Generalized Anxiety Disorder
Both phobias and panic attacks are a source of enormous suffering and can be horribly disruptive to someone’s life. But both are limited in an important sense: In the absence of the phobic stimulus, someone with phobias feels all right. Between attacks, someone with panic disorder can function more or less normally. These limits are not in place, however, for someone who suffers from generalized anxiety disorder (GAD). For this person, the anxiety is not related to anything in particular; instead, it is continuous, pervasive, and very difficult to control.
GAD is relatively common, with a lifetime prevalence of 6% (Kessler et al., 2005), and it is seen twice as frequently in women as in men. Patients with this disorder are visibly worried almost all the time. One form this may take is worry about family mem-bers: as one patient put it, “I worry all the time about whether my husband is safe so I telephone him half a dozen times a day to see if he’s okay”. Another form it may take is worry about work: as another patient put it, “I’m so nervous about making a mistake at work I take all my reports home to rewrite them the night before I’m supposed to hand them in”. In fact, people with GAD worry about anything and everything. As still another patient put it, “I was worried all the time about everything. It didn’t matter that there were no signs of problems, I just got upset. I was having trouble falling asleep at night, and I couldn’t keep my mind focused at work. I felt angry at my family all the time”.
People with GAD feel inadequate, are oversensitive, cannot concentrate, and may suffer from insomnia. They have enormous difficulty making decisions and worry afterward about whether each decision was a mistake. This state of affairs is often accompanied by bodily symptoms: rapid heart rate, irregular breathing, excessive sweating, and chronic diarrhea (Rickels & Rynn, 2001).
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