Anxiety and Panic Attacks and Generalized Anxiety Disorder (GAD)\

Anxiety is a very common malady affecting many people in today’s fast paced world with constant stimulation from every direction. The diagnostic and statistical manual (DSM-IV-R)of the American Psychological Association recognizes Generalized Anxiety Disorder as “a persistent,  excessive and difficult to control anxiety with significant symptoms of motor tension, autonomic hyperactivitiy, and/or disturbances of sleep lasting greater than 6 months” (Flynn, Kaplan-Gill, 2012). Lifetime prevalence is thought to be about 5.7% of the population. Onset can be at anytime in life from adolescence to adulthood and it is more common in females with a 2:1 ratio. The median age of onset is 31 years old as Flynn and Caplan-Gill have found in their research.

Risk factors for anxiety disorder are caucasian race, adverse life events such as a death, loss of a job, marital distress and others. A family history of anxiety, lack of social support, increase in stress, and depression are common.  Lesbian/bisexual women are more likely than heterosexual women but this increased risk is not seen in male homosexual relationships or bisexual men (Flynn, Kaplan-Gill, 2012).

Commonly associated conditions are “major depressive disorder, bipolar disorder and dysthymic disorder. Alcohol and drug abuse, cigarette smoking that started in adolescence, panic disorder, and social anxiety disorder” are commonly found (Flynn, Kaplan-Gill, 2012).

Diagnosis criteria noted by Flynn, Kaplan-Gill  from 5 Minute Clinical Consult, 2012 and DSM-IV-R:

  • Symptoms of excessive anxiety and worry must occur for 6 months.
  • 3 or more of the symptoms below must be present:

-Restlessness or feeling keyed up or on edge.
-Easily fatigued.
-Difficulty concentrating o mind going blank.
-Irritability.
-Muscle tension.
-Sleep disturbances (difficulty falling asleep or staying asleep).
-Difficulty controlling worry.

  • This persistent worry must cause significant distress or impairment in social, occupational or other areas of functioning.
  • Focus of anxiety is not consistent with other psychological disorders. Not directly related to PTSD.
  • Tremor.
  • Patient may report symptoms of dyspnea (difficulty breathing),  palpitations (irregular heart beat), diaphoresis(sweating), nausea, or diarrhea.

Treatment

Prescription medications are the mainstay of treatments. Benzodiazepines work quickly but may if used for prolonged periods of time cause dependence. The benzodiazepines can be used in the short term and tapered down while the SSRIs and SNRIs until the other medications take effect. The main treatments are SSRIs and SNRIs. These medications take longer to work but are better and safer in the long term and are effective and inexpensive and have minimal side effect profiles.
Relaxation, mind body techniques, yoga and exercise are also being investigated into their effectiveness and are showing promise in therapy especially if combined with medications. Cognitive behavior therapy is very effective and comparable with medication treatments (Flynn, Kaplan-Gill, 2012).

If you or a family member, friend, coworker or other acquaintance, suffer from anxiety, call our office and we can help you with this problem. If we determine you need a psychiatric consultation we will schedule you for that appointment. Call us for an immediate appointment at 817-274-2343
References

  • The 5 Minute Clinical Consult, 2012, Mary K. Flynn, Margo L. Kaplan-Gill, 2012, pp 86-87.