Psychology

Running Head: GENERALIZED ANXIETY DISORDER

GENERALIZED ANXIETY DISORDER 2

Generalized Anxiety Disorder

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This paper will focus on the article titled “Generalized Anxiety Disorder” by Stein & Sareen (2015). Generalized anxiety disorder is a psychological condition that is characterized by exaggerated persisted worry. This can be as a result of health family, finances or even the future and is not an easy task to manage. The worry is also accompanied by other physical and psychological health issues. The prevalence of generalized anxiety is at 3.1% in the United States according to epidemiologic surveys. While some cases begin at early childhood, most of the reported cases start in adulthood. This disorder is prevalent in the primary care occurring among 7% of the patients.

It is difficult to distinguish generalized anxiety from major depression as their symptoms overlap. However, persistent anhedonia one of the main characteristics of major depression does not manifest itself in generalized anxiety. People suffering from generalize anxiety will often have a sense of helplessness unlike major depression patients who experience hopeless. Patients suffering from generalized anxiety are at a higher risk of harming themselves. They are also at a higher risk of other physical and mental health conditions. The diagnosis of generalized anxiety is therefore difficult due this overlap in symptoms.

Management of generalized anxiety requires serious considerations of a wide range of physical and psychological symptoms due to the high rate of coexisting conditions. Some risk factors for this disorder include parental issues, exposure to childhood adversity, low socio-economic status and female sex. Nevertheless, these risk factors are not specific and are also associated with other mood and anxiety conditions. Multiple studies have also showed that there is a moderate generic risk. Patients suffering from generalized anxiety react negatively to uncertain situations. While the origin of this construct has not been determined, it provides significant insights ion how behavioral therapy can help improve the symptoms.

There are various treatments that can be used to manage generalized anxiety. Multiple studies have provided strong evidence that some types of psychotherapy and pharmacotherapy are very effective in managing the disorder. The choice of treatment in most cases depends on the preference of the patient. Physicians can provide medication for patients suffering from generalized anxiety. However, in serious cases, referrals are made so that the patients can be attended by psychiatrists. The physician providing the referral should also provide support to the therapeutic work for the patient. Primary care physicians can involve social workers and nurses to help them handle to patients. This approach is more effective as compared to the normal treatment.

Pharmacologic treatment of the condition significantly reduces the symptoms. Multiple studies support the effectiveness of pregabalin, buspirone, benzo-diazepines and antidepressants in the treatment of generalized anxiety. The choice of drugs prescribed to patients depends on their response and the cost. The first pharmacotherapy medications to be considered in the treatment of this disorder are the SNRIs and SSRIs. When thye are used in the treatment of generalized anxiety, they are prescribed at the same dose given to patients suffering from major depression. The expected time of response is between four to six weeks. These medications should however be prescribed by qualified and experienced psychiatrist and this should only be done when psychotherapy approaches have failed especially for children.

There are various techniques that can be used for psychotherapy. This includes applied relaxation therapy, mindfulness-based therapy, psychodynamic therapy and cognitive behavioral therapy. Among these techniques, cognitive behavioral therapy is the most effective in the treatment of the condition. This therapy involves helping patients to reconstruct their cognition and understand that worry is hindering their productivity to help them learn how to relax. The technique used to deliver this therapy involves weekly individual sessions, group sessions, therapy assisted by computer and therapy administered through telephone. Multiple studies have indicated that these methods are very effective in the management of generalized anxiety.

Combined medication and psychotherapy can be used for patients who do not respond to any of these treatments. Most studies recommend the use of combined treatment. There is evidence that combined medication and psychotherapy yields the best results for young children, adolescents and adults. However, most psychiatrists recommend the use of cognitive behavioral therapy and if needed adding pharmacotherapy sequentially. While combined medication and psychotherapy is effective in reducing symptoms for patients suffering from generalized anxiety, it still remains unknown how patients who do not respond to this treatments should be treated. The most appropriate duration of administering medication for patients suffering from this disorder is unknown despite experts suggesting that the period of maintenance should be one year.

References

Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of Medicine, 373(21), 2059-2068.