By Nan Little
“It was a Friday morning and a very beautiful morning at that. Even though the weekend was around the corner and the weather was perfect I was feeling down. As I got into my vehicle to go to class, I started to think about when all the bills were due, if I would pass my test next week, did I do a good job at work last night, will I get fired today, etc. As I started to drive off my stomach felt uneasy and I began to break out into a cold sweat. Sitting behind the wheel at a traffic light, my heart began to race, my chest began to tighten, my breathing got shallow, my face and feet began to feel numb, and I got this burning sensation running up my back. As I looked around it seemed everyone else was going on their merry way and I was scared to make a scene. My hands began to sweat,and I felt light-headed…as if about to pass out. I also felt like the world was closing in on me and I had nowhere to escape. I soon realized that I was out of control and needed help. I had this urge to run, but run where? Who was going to help me? Maybe running would make it worse. Is this a heart attack? Am I going to die? Help me!”
Ever wonder why some people worry about everything under the sun, when in all reality, there isn’t much to worry about? The constant worry seems to take control and dominate the individual’s life. These worries tend to be unrealistic and exaggerated in nature. Over a period of time the constant worry will start to influence negative thinking that can send the individual into a downward spiral toward depression. Once depressed, these negative thoughts then seem to trigger debilitating anxiety and panic attacks. The person may also become slightly obsessive about his/her health, money, schooling, work, etc. It is normal for humans to worry a bit, but excessive worry is abnormal and needs to be professionally treated.
As a graduate student in the field of psychology, I have a strong interest in affective disorders, such as Generalized Anxiety Disorder (GAD). The National Institute of Mental Health (NIMH) states that that nearly 6.8 million American adults suffer from GAD each year. I personally know individuals who worry themselves into a panic attack and/or a deep depression. This firsthand experience allows me to observe the devastating effects this illness can have on an individual’s personal, social, and working environment. I have come to the conclusion that many people lack knowledge about this disorder and are not aware of the many treatment options available. My goal is to bring forth awareness to help individuals who think they may have, or know someone who may have GAD. In order to better educate the general public, I have gathered information and treatment options that are available for people to make their own decisions.
When a person gets scared or nervous in a stressful situation, there is normally a good reason. The human body has a built-in mechanism for combating fear that makes us scared or nervous. This survival trait is known as the fight-or-flight response. Today it is theorized that the brain structures responsible for this response are the hypothalamus and the amygdala. In short, the hypothalamus and amygdala are influenced by neurotransmitters, which signal the Autonomic Nervous System (ANS) and the endocrine system. These work together to produce the fight-or-flight response. For some people this fight-or-flight response continues to induce fear and causes several different types of disorders – and one very common disorder is GAD.
It has been theorized that abnormalities of neurotransmitters are the root cause of this illness. Today’s medical advancements allow us to better understand why some people are affected by this disorder and some are not. Advancements in magnetic resonance imaging, such as the fMRI, have allowed us to look in real-time at chemical changes in the brain regions. R. Robertson-Nay and his colleagues (2006) state that Functional Magnetic Resonance Imaging (fMRI) advancements provided sufficient evidence that abnormalities and hyperactivity of the amygdala trigger mental illness. A study conducted by Kolb and Whishaw (2003) provide intriguing evidence that malfunctions of neurotransmitters, such as acetylcholine, norepinephrine, dopamine, and serotonin contribute to mental illness such as GAD. Although there may be no escaping this disorder, there are treatment options.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines GAD as:
The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months, and is clearly excessive.
If one has unexplained anxiety or constant worry and has not been diagnosed with Phobic Disorders, Panic Disorders or OCD, it may be GAD. It can be argued that these disorders are genetic in nature or environmentally nurtured. Either way it is important for a person to realize the symptoms and become aware if any do arise in the future. Some symptoms of GAD, described in the DSM, may include the following:
- Motor tension – shakiness, jitteriness, trembling, tension, muscle aches, fatigue, inability to relax, restlessness and fidgeting.
- Autonomic hyperactivity – sweating, heart pounding, cold, clammy hands, dry mouth, light-headedness, and dizziness, upset stomach, hot or cold spells, high respirations.
- Apprehensive expectation – continuous anxious feeling, worries, anticipates that something bad will happen, fear of fainting or dying, or illness or injury to a family member.
- Vigilance and scanning – feels “on edge,” impatient or irritable, difficulty concentrating, distracted, insomnia, difficulty falling asleep, staying asleep and is fatigued upon waking.
These symptoms can vary in combination depending on the person and their predisposition to this illness.
There are some risk factors that can increase the likelihood of a person getting GAD. The Mayo Clinic, an online health website, describes four factors that may contribute to GAD. These factors include allowing stress to build up, having a serious chronic physical illness, having a personality type that could leave a person prone to getting anxiety, and having a family history of anxiety disorders. These risk factors can increase your chances of getting GAD, but do not guarantee that you will. If you or someone you know has any or all of these risk factors, it may be a good idea to seek professional help from a doctor or psychiatrist.
There are many treatment options available to someone who suffers from GAD. Some of these treatments include simple life style changes, such as diet and exercise, medications, alternative medicines, behavioral therapy, or Cognitive-Behavior Therapy (CBT). Some GAD patients may choose to do one or more types of treatment for their disorder.
The National Institute of Mental Health explains some of these treatments. The first treatment listed by NIMH is behavioral therapy. Behavior therapy focuses on different techniques, for example, relaxation that will help reduce anxiety-causing behaviors. There are other types of behavioral therapies, for instance, learning to control breathing and gradually exposing a person to an object that he or she fears, known as flooding, counter conditioning, and systematic desensitization. Cognitive-behavioral therapy relies on becoming aware of one’s unhealthy thinking patterns and learning techniques to help control these thoughts.
The second treatment option that is explained by NIMH is medication. Anti-anxiety medications and antidepressants could be helpful in relieving some of the symptoms of GAD.
Often, GAD is treated with a combination of medication and therapy.
If one of the treatments is not appropriate for you or someone you know, there is also an option called Holistic medicine. Holistic medicine is also known as alternative medicine. This type of treatment can also help patients with GAD. This type of treatment is for someone who is trying to find a different approach other than drug treatments.
GAD is not a life sentence because it can be controlled. If you or someone you know has GAD, there is hope for a future without worry, fear, and anxiety. You may find that talking to a counselor or therapist is more beneficial to you than medications alone. Another thing to remember is that GAD may not be acting in isolation. You may have other problems such as depression or IBS (irritable bowel syndrome) that are inhibiting you from enjoying everyday life. These and many other problems affect the way that you interact with your friends and family members as well as those with whom you work or go to school. One good starting point for someone who has or thinks he or she may have GAD is to contact your personal doctor, local mental health center, or hospital.