Considerable and Persistent Impairment of Generalized Anxiety Disorder

Description

Excessive and persistent anxiety describes Generalized Anxiety Disorder (GAD), which lasts at least six months. GAD is linked to considerable and persistent impairment in a variety of areas, including decreased work productivity, interpersonal issues, and greater use of medical services. Furthermore, GAD appears to be a chronic and largely unrelenting condition, with the majority of patients reporting beginning at a young age. This article provides information about the phenomenology, aetiology, conceptual models, and treatment options for GAD, which include psychodynamic, cognitive-behavioral, emotion-focused, integrative, and pharmaceutical therapy.

According to current practise recommendations, the first step in treating an anxiety illness is education. Many people are perplexed, terrified, or frustrated by the symptoms and behaviour and are relieved to learn that they are not alone and that effective remedies are available. When needed, the patient should have an adequate medical workup, including a physical examination and tests (e.g., ECG, thyroid-stimulating hormone). After analysing medical problem, forming a strong working relationship with the patient allows for continued disease care and avoids unneeded or overuse of the medical system, as well as potential symptom worsening.

As a first-line treatment for GAD, a combination of psychotherapy and medication management is advised. For the treatment of anxiety, CBT has the most empirical backing to date. The evidence for Mindfulness-Based Stress Reduction (MBSR) as an effective alternative or supplemental behavioural therapy programme for anxiety is growing. Both use a skills-based therapeutic method. In CBT, the therapist and the patient collaborate and work together to solve problems. It's systematic and usually short-term, with the goal of lowering symptoms and preventing "flare-ups" by tracking and modifying unhelpful or erroneous thinking habits that cause anxiety attack.
Learning and using behavioural relaxation strategies (e.g., diaphragmatic breathing, guided imagery, progressive muscle relaxation) and distress tolerance skills are also important parts of CBT for GAD (e.g., mindfulness, acceptance). Many studies show that CBT therapies for GAD are effective, but success needs the patient's commitment to treatment. Its effectiveness is also determined by the therapist's ability and the length of time spent in treatment. Individuals who receive a combination of CBT and medicine had nearly twice the remission rate as patients who receive monotherapy, according to studies.

SSRIs have been demonstrated to be the most well-tolerated drug class, with response rates for GAD much greater than placebo. Fluvoxamine (Luvox), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), and sertraline are all SSRI drugs (Zoloft). Within 3 to 4 weeks, there should be some relief in symptoms, and if there isn't, the dose should be increased. To avoid an early attack of anxiety, SSRIs should be begun at low dosages and progressively titrated up to therapeutic levels in the treatment of any anxiety disorder. Pharmacological strategies for treating GAD are discussed.

Benzodiazepines, which were once widely used to treat anxiety disorders, are now only suggested for usage in cases of severe impairment of function and for very short periods of time. The SSRIs are preferable for long-term care due to their tolerability and lack of addiction potential, but for individuals with the most impairment, short-term symptom alleviation with a benzodiazepine is preferable. Because of the danger of rebound anxiety upon discontinuing short-acting benzodiazepines like alprazolam (Xanax), many people choose longer-acting benzodiazepines like clonazepam (Klonopin). However, because of the potential for addiction and abuse with any medicine, this is a last-resort therapy choice.