Table of Contents
What is Generalized Anxiety Disorder?
Characterized by irrational and uncontrollable worry that significantly reduces a person’s quality of life, generalized anxiety disorder (GAD) is one of the most prevalent psychological disorders aside from psychiatric issues associated with substance abuse. The American Psychiatric Association offers the following criteria for a diagnosis of GAD:
- Patient reports feeling excessive worry, apprehension and anxiety frequently for six months or longer.
- Patient finds it difficult to stop “thinking” about worrying or feeling anticipatory worry about non-existent occurrences.
- Patient reports experiencing at least three of these six symptoms: restlessness, fatigue, problems concentrating, muscle tension, insomnia and irritability.
- Physical and psychological symptoms of chronic anxiety cause significant impairment in occupational and social areas of functioning.
- Patient is not suffering from a medical condition known to cause anxiety (side effects of medication, addiction or hyperthyroidism, for example). Also, the anxiety is not attributed to a pervasive developmental disorder, psychotic disorder or post-traumatic stress disorder.
Physical Symptoms of GAD
People diagnosed with GAD suffer chronically from one or more of these symptoms:
- Pounding heart/palpitations
- Profuse sweating/cold chills
- Trembling
- Dry mouth
- Chest discomfort
- Rapid breathing
- Nausea
- Dizziness/light-headedness
- Numbness and tingling in the extremities
What Causes Generalized Anxiety Disorder?
Psychiatrists think GAD emerges from the complex interplay of biological (genetic), environmental and socioeconomic factors. In addition, abnormal levels of neurotransmitters in the brain–specifically, norepinephrine, dopamine and serotonin–can negatively influence emotional stability and interfere with normal thinking patterns in people with GAD.
People at risk for developing anxiety disorders include adult women, having a family history of anxiety disorders, those who have suffered past trauma and people with certain health conditions, such as mitral valve prolapse, sleep apnea, migraines and chronic fatigue syndrome.
Anxiety Treatment Centers
Treatment methods offered by anxiety treatment centers include medication, counseling and cognitive behavioral therapy.
Types of Anxiety Medications
Serotonin-norepinephrine-reuptake inhibitors
SNRIs are medications that regulate levels of norepinephrine and serotonin in the brain. The most prescribed of these medications is venlafaxine (Effexor), a newer antidepressant that works to relieve anxiety by allowing serotonin and norepinephrine to remain in the synapse longer where the brain can better utilize these neurotransmitters to stabilize mood and emotions.
Tricyclic antidepressants
For some people, these are older antidepressants that are sometimes more effective than newer antidepressants in treating anxiety. Elavil and Tofranil are the most commonly prescribed tricyclics for GAD and depression.
Selective serotonin-reuptake inhibitors
SSRIs present mechanisms of action similar to tricyclics and venlafaxine but target reuptake of serotonin only.
Therapeutic Interventions for Anxiety Disorders
Anxiety treatment centers provide psychotherapy to treat specific psychological components involved in the evolution of an anxiety disorder. These components include:
- Ineffective problem-solving and coping skills
- Previous trauma
- Emotional hyperarousal
- Maladaptive management of emotions
- Interpersonal issues
- Poor self-esteem
- Avoidance personality traits
Psychologists employ cognitive behavioral therapy, motivational interviewing and acceptance and commitment therapy to treat patients at anxiety treatment centers. CBT helps patients understand how and why their feelings and thoughts influence behavior by introducing them to exposure therapy, principles of cognitive restructuring and relaxation techniques.
What is Panic Disorder?
Correlated with anxiety disorders is panic disorder, an even more crippling psychological condition that produces severe symptoms of inexplicable anxiety. The DSM-IV-TR states that panic disorder is diagnosed when a patient experiences repeated “panic attacks” or episodes for more than one month that involve the following symptoms:
- Uncontrollable feelings of terror, dread and apprehension
- Pounding heart (tachycardia)
- Profuse sweating, dizziness and weakness
- Hyperventilation
- Chest pain/heaviness
- Numbness and tingling of hands and feet
- Sensations of unreality, impending doom and depersonalization
- Fear of dying or losing control
Panic attacks are unpredictable and can even happen during sleep. Typically lasting about 10 to 15 minutes, panic attacks leave the affected person feeling extremely drained, weak and confused. Another type of panic disorder called anticipatory panic disorder frequently arises from suffering repeated panic attacks because the individual now constantly anticipates the panic attack happening again. Consequently, someone with anticipatory panic disorder remains intensely preoccupied with worrying about surviving the next attack.
Panic disorder can also produce specific phobias to situations and places. For example, someone who has a panic attack in an elevator or a bus may develop an intense fear of elevators and buses and avoid them altogether. Agoraphobia often affects people with panic disorder, who eventually become so afraid of leaving their home for fear of suffering a panic attack that they may remain housebound for years unless they seek help from panic disorder treatment programs.
What Causes Panic Disorder?
Research has yet to pinpoint an exact cause of panic disorder but many theories exist as to its development. Having a history of sexual, emotional or physical abuse, substance abuse and an inherited tendency to suffer psychological problems are suspected of playing roles in the etiology of panic disorder. In addition, neuroscientists are also looking at chemical imbalances in the limbic system involving GABA-A, a neurochemical responsible for regulating the “fight or flight” response to perceived dangers.
Panic Disorder Treatment Programs
Five types of medications may be prescribed to treat panic disorder that are also prescribed to relieve anxiety disorders. These are:
- Selective serotonin-reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Benzodiazepines (Clonazepam, Lorazepam, Diazepam)
- Tricyclic antidepressants
- Monamine oxidase inhibitors (MOAs)
Psychotherapeutic Interventions
Positive self-talk and cognitive behavioral therapy are counseling methods predominantly used by therapists in charge of panic disorder treatment programs at anxiety treatment centers. The goal of CBT when used to treat panic disorder mainly focuses on exposure therapy, or guiding the patient through a series of events that mimic a panic attack.
The therapist may have the patient intentionally breath rapidly to precipitate hyperventilation or run in place to increase heart rate and respiration. By assisting the patient through these simulated panic attacks, CBT therapists can help them realize the strong connection between the mind and body and that nothing “bad” will happen to them as a result of experiencing physiological symptoms of fear, panic and terror.
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