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The Complexity of Anxiety
Disorders- Generalized Anxiety
Disorder (GAD)
Deva Pramod V B
M.Sc. Psychology
Department of Psy...
What is Anxiety?
mood,
thoughts,
behaviors,
& body.
Anxiety is a medical
condition that affects a
person’s
2
but only one-third of
those who suffer from it
receive treatment
Depressionoften
accompanies anxiety
disorders
Highly
Trea...
Anxiety is Pathological if:
So intense become incapable of speech,
movement or thought
Occurs so frequently & unpredictabl...
Contributors/Causes of Anxiety
Stress
Life Experiences
Brain Chemistry
Personality
Physical Illness
5
Additional Contributing Factors
Heredity
Personality
Situations
Medical Conditions
Medications
Substance Abuse
6
Anxiety Disorders
• Anxiety Disorders include disorders that share features of excessive
fear and anxiety and related beha...
The term “Anxiety Disorders” refers to
 Generalized Anxiety Disorder (GAD)
 Obsessive-Compulsive Disorder (OCD)
 Panic ...
Generalized Anxiety Disorder (GAD)
• General anxiety disorder (GAD) is a broad term covering several different forms
of ab...
Difference Between Normal Anxiety and GAD?
10
Risk Factors
Factors that may increase the risk of GAD include:
 Family members with an anxiety disorder
 Increase in st...
What are the Signs and Symptoms of GAD?
Emotional symptoms of generalized anxiety disorder
 Constant worries running thro...
Behavioral symptoms of Generalized Anxiety Disorder
 Inability to relax, enjoy quiet time, or be by yourself
 Difficulty...
Physical symptoms of Generalized Anxiety Disorder
 Feeling tense; having muscle tightness or body aches
 Having trouble ...
DSM V
Diagnostic Criteria for Generalized Anxiety Disorder
A. Excessive anxiety and worry (apprehensive expectation), occu...
3. Difficulty concentrating or mind going blank.
4. Irritability.
5. Muscle tension.
6. Sleep disturbance (difficulty fall...
F. The disturbance is not better explained by another mental disorder
(e.g., anxiety or worry about having panic attacks i...
ICD 10 Criteria
F41.1 Generalized anxiety disorder
The essential feature is anxiety, which is generalized and persistent b...
Diagnostic guidelines
The sufferer must have primary symptoms of anxiety most days for at
least several weeks at a time, a...
Associated Features Supporting Diagnosis
• Associated with
• muscle tension,
• There may be trembling,
• feeling shaky, an...
Prevalence and Age of Onset
• It is a common condition; approximately 3 percent of the population
suffers from it in any 1...
Co-Morbidity with other disorders
• GAD often co-occurs with other Axis 1 disorders, especially other
anxiety and mood dis...
Treatment
Cognitive-Behavioral Therapy
• Self-monitoring, relaxation training
• Focus on controlling worry.
Medication
•...
Self-Management
 Changes in diet and nutrition.
 Regular exercise.
 Use relaxation strategies.
 Learning new problem ...
Self-help Strategies For GAD
STEP 1: Learning about anxiety and GAD
STEP 2: Identifying and recognizing worry
STEP 3: C...
STEP 4: Building Worry Management Toolbox
• TOOL #1: Learning to calm anxiety by slowing down breathing
• TOOL #2: Learni...
To Cope with Anxiety, Remember A-W-A-R-E
The key to switching out of an anxiety state is to accept it fully.
Remaining in ...
Take Four
& Manage Your Anxiety
Exercise. Go for a
walk or jog.
Do yoga.Dance.
Just get moving!
Talk to someone …
spouse, ...
Keywords
 Anxiety
 Anxiety Disorders
 Generalized Anxiety Disorder (GAD)
 Cognitive-Behavioral Therapy
 Medication
 ...
References
 Diagnostic and Statistical Manual for Mental Disorders (DSM-V). Fifth Edition,
Washington DC, the Division of...
Thank You
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Generalized Anxiety Disorder (GAD)

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Generalized Anxiety Disorder (GAD), Anxiety, Anxiety Disorders, Risk Factors , Signs and Symptoms of GAD, DSM V Diagnostic Criteria for Generalized Anxiety Disorder, ICD 10 Criteria F41.1 Generalized anxiety disorder, Prevalence and Age of Onset, Treatment, Self-help Strategies For GAD

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Generalized Anxiety Disorder (GAD)

  1. 1. The Complexity of Anxiety Disorders- Generalized Anxiety Disorder (GAD) Deva Pramod V B M.Sc. Psychology Department of Psychology Bharathiar University, India vbdevan.psy@gmail.com
  2. 2. What is Anxiety? mood, thoughts, behaviors, & body. Anxiety is a medical condition that affects a person’s 2
  3. 3. but only one-third of those who suffer from it receive treatment Depressionoften accompanies anxiety disorders Highly Treatable 3
  4. 4. Anxiety is Pathological if: So intense become incapable of speech, movement or thought Occurs so frequently & unpredictably in an attack-like manner Persists over extended periods of time (chronic) Leads to avoidance behavior, ritualistic behaviors, always feel uptight 4
  5. 5. Contributors/Causes of Anxiety Stress Life Experiences Brain Chemistry Personality Physical Illness 5
  6. 6. Additional Contributing Factors Heredity Personality Situations Medical Conditions Medications Substance Abuse 6
  7. 7. Anxiety Disorders • Anxiety Disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances • Anxiety Disorder include : • Intense and prolonged feelings of fear and distress that occur out of proportion to the actual threat or danger • Feelings of fear and distress that interfere with normal daily functioning 7
  8. 8. The term “Anxiety Disorders” refers to  Generalized Anxiety Disorder (GAD)  Obsessive-Compulsive Disorder (OCD)  Panic Disorder  Posttraumatic Stress Disorder (PTSD)  Social Anxiety Disorder, and  Specific Phobias. 8
  9. 9. Generalized Anxiety Disorder (GAD) • General anxiety disorder (GAD) is a broad term covering several different forms of abnormal, pathological anxiety, fears, phobias and nervous conditions, which may have sudden onset or may occur gradually over a period of several years • GAD is an anxiety disorder marked by chronic, exaggerated worrying and anxiety about everyday life. The worry is so severe that it interferes with their ability to live their lives. • Excessive uncontrollable worry about everyday things. This constant worry affects daily functioning and can cause physical symptoms. • GAD can occur with other anxiety disorders, depressive disorders, or substance abuse. 9
  10. 10. Difference Between Normal Anxiety and GAD? 10
  11. 11. Risk Factors Factors that may increase the risk of GAD include:  Family members with an anxiety disorder  Increase in stress  Exposure to physical or emotional trauma  Unemployment, poverty  Drug abuse  Medical condition or disability 11
  12. 12. What are the Signs and Symptoms of GAD? Emotional symptoms of generalized anxiety disorder  Constant worries running through your head  Feeling like your anxiety is uncontrollable; there is nothing you can do to stop the worrying  Intrusive thoughts about things that make you anxious; you try to avoid thinking about them, but you can’t  An inability to tolerate uncertainty; you need to know what’s going to happen in the future 12
  13. 13. Behavioral symptoms of Generalized Anxiety Disorder  Inability to relax, enjoy quiet time, or be by yourself  Difficulty concentrating or focusing on things  Putting things off because you feel overwhelmed  Avoiding situations that make you anxious 13
  14. 14. Physical symptoms of Generalized Anxiety Disorder  Feeling tense; having muscle tightness or body aches  Having trouble falling asleep or staying asleep because your mind won’t quit  Feeling edgy, restless, or jumpy  Stomach problems, nausea, diarrhea 14
  15. 15. DSM V Diagnostic Criteria for Generalized Anxiety Disorder A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). B. The individual finds it difficult to control the worry. C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months); Note: Only one item is required in children. 1. Restlessness or feeling keyed up or on edge. 2. Being easily fatigued 15
  16. 16. 3. Difficulty concentrating or mind going blank. 4. Irritability. 5. Muscle tension. 6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep). D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). 16
  17. 17. F. The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder). 17
  18. 18. ICD 10 Criteria F41.1 Generalized anxiety disorder The essential feature is anxiety, which is generalized and persistent but not restricted to, or even strongly predominating in, any particular environmental circumstances (i.e. it is "free-floating"). As in other anxiety disorders the dominant symptoms are highly variable, but complaints of continuous feelings of nervousness, trembling, muscular tension, sweating, lightheadedness, palpitations, dizziness, and epigastric discomfort are common. Fears that the sufferer or a relative will shortly become ill or have an accident are often expressed, together with a variety of other worries and forebodings. This disorder is more common in women, and often related to chronic environmental stress. Its course is variable but tends to be fluctuating and chronic. 18
  19. 19. Diagnostic guidelines The sufferer must have primary symptoms of anxiety most days for at least several weeks at a time, and usually for several months. These symptoms should usually involve elements of: (a)Apprehension (worries about future misfortunes, feeling "on edge", difficulty in concentrating, etc.); (b)Motor tension (restless fidgeting, tension headaches, trembling, inability to relax); and (c)Autonomic overactivity (lightheadedness, sweating, tachycardia or tachypnoea, epigastric discomfort, dizziness, dry mouth, etc.). 19
  20. 20. Associated Features Supporting Diagnosis • Associated with • muscle tension, • There may be trembling, • feeling shaky, and • muscle aches or soreness • Also experience somatic symptoms (e.g., sweating, nausea, diarrhea) and an exaggerated startle response. 20
  21. 21. Prevalence and Age of Onset • It is a common condition; approximately 3 percent of the population suffers from it in any 1-year period and 5.7 percent at some points in their lives-National Co morbidity Survey-Replication. • GAD is approximately twice as common in women as in men. • People with GAD manage to function and are less likely to go to clinics for psychological treatments though they do show up frequently in physician’s offices with medical complaints. • Age of onset is often difficult to determine. However recent studies documented that GAD often occurs in older adults where it is the most common anxiety disorder. 21
  22. 22. Co-Morbidity with other disorders • GAD often co-occurs with other Axis 1 disorders, especially other anxiety and mood disorders such as panic disorder, social phobia, specific phobia, and PTSD. • Many of these people are mildly to moderately depressed as well as chronically anxious. 22
  23. 23. Treatment Cognitive-Behavioral Therapy • Self-monitoring, relaxation training • Focus on controlling worry. Medication • Use medicine under registered medical perception 23
  24. 24. Self-Management  Changes in diet and nutrition.  Regular exercise.  Use relaxation strategies.  Learning new problem solving strategies.  Join support groups. 24
  25. 25. Self-help Strategies For GAD STEP 1: Learning about anxiety and GAD STEP 2: Identifying and recognizing worry STEP 3: Classifying your worries • 1. Worries about current problems (for example, “what if I don’t have enough money to pay the bills?”, “what if I don’t finish my report on time?) • 2. Worries about hypothetical situations (for example, “what if the flight I’m taking next month crashes?”) 25
  26. 26. STEP 4: Building Worry Management Toolbox • TOOL #1: Learning to calm anxiety by slowing down breathing • TOOL #2: Learning how to calm your anxiety by relaxing the muscles in body • TOOL #3: Learning to become comfortable with uncertainty • TOOL #4: Rethinking the usefulness of worry • TOOL #5: Improving problem-solving ability • TOOL #6: Writing a worry script STEP 5: Building on bravery PRACTISE, PRACTISE, PRACTISE!! 26
  27. 27. To Cope with Anxiety, Remember A-W-A-R-E The key to switching out of an anxiety state is to accept it fully. Remaining in the present and accepting your anxiety cause it to disappear. A: Accept the anxiety. W: Watch your anxiety. A: Act with the anxiety. R: Repeat the steps. E: Expect the best. 27
  28. 28. Take Four & Manage Your Anxiety Exercise. Go for a walk or jog. Do yoga.Dance. Just get moving! Talk to someone … spouse, significant other, friend, child, or doctor. Keep a daily journal. Become aware of what Triggers your anxiety. Eat a balanced diet. Don’t skip meals. Avoid caffeine,drugs and all which can trigger anxiety symptoms 28
  29. 29. Keywords  Anxiety  Anxiety Disorders  Generalized Anxiety Disorder (GAD)  Cognitive-Behavioral Therapy  Medication  Self-Management 29
  30. 30. References  Diagnostic and Statistical Manual for Mental Disorders (DSM-V). Fifth Edition, Washington DC, the Division of Publications and Marketing, American Psychiatrist Association.  ICD-10. (2007). The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines, Geneva, World Health Organization, AITBS Publishers in India.  Carson.C.R, Butcher.N.J(2007).Abnormal Psychology; Dorling Kindersley: South Asia.  Niraj Ahuja (2011),A Short Textbook Of Psychiatry 7th ed. Jaypee Brothers Medical Publishers Pvt Ltd.  Kaplan, H.I. & Sadock, B.J. (2007). Synopsis of Psychiatry – Behavioral Sciences/Clinical Psychiatry. (10th Edn). NY: Williams & Wilkins. 30
  31. 31. Thank You 31

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