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Cognitive Behavioral Treatment of Generalized Anxiety Disorder

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Generalized Anxiety Disorder -- Overview and Case History

Case study: "i can't stop my head": the case of the persistent worrier, psychiatric and medical history.

Nancy L., a 45-year-old married lawyer, presented with exacerbation of her chronic generalized anxiety and recurrent depressive symptoms in January 2005.

Nancy had a history of anxiety dating back "as far as I can remember." She was an anxious young girl with separation anxiety and shyness that manifested in elementary school. As she grew up, she experienced ongoing anxieties about the health of her parents (worrying that her parents would die, even though they were in good health) and her school performance (though she was a good student). She remembers marked fears, including fears of the dark and thunder, most of which she "outgrew" except for a persistent fear of insects, particularly spiders.

Her anxiety became more prominent and persistent after she left home at age 18 and entered college. She sought care at the university health service and received a prescription for diazepam that she used over the next 4 years on an as-needed basis during periods of increased anxiety such as examinations; she also met episodically with a therapist at the counseling center. In the spring of her freshman year, she experienced her first major depressive episode following a break-up with a boyfriend. She was prescribed imipramine, which she took for a couple of months but then discontinued because of intolerable side effects (dry mouth and lightheadedness). The depression gradually resolved over the next 6 months.

Nancy continued to be plagued by persistent feelings of anxiety and worry associated with insomnia, irritability, tension, and fatigue. Over the years, her friends and family chided her for "worrying too much," and she reported difficulty controlling her anxiety over her financial situation, job security, and her children's safety, despite evidence that none of these were problematic. Her husband reported that he found her persistent anxiety and ongoing need for reassurance "exhausting" and that he noticed himself withdrawing from her, which led to significant tension between them. The high quality of her work at the law firm was recognized and she was well-compensated financially, yet she continued to worry about her performance and was, in fact, passed over for promotion to team leader because, as one of her annual reviews stated, her "constant anxiety makes everyone else too nervous." In addition, over the last 25 years, she has had 5 or 6 episodes of major depression lasting from 3 to 4 months to over a year. These episodes have sometimes, but not always, been triggered by situational stressors; one occurred during a postpartum period.

After college, she was treated intermittently with benzodiazepines at low doses (eg, diazepam 5-10 mg), which she took on an as-needed rather than daily basis when the anxiety worsened because of her concerns about addiction. As noted, she was briefly on imipramine during college but discontinued it because of side effects. About 10 years before the January 2005 examination, she was started on fluoxetine 20 mg/day by her primary care doctor. She discontinued it after a few days because it made her feel jittery and more anxious. She had been in supportive therapy on and off since college to help her deal with situational stressors.

Other relevant aspects of her medical and psychiatric history include the fact that her overall health had been generally good, although she had presented numerous times to her primary care physician with a variety of somatic complaints, including headaches, gastrointestinal disturbance, and muscular aches and pains with no clear etiology. She had repeated thyroid testing with normal results. Her mother had had a history of menopause in her early 40s and the patient noted that her menstrual cycles had become more irregular over the last couple of years, and her anxiety and irritability become notably worse premenstrually.

She smoked a pack of cigarettes a day and reported that having a cigarette would sometimes temporarily decrease her tension and anxiety. She attempted to quit smoking several times and noted that the increased anxiety and tension she experienced during these attempts contributed to her lack of success in these efforts. She typically had 1 or 2 glasses of wine at social occasions or on the weekends; she has no history of abuse or dependence on alcohol but did say that a glass of wine made her feel temporarily less anxious. She carefully monitored her intake because of worry that she would become an alcoholic. She smoked marijuana a few times in college but it made her feel dysphoric and more anxious, and she had not used it or other illicit drugs since that time.

Social and Family History

After finishing college, Nancy went to law school, where she met her husband. She reported being attracted to his sense of calm and stability. He reported that part of what drew him to her was the sense of how much she seemed to need and depend on him. They were married shortly after graduation and had 2 children over the next 5 years. After the birth of her second child, she developed a postpartum depression that lasted almost a year and for which she didn't seek treatment. She said that her youngest child "is just like I was -- she's afraid of her own shadow."

She grew up in a middle-class home, the second of 3 children. She reported that childhood was "generally happy," although she was troubled by anxiety starting early in life. There was no history of physical or sexual abuse. Both parents were still alive in January 2005, although they had significant medical conditions and she was worried about their health. She noted that her mother and father were both "nervous" people, and though never formally diagnosed and treated, her maternal grandmother had a history of depression.

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A Comprehensive Review of the Generalized Anxiety Disorder

Aneesh k mishra.

1 Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Anuj R Varma

2 Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Excessive, uncontrollable, and usually unjustified worry about certain things is a sign of the mental and behavioral disease known as generalized anxiety disorder (GAD). Genetic research suggests that numerous genes are likely implicated in the development of GAD, even if much is yet unclear about this. As a result, if someone in a family has GAD, there is a high likelihood that someone else will also suffer from the illness, as well as another anxiety disorder. Individuals with GAD are frequently overly bothered about workaday affairs like health, assets, demise, family, accord issues, or effort challenges. Worry frequently interferes with daily functioning. Excessive concern, restlessness, difficulty sleeping, tiredness, irritability, sweating, and trembling are a few symptoms that may be present. For a formal diagnosis of GAD, symptoms must be persistent for at least six months and consistent. Conversion in the amygdala's utilitarian congruence and how it processes fear and anxiety have been linked to generalized anxiety disorder. Neurotransmitters, and particularly the gamma-aminobutyric acid (GABA) variant, have long been known to cause GAD through dysregulating amygdala activity in the brain. Anxiety, concern, or physical symptoms must significantly hinder social, academic, or occupational functioning in order to qualify for a GAD diagnosis. The Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) provides explicit ethos to aid doctors in identifying this disorder. Psychological therapy based on cognitive behavioral therapy (CBT) principles is effective in reducing anxiety symptoms for short-term treatment of GAD. In this, the patient's thinking ability and methods are focused. The main principle behind CBT is that your thought patterns affect your feelings, which in turn can affect your behavior. Drugs like antidepressants, buspirone, benzodiazepines, and can all be worn to goody GAD. Outside of therapy, patients with anxiety can learn to manage it by practicing relaxation methods, reframing unfavorable ideas, and adopting stress-relieving adjustments. Being socially active and setting aside time for proper self-care are crucial components of managing generalized anxiety disorder.

Introduction and background

Usually, a person who perceives sadness or difficulties quickly overcomes it, however, in generalized anxiety disorder (GAD), their sadness or anxiety spirals out of control. He cannot regulate his stress, and his regular life begins to be affected by his fear of the unexpected. It can occasionally last for a very long time, and this condition affects twice as many women as it does men [ 1 ]. In contrast to the projected current prevalence of between 2% and 3%, the expected lifetime prevalence of the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) GAD in the United States is about 5%. Gender, race, and social class all have different rates of illness. GAD affects 6.8 million adults or 3.1% of the US population, yet only 43.2% are receiving treatment. This estimated increase in anxiety disorders in the United States is believed to be due to excessive use of social media, lack of proper sleep, genetic factors, and environmental factors [ 2 ]. Few thorough demographic modules have been the antecedent brainy disease or brainy healthcare code and fulfillment, the 2016 Indian National Mental Health Survey (NMHS) steered to improve brainy health throughout the nation [ 3 ]. While generalized anxiety disorder is frequently observed in general practice, the more dramatic varieties of anxiety disorders, such as psychiatric illness and fetishes, have received more detailed research [ 4 ].

Types of generalized anxiety disorders

Social Phobia

An extreme awe of one or more cordial or consummation bearings that last for an extended period is the definition of social anxiety, a common disorder. Evident reluctance is one of the earliest indications of collective disquiet, which may grow into a specific personality type (reduced agreeableness and elevated psychoticism) and the emergence of adverse cognitive biases [ 5 ].

Obsessive-Compulsive Disorder (OCD)

It includes obsessions, compulsions, or frequently both. It is the fourth most commonplace brainy anarchy after social phobia, alcoholism, and depression, with a lifetime prevalence in population surveys of 1.6%. OCD severity varies significantly from person to person. Even from their own family, people can frequently conceal their OCD, although it can interfere with relationships and make it difficult to study or work [ 6 ].

Post-traumatic Stress Disorder (PTSD)

Due to its prevalence, long-term nature, and impact on daily functioning, it is a notable public health matter. Military psychiatrists and early psychoanalysts have understood and studied PTSD since antiquity. Still, today, more than ever, it is a hot topic due to the numerous events like terrorist attacks or weather disasters recently in France and elsewhere. Reexperiencing, avoidance, hyperarousal, and changes in cognition and mood are the four essential characteristics of this illness [ 7 ].

Panic Disorder

The hallmarks of anxiety disorders such as panic disorder are brief, intense moments of dread accompanied by physical symptoms, including breathing difficulties, chest pain, heart palpitations, nausea, and stomach aches [ 8 ]. Certain generalizations regarding the illnesses have been made, including abnormalities in the limbic system, anomalies in the hypothalamic-pituitary-adrenal axis, genetic makeup, additional humdrum peril ingredient for dread anarchy encompass womanish and familial antiquity of dread, and some form of autism [ 9 ].

Methodology

The terms "generalized anxiety," "panic disorder," "social phobia," and "neuroticism" were searched in a database like "PubMed." There were only English-related results shown. The most recent report from a similar study was utilized if there were multiple published reports. We only considered reviews that also included original data. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram for the search is shown in Figure ​ Figure1 1 .

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Pathophysiology

A lively and active field, research into the pathophysiology of GAD typically involves the intersection of genetics and brain structure. A connection has been made between generalized anxiety disorder and a shift in the handy congruence of the amygdala and how it processes despair and misery. The etiology of generalized anxiety disorders is complicated by so many ingredients, including genetics, an imbalance of levels of neurotransmitters, and others.

Genetic factors predispose certain people to develop a generalized anxiety disorder. Depression is referred to as genetic depression because it affects about 40% of depressed individuals. The chance of acquiring depression can increase up to three times if a close relative, such as a parent or sibling, is affected by the illness. Genes may raise the likelihood of inheriting depression, but other environmental variables ultimately cause the condition. The serotonin transporter gene has also been linked to genetic depression, according to research [ 10 ].

Noradrenergic Activity

Patients with GAD had higher levels of plasma norepinephrine (NE) and free 3-methoxy-4-hydroxyphenethylene glycol (MHPG) and lower levels of alpha 2-adrenoreceptor. Patients with GAD appear to have enhanced noradrenergic activity. Higher catecholamine levels in GAD patients could result in a down-regulation of presynaptic alpha 2-adrenoreceptor [ 11 ].

Role of Gamma-Aminobutyric Acid (GABA)

It is an inhibitory neurotransmitter identified in numerous studies to be dysregulated, particularly the GABA variation, which has long been found to increase amygdala activity in the brain and result in GAD. After a neurotransmitter release brought on by stress, the body finds it difficult to relax when the level of GABA is deficient. Depression, sleeplessness, and mood disorders are caused by this [ 12 ].

Role of Serotonin Receptor in Generalized Anxiety Disorder

Multiple receptors are activated by serotonin, which controls a variety of physiological processes. Abnormalities in these receptor systems have been linked to several brain problems, like dreed, blahs, lunacy, migraine, sleep, cognition, and feeding. While less abundant in the primary sensory regions, the 5-hydroxytryptamine (5-HT1A) receptor is expressed in high concentrations in the limbic, temporal, and prefrontal cortex [ 13 ].

Role of Dopamine in Generalized Anxiety Disorder

Numerous brain regions may be affected by dopamine's effect on anxiety modulation. According to some studies, the dopaminergic systems in the mesolimbic, mesocortical, and nigrostriatal regions affect anxiety. The dopamine D1 and D2 receptor loops and misery are involved [ 14 ].

Risk factors

Use of tobacco, alcohol, and cannabis, not to mention avoidance, adverse assessments of brio drill, and occupational characteristics were all found as risk factors. The risk factor that has been investigated the most is cigarette smoking. Evidence supports tobacco as a problematic element for frenzy and agoraphobia [ 15 ].

Characteristics

GAD people contain a broad range of features and varying degrees of severity. Some patients can place more emphasis on a particular symptom than others that are often related to GAD's highly enhanced physiological arousal, emotional lability and muscular stress, fatigue, restlessness, and difficulty sleeping. Some other symptoms seen in a person suffering from GAD include an excessive attachment to any unnecessary thing, unnecessary emphasis on something, lack of concentration, weakening of memory, rapid heartbeat, and inability to remain stable and calm. Also, symptoms like physical weakness, irritability, restlessness, etc. are included [ 16 ].

Specifications for diagnosing

Several different scales are used to determine a diagnosis and evaluate severity. A rate of 10 or higher has appropriate indicative subtlety and idiosyncrasy and the GAD-7 has been approved as an indicative gizmo and an austerity-grade extent. There is a correlation between higher GAD-7 scores and spare serviceable ruination. Even though the scope was created and ratified using DSM-IV decency, it is still clinically fruitful due to modest modifications in the GAD diagnostic criteria. Its trendy indicative ascetic dispatch measure for angst cloaking, scrutiny, and acerbity estimate is the GAD-7 [ 17 ].

Generalized Anxiety Disorder Indicative Conventionalities Akin to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Criteria

Its purpose is to provide a structure for organizing each of the mentioned conditions, to create diagnostic standards, and to categorize diseases. In Table ​ Table1, 1 , the DSM-IV criteria are displayed [ 18 ].

DSM: Diagnostic and Statistical Manual of Mental Disorders

Generalized Anxiety Disorder Convention According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V)

Diagnostic criteria used to characterize GAD in the final version of the DSM-V were as follows: extreme tension and worry for a minimum of six months around various occasions or enterprises, like consummation in the workplace or school. It is challenging for the person to keep the worry under the curb. Dreed is related to unease or a sense of tension or apprehension, being easily worn out, inability to focus or mental disorientation, irritation, tight muscles, sleep disruption, inability to decline or keep asleep, or restive, uncomfortable sleep [ 19 ].

Extensive gloom and generalized anxiety disorders are co-occurring, and this combination often results in worse outcomes than either disorder by itself. Additionally, according to epidemiological data, 59% of people with this disorder meet the requirements for major depressive disorder (MDD). So, the most prevalent type of depression and anxiety comorbidity is MDD and GAD. Even though co-occurring GAD and MDD are more common in some clinical samples than others, this clinical problem is unquestionably present in people undergoing psychiatric care [ 20 ].

Pharmacological management

Based on different types of studies, it has been reported that drugs based on serotonin and non-epinephrine are broadly used because of their higher efficacy and rapid improvement of symptoms and relief for the patients. These drugs have a wide range of benefits [ 21 ]. To reduce anxiety, one can take support of different types of therapy like cognitive therapy, using depression and anxiety-reducing drugs [ 22 ].

Selective serotonin reuptake (SSRI) inhibitor

The SSRIs impede the functions of some transporters and, in some cases, affect a few other reuptake processes. Some levels are up, and some groups are down by this. Synaptic 5-HT concentrations are raised by inhibiting 5-HT reuptake, which also raises extra-synaptic diffusion. SSRI examples are given below.

Fluoxetine was created in the early 1970s and was the first SSRI available in the United States in 1987. Fluoxetine improves serotonergic transmission in the brain, but it also purportedly has noradrenergic and dopaminergic actions that contribute to its therapeutic success. It is very effective, which various research proves [ 23 ].

Sertraline is an antidepressant. It functions by raising the brain's concentration of the chemical messenger serotonin. It lowers the psychological and physiological signs of depression, as well as the symptoms of anxiety and some other diseases. Sertraline, the finest remedy for reducing treatment disruption, is the second excellent remedy for decisive echo in persons who do not stop their regimen due to adverse fallout. Sertraline appears to be the most reasonably priced drug for treating GAD patients [ 24 ].

Paroxetine is now ratified to cure social anxiety, panic disorder, and depression. Additionally, it is worn to treat persistent headaches and other brain disorders. The strongest inhibitor of serotonin (5-hydroxytryptamine {5-HT}) reuptake among all currently prescribed antidepressants, including the SSRI family, is paroxetine, a phenylpiperidine derivative. It is a much weaker than average NE uptake inhibitor, yet it is still more effective at this location than the other SSRIs [ 25 ].

Citalopram hydrobromide was declared the most efficient selective serotonin reuptake inhibitor by the FDA in 1998. It is an edict remedy in the WHO model agenda of essential medications for treating depressive disorders. Serotonergic activity in the central nervous system is potentiated due to its reduction of serotonin absorption by CNS neurons [ 26 ].

Selective serotonin-norepinephrine reuptake (SNRI) inhibitor

It conveys messages among brain cells and boosts well-being, an optimistic outlook, appetite, and social behavior while regulating internal body clocks and sleep-wake patterns. Dual serotonin and noradrenaline reuptake inhibition may be advantageous since it addresses a broader range of symptoms than other antidepressants. Some examples are given below.

Venlafaxine

Venlafaxine is a perfect remedy, broadly used to relieve patients. They were first blocking serotonin and then norepinephrine. Medical conditions and treatment responses are considered while determining the dosage [ 27 ].

The use of duloxetine as an antidepressant and other members of the pharmacological group of serotonin-norepinephrine reuptake inhibitors to cure brainy diseases and correct the chemical imbalance in the brain is approved. Its action method depends on the central nervous system's reuptake inhibition of norepinephrine (NE) [ 28 ].

Anxiolytics

Antianxiety drugs, also called anxiolytics, are administered to treat and lessen anxiety brought on by various anxiety disorders. These drugs have a quick start of the action and can establish habits. They are typically only prescribed for short-term use as a result. It is not advised for those who have an antiquity of stuff misdeed. Some examples of anxiolytics are given below.

The drug buspirone is a popular anxiolytic; buspirone has become increasingly popular recently. Anxiety disorders are typically treated with buspirone. SSRIs are repeatedly worn as an additional cure for patients who do not react to or cannot tolerate their adverse effects [ 29 ].

Benzodiazepines 

Benzodiazepines are helpful for anxiety disorders because they act immediately. However, the effectiveness of benzodiazepines can differ depending on the form of drug illness. The popularity of benzodiazepines has persisted for a number of reasons, including their consistent efficacy in reducing anxiety, tension, and various physical symptoms of anxiety, rapid onset of therapeutic action, relatively good tolerability, ability to be administered on an as-needed basis, and comparatively safe overdose rate. Benzodiazepines are successful in the cure of such diseases [ 30 ].

Role of psychotherapy in generalized anxiety disorder

Psychotherapy aims to improve a person's relationships, social skills, and mental and physical health. Additionally, it works to eliminate or diminish negative feelings, thoughts, compulsions, or behaviors. Two regularly employed psychological therapies are supportive, interpersonal, and cognitive behavioral therapy [ 31 ].

Cognitive-Behavioral Therapy (CBT)

CBT is regarded as the "gold standard" [ 32 ]. Reduced anxiety, more accessible job performance, and an overall higher quality of life are all benefits of this [ 33 ]. The typical understanding of CBT is that it is an efficient, dexterity-core remedy to comfort patients to revise their faith and behaviors [ 34 ]. CBT is a common strategy for people who need to improve their response to medicine and a successful approach for those who don't respond to medication, want to stop taking their drugs, or don't respond to treatment [ 35 ].

Interpersonal Therapy (IPT)

Although there has been far less research on IPT's effectiveness in treating anxiety disorders, it has successfully treated eating and mood disorders. In patients with eating and mood disorders, IPT reliably improved anxiety symptoms [ 36 ]. IPT helps patients strengthen social networks and boost the quality of their relationships by emphasizing traumatic events, including grieving, interpersonal conflicts, life changes, or social isolation [ 37 ].

Computer-Aided Psychotherapy (CP)

Computer-assisted psychotherapy is very useful for persons with anxiety disorders, requiring less therapist time, expediting access to care, and decreasing travel time. Computers that are standalone or connected to the Internet, handheld devices, interactive voice response phones, DVD players, and cell phones can all be used to offer CP [ 38 ].

Supportive Therapy

Active and inactive conditions were separated from it. All psychiatric treatments were compared to waiting lists and standard care, including functional, supportive therapy. Compared with CBT, ST was an additional psychological treatment [ 39 ].

Applied Relaxation (AR) Therapy

Well-established and successful treatment for phobias, panic attacks, and, later, generalized anxiety disorder is called applied relaxation therapy (AR). Early therapy sessions assist individuals in identifying their anxiety's warning symptoms. Throughout the week, clients are instructed to pay attention to and note the events that cause them stress and their responses to these situations. During this monitoring process, they can differentiate between cognitive, affective, physiological, and behavioral cues. AR aims to calm down quickly and use this ability when necessary to lessen physiological reactions and, as a result, the anxiety cycle [ 40 ].

Conclusions

Generalized anxiety disorder are a category of mental disorders that distinguish themselves from other problems with two key features fear and worry. Fear is an emotion experienced in response to an impending danger. On the other hand, anxiety is an emotional state experienced in anticipation of a possible future threat. Patients with GAD exhibit a substantial degree of impairment and disability. Anxiety disorders are associated with cognitive impairment such as reduced processing speed, attention, and inhibition, which may be exacerbated by antianxiety medications. People with generalized anxiety disorder worry about entirely unimportant things, distinguishing them from typical worrying. Additionally, they struggle to get through the day because they constantly fret about potential outcomes. Women seem to have this condition on average twice as often as males. Anxiety disorder can also be caused by any disease related to the body, such as thyroid, asthma, sugar, or heart disease. The self-reported questionnaire diagnoses and appraises grievousness and generalized anxiety disorder. DSM-IV and DSM-V criteria are used widely for the diagnosis of this. The most popular treatments are medication and psychotherapy. Several regimens are beneficial in the management of such conditions. The pharmaceutical classes SSRI and SNRI are among the first-line therapies. People with GAD can use various strategies, including meditation and other stress-reduction exercises, including aerobics and soothing exercises. The challenge of GAD is that anxiety is a ubiquitous emotion, and so it can be difficult to know when anxiety has crossed the line of too much, for this reason, it is important to be aware of its symptoms. Seek immediate medical help if any symptoms are felt. Mental illness carries serious consequences throughout society and calls for new strategies for prevention and intervention. To accomplish these strategies, early detection of mental health issues is an essential process. Therefore, there is a need for more research and study on this in the future.

The authors have declared that no competing interests exist.

Generalized Anxiety Disorder & Panic Anxiety

Aug 01, 2014

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Lam#27, Linh#28 Per.6. Generalized Anxiety Disorder & Panic Anxiety. Case Study.

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Lam#27, Linh#28 Per.6 Generalized Anxiety Disorder&Panic Anxiety

Case Study • Homer, who is eating a snack calmly, gets an unexpected wave of panic, out of nowhere. His heart raced, and became sweaty, worrying he may die. To make matters worse, he finds himself with nowhere to escape very easily

Definitions • Generalized Anxiety Disorder (GAD)-psychological problem characterized by persistent feelings of anxiety without external cause. Symptoms: -constant worry over nothing -no relaxation -jumpy -nausea • Panic Disorder: sudden urge of overwhelming anxiety and fear; unlike GAD victim is usually free of anxiety between panic attacks. Symptoms: -nausea -uncontrollable breathing and heart rate

Theories of These Disorders • Biological Perspective: -There’s imbalance of seretonin (mood), norepinephrine (sleep), and GABA (relaxing) • Psychodynamic Perspective: -This includes the unconscious mental life and defense mechanisms until alertness • Cognitive-Behavioral Perspective: -Theorists viewed panic attacks as conditioned response to learned physical sensations • Humanistic Perspective: -People with panic disorders or GAD may not be meeting their safety need of their goals

Treatments of GAD For GAD: -Use the method of this acronym: AWARE Acceptance (welcome it, don’t fight it) Watch (look at your anxiety w/o judgments; separate yourself from it) Act with it (breathe slowly and normally; allow anxiety to leave your mind) Repeat (continue the three steps) Expect the best (know your potential anxiety for your future)

The Drug Route • Benzodiazephines • Barbituates • Valium

Facts Victims of panic disorder have addition symptoms of agoraphobia (open space) Agoraphobia affects 35%-37% of population a year with GAD You can get accustomed to anxiety that you won’t even feel it anymore but your body still shows signs of anxiety Animals also have anxiety

Sources That darn psych book….. Helpguide.org/mental/generalized_anxiety_disorder.htm Webmd.com/facts_of_panic_disorder.htm wikipedia.org/disorders.htm

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Assessment Framework for Generalized Anxiety Disorder

Assessment Framework for Generalized Anxiety Disorder. Jo Friesen, Stephanie Poole, Shawna Sjoquist , & Stacy Thiry APSY 660: Social, Emotional, & Behavioural Assessment. Outline for Discussion. Anxiety Anxiety Disorders in the DSM-IV-TR Overview of Generalized Anxiety Disorder (GAD)

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Generalized anxiety disorder

Generalized anxiety disorder. Mukesh Bhimani. Objectives. Historical perspective Epidemiology Clinical features Diagnosis Comorbidity Course and prognosis Management. Introduction.

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Generalized Anxiety Disorder. R. Bruce Lydiard PhD, MD Director, Southeast Health Consultants Charleston SC And Medical University of South Carolina. Generalized Anxiety Disorder (GAD) Pharmacotherapy Lecture Outline. Questions and Learning Points Diagnosis and Epidemiology

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Generalized Anxiety Disorder. TREATMENT: Cognitive Behavioral Therapy (CBT) is currently considered to be most effective (some sources report that CBT in conjunction with medicinal treatment is efficacious)

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Generalized Anxiety Disorder. Brittany Smith Wake Forest University Fall 2012 October 29, 2012. Background Information. Affects psychological health, causes physiological effects, and diminishes the overall quality of life Characterized by excessive worrying, somatic symptoms

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Anxiety disorder. DSMIV-TR-2000 classification of anxiety disorders. Panic disorder without agoraphobia Panic disorder with agoraphobia Agoraphobia without panic disorder Specific phobia Social phobia Obsessive compulsive disorder Posttraumatic stress disorder Acute stress disorder

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Cognitive Behavioral Treatment of Generalized Anxiety Disorder

Cognitive Behavioral Treatment of Generalized Anxiety Disorder. The original version of these slides was provided by Michael W. Otto, Ph.D. with support from NIMH Excellence in Training Award at the Center for Anxiety and Related Disorders at Boston University (R25 MH08478).

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Anxiety Disorders: Separation Anxiety Disorder

Prof. Debbie van der Westhuizen Head: Child and Adolescent Units Weskoppies Hospital. Anxiety Disorders: Separation Anxiety Disorder. Separation anxiety is very normal among preschoolers, especially those who are going to school for the first time. Separation anxiety (SA).

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Generalized Anxiety Disorder (GAD). By: Corina Acosta, Xiomara Zelaya, and Henry. What is GAD?. Generalized Anxiety Disorder involves anxiety and worry that is excessive and unrelenting. This high-level anxiety makes normal life difficult and relaxation impossible.

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