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Generalized Anxiety Disorder, Counseling Available in Broken Arrow, Tulsa County

By Alina Morrow, LPC

Disclaimer: The article below is for informational purposes only and should not be considered as direct advice, a personal diagnosis, or as an individual treatment plan. Always consult with a mental health professional or medical doctor if you have concerns.

Introduction & Overview

Generalized anxiety disorder (GAD) is an anxiety disorder characterized by an excessive or unrealistic anxiety and worry over multiple life circumstances accompanied by involuntary hyperactivity, motor tension, vigilance and scanning (Borkovec and Inz). Anxiety is a normal emotional and physical response to stressful, dangerous or threatening situations or events with a beneficial effect in every day life. It helps the individual to be motivated and appropriately respond to danger.

In normal situations, anxiety is triggered by real situations and events, and it represents a natural and realistic reaction.

Therefore, when anxiety develops spontaneously in the absence of immediate or future stressful, dangerous, or threatening events, and it becomes excessive and persistent enough to affect the individual's ability to function normally, the person is suffering from a psychological disorder called generalized anxiety disorder.

There are several criteria that has to be met in order for a generalized anxiety disorder diagnosis to be established:

1. Excessive anxiety and worry occurs at least 4 days out of 7 for at least 6 months.
2. The individual cannot control the worry.
3. Excessive anxiety and worry are associated with at least three of the following symptoms:

(1) restlessness or feeling keyed up or on edge,
(2) being easily fatigued,
(3) difficulty concentrating or mind going blank,

4. irritability,
5. muscle tension, and
6. sleep disturbance.

Generalized anxiety disorder is characterized by excessive anxiety and worry usually over future events, the person predicts that something bad is about to happen and he and she cannot control it. The person is constantly tormented by the unpredictable and uncontrollable nature of the distressful events and by his or hers inability to control them.

According to the National Institute of Mental Health, people suffering from generalized anxiety disorder anticipate disaster and are overly concerned about health issues, money, family problems, and work, since they are unable to stop worrying. Among children and adolescents, anxiety and worry is focused on the quality of their performance or competence in school or sport events whether or not their performance is being evaluated by others. Children that suffer from this disorder are usually over conforming, perfectionist, unsure of themselves, and tend to redo tasks due to their excessive dissatisfaction with a “less-than-perfect performance." They display an overzealous need to receive approval and seek excessive reassurance about their performance and other worries.

People that suffer from generalized anxiety disorder also develop a set of beliefs about worry. Worrying becomes a coping strategy. Worrying is believed to prevent future bad events from happening. This leads to the impossibility of effectively solving potential problems. Those that suffer from generalized anxiety disorder are caught in a vicious cycle of exaggerated worry and physical distress that lead to dysfunctional, maladaptive coping skills that cause more worrying.

Generalized anxiety disorder can affect every aspect of a person’s life from the social life and work setting to the family life. According to the Anxiety Disorder Association of America (ADAA), seven out of ten people that suffer from generalized anxiety disorder have their relationship with their spouse or other significant person in their life affected by the chronic anxiety, while two thirds reported that the disorder has a negative impact on their friendships.

Generalized anxiety disorder prevalence among the U.S. population age 18 to 54 is about 2.8 percent (four million). The lifetime prevalence is about 5 percent. This disorder affects women more often than men. Most of those that suffer from generalized anxiety disorder report that they felt anxious and nervous all their lives. The average onset age is around the age of 20.

Those that suffer from generalized anxiety disorder develop co-occurring disorders. More than half suffer from a mood disorder (usually depression), while others develop other anxiety disorders or addictions.

Studies suggest that individuals that develop generalized anxiety disorder might have a biological predisposition to be anxious. However, the actual disorder may develop when a biologically prone person experiences an environment characterized by unpredictability and lack of control (such as dysfunctional families where there are aggressive behaviors, abuse, or substance abuse related problems).

Signs & Symptoms

Generalized anxiety disorder symptoms can be divided in three categories:

1. Psychological symptoms, which include the following:

- Excessive anxiety and chronic worry about events that are not likely to occur.
- Inability to control and stop the anxious thoughts.
- Feelings of dread (fearful expectation or anticipation).
- Restlessness and inability to relax.
- Feeling of being keyed up or on edge.

2. Physical symptoms, which include the following:

- Lack of energy.
- Muscle tension accompanied by trembling, twitching, feeling shaky, muscle aches or soreness.
- Stomach problem such as nausea or diarrhea.
- Sweating or hot flashes.
- Headaches, chest or muscle pains.
- Grinding the teeth or dry mouth.
- Dizziness or lightheadedness.
- Accelerated heart rate or shortness of breath.

3. Behavioral symptoms, which include the following:

- Difficulties concentrating.
- Impatience.
- Difficulties falling asleep or staying asleep.
- Irritability.
- Exaggerated startle.

Counseling & Treatment Options

Generalized anxiety disorder is a debilitating condition due to the chronic worry and exaggerated anxiety that requires treatment. The treatment option available include psychotherapy and medication, usually administrated in combination for a better outcome.

I. Psychotherapy, includes three options that have proven to be effective:

  1. Behavioral Therapy
  2. Cognitive Therapy
  3. Cognitive Behavioral Therapy

Behavioral therapy is a form of psychotherapy that focuses on modifying or “unlearning” those maladaptive behaviors that cause psychological discomfort.

Behavioral therapy uses two major approaches:

1. various relaxation techniques to change the anxiety-causing behaviors and

2. exposure techniques that gradually expose the person to situations that cause anxiety by forcing the person to cope with the fear.

Cognitive therapy is a form of psychotherapy that focuses on changing peoples’ unproductive and inaccurate beliefs which are the main source of psychological problems.

There are two cognitive therapy approaches effective in treating generalized anxiety disorder:

1. cognitive restructuring techniques that focuses on altering the dysfunctional thinking pattern that leads to excessive worry and

2. relaxation training that focuses on reducing the physical over arousal state that maintains the worry process and psychosomatic symptoms associated with the disorder (gastrointestinal distress, sleeplessness, fatigue, breathing problems).

Cognitive-behavioral therapy is one of the most effective psychotherapies in the treatment of generalized anxiety disorder. This type of therapy considers that our thoughts and not the external situations, people or events, trigger the behavior and feelings. The benefit of this perspective is that a person can change the way he or she thinks and further the way he or she feels and acts when the situations, other people or events do not change. This form of therapy combines methods from behavioral and cognitive therapies for a better outcome.

Cognitive-behavioral therapy for generalized anxiety disorder focuses on re-training the way the person thinks. This is possible if following several essential steps:

Education, step where the therapist explains the cognitive, emotional, and behavioral processes involved in anxiety.

Monitoring, step where the person who suffer from GAD learns to monitor his or her anxiety by identifying the triggers, conditions when anxiety occurs, the specific things that make the object of worry, and the severity and length of the anxiety episodes.

Physical control strategies, step when the person that suffers from GAD is taught how to relax and decrease the physical over arousal that maintain the fear and anxiety.

Psychological control strategies, step where the person is taught to realistically evaluate and modify thinking patterns that trigger and help maintain the fear.

Behavioral strategies, step where the person is encouraged to face those situations that cause him fear and anxiety. This step can be first tried by imagination and in some cases even in reality.

II. Medication is another treatment option available for those that suffer from generalized anxiety disorder. There are three main types of medication prescribed for people that suffer from generalized anxiety disorder:

Selective serotonin reuptake inhibitors (SSRIs), which includes: fluoxetine, sertraline, paroxetine, venlafaxine, is a group of antidepressants that correct the serotonin imbalance by blocking the reuptake of the serotonin from the synapse to the nerve and artificially increasing the serotonin that is available in the synapse. This type of medication reduces the generalized anxiety disorder symptoms and the depressed symptoms, common among those that suffer from this disorder.

Tricyclic antidepressant seems to be as effective as the new antidepressants, but are rarely prescribed due to their uncomfortable side effects (dizziness, drowsiness, dry mouth, and weight gain).

High-potency anti-anxiety medications includes two different medications, both targeting only the anxiety symptoms:

1. Benzodiazepines, such as Xanax and Valium. This type of anxiety medication works fast (usually within 30 minutes to an hour after administration) and have few side effects. However, the main disadvantage is that taken for a long period of time, it can become addictive. This medication is usually prescribed in severe forms of anxiety.

2. Buspirone, such as Buspar. This medication needs to be taken for at least two weeks in order to start working and is consider safe for chronic forms of anxiety. However, this medication improves the symptoms, but will not completely eliminate anxiety.

See Also: Social Anxiety Disorder, and Separation Anxiety Disorder

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Are you suffering with anxiety? Do you want to get help? Contact Tulsa Therapist Alina Morrow, LPC, today to make an appointment and get the help and relief you deserve. You can reach me by texting or calling 918-403-8873 or by Email.

Page Last Modified: October 30, 2016

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