperreactivity to unexpected situations or fear,
- inability to concentrate, mental activity,
- chronic irritability
- insomnia, complete or partial.
The next grouping of GAD symptoms is based on the division according to the functional systems of the body. This approach allows you to choose the correct symptomatic treatment for generalized anxiety disorder:
- gastrointestinal symptoms: dry mouth, difficulty swallowing, pain in the stomach area, flatulence (excessive gas production), loud and frequent sounds of intestinal motility,
- respiratory symptoms: feeling of pressure in the chest, respiratory shortness of breath,
- cardiovascular symptoms: false angina pectoris, tachycardia, a feeling of no heartbeat, heart rate echoes in the ears,
- urogenital symptoms: polyuria (increased urination, impotence, decreased sexual desire, menstrual dysfunction),
- symptoms of the nervous system: inability to maintain a static position of the body in space, blurred vision, dizziness, head twitching.
Unaware of the development of GAD, patients will always complain of any of the above symptoms, believing that they are developing heart disease, digestive system or migraine.
Sleep disturbances are a very common symptom in generalized anxiety. Falling asleep is always very difficult, sleep is superficial, short-term, more reminiscent of oblivion, a dip into emptiness that does not bring rest. Dreams are unpleasant, nightmarish, difficult to remember.
Outwardly, patients look tense, cautious, and sensitive to any change in the situation. The color of the skin is pale with a gray tinge. Excessive sweating at optimal ambient temperatures, especially in the armpits, feet and palms. Many patients have increased tearfulness.
Fatigue, a tendency to depression, a feeling of hopelessness and loss of one's ego are the next set of symptoms inherent in GAD, which complicates the differential diagnosis of anxiety disorder from depressive neurosis.
Differential diagnosis of GAD
To clarify the diagnosis of generalized anxiety disorder, the following pathologies with similar clinical signs should be excluded:
- diseases of somatic origin: hyperthyreidism, diabetes mellitus, pheochromocytoma. With dysfunctions of thyroid etiology, there are symptoms of an enlarged thyroid gland, atrial fibrillation, exophthalmos. Hypoglycemia and pheochromocytoma are suggested if anxiety occurs sporadically for no apparent reason. Oncological pathology is also accompanied by a state of increased anxiety, which is explained by the shock state of patients, especially in cases where their relatives died for this reason,
- a mental disorder at the level of organic damage to the central nervous system or as a result of the use of psychoactive substances, for example, amphetamine-like drugs. Alcohol or drug addiction is expressed by anxiety, which is more characteristic of the morning time of the day,
- panic disorder
- phobias,
- hypochondriacal disorder
- the classic manifestation of schizophrenia, the starting symptom of which, in the debut phase, is a feeling of anxiety,
- depressive state.
Key areas of treatment for generalized anxiety disorder
With the exception of the cognitive model of the onset of the disorder, the use of drugs for the treatment of GAD in the early stages of treatment is not recommended. In such cases, primary psychoanalysis is shown at the reception of a psychotherapist, which in 60% of cases gives a positive result.
If the analytical technique does not provide the desired therapeutic effect, it is advisable to use drug therapy in the following cases:
- first aid for overwhelming fear - benzodiazepine tranquilizers. Used carefully for no more than two months due to the possibility of addiction,
- for sleep dysfunctions, hypnotics are used in combination with sedatives,
- as symptomatic therapy with pronounced signs of vegetative manifestations - beta-blockers,
- antipsychotics are used for severe anxiety associated with aggressive behavior towards oneself or others.
On average, in half of patients, the prognosis for generalized anxiety disorder is favorable, provided that adequate therapy, corresponding to a specific etiology, has been carried out. In the second half, GAD very often transforms into depressive psychosis, which makes it possible to determine the prognosis as cautious. The effectiveness of therapy and the level of predictability in such a disorder can be determined only in the last stages of treatment. It should also not be forgotten that the propensity to relapse in GAD is relatively high.
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