Definition
It's normal to feel anxious, especially when difficult situations arise in life. However, sometimes anxiety can persist, become difficult to manage, and interfere with daily life. This is known as generalized anxiety disorder (GAD), which can affect people of all ages, from children to the elderly. The symptoms of GAD can be similar to those of other anxiety disorders, such as panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Still, the nature of the condition varies depending on the type.
Causes
Generalized anxiety disorder, like other psychiatric conditions, results from a complicated interplay between biological, psychological, and social/environmental factors. Biological factors such as genetic predispositions and neurotransmitters in the brain play a role. People with a family history of the disorder are more likely to develop it. Still, specific genes have not been identified, and lifestyle tendencies, attitudes, and behavior can also affect it. Neurotransmitters regulate communication between nerve cells in the brain, and those involved in the stress response, such as norepinephrine and serotonin, are also thought to contribute to generalized anxiety disorder.
Psychological factors, such as a person's personality, can increase the risk of developing a disorder. For instance, individuals who tend to think negatively or avoid problems may be more susceptible. Another psychological factor is how a person manages stress in their daily life. Social factors can also play a role, including experiences from childhood, recent trauma, or prolonged medical illness. The presence of other mental disorders can also increase the risk.
Additionally, environmental factors such as severe life stress and addiction to substances like alcohol, caffeine, and nicotine can contribute to the development of the disorder. It's important to consider all of these factors when trying to understand and treat the disorder.
Risk factor
Risk factors for generalized anxiety disorder are generally related to interactions between biological, psychological, and social/environmental factors. Biological factors can include genetic factors and brain function. Biological factors can include a person's personality and the way they respond to problems. Social/environmental factors can include lifestyle, drastic changes in life, the presence of other accompanying conditions, and trauma either in childhood or recently occurred.
Symptoms
Generalized anxiety disorder affects the way a person thinks and can even cause physical symptoms. Other medical disorders must not cause these symptoms and last for at least 6 months continuously. These symptoms include:
- Excessive and constant worry and stress
- An unrealistic way of looking at problems
- Feeling restless, disturbed, nervous
- Difficulty concentrating
- Get tired easily and quickly
- Easily angry, irritated, and irritable
- Hard to sleep
- Pain or soreness in the muscles
People with generalized anxiety disorder can have other anxiety-related conditions such as panic disorder, phobias (excessive fear of something), obsessive-compulsive disorder, depressive disorders, and other disorders such as substance and alcohol abuse.
Diagnosis
It is important to note that only medical professionals such as doctors, psychiatrists, and psychologists can diagnose generalized anxiety disorder. Self-diagnosis is not recommended as it may result in harm to yourself and those around you. Suppose you are experiencing symptoms of anxiety disorder. In that case, you will be asked about your medical and psychiatric history, as well as any previous illnesses you may have had, both psychiatric and non-psychiatric. In addition, you may undergo various physical and laboratory tests. Although laboratory tests cannot establish a diagnosis of generalized anxiety disorder, they can help to eliminate medical conditions that share similar symptoms.
Determining a diagnosis of generalized anxiety disorder will depend on the information you provide to your doctor regarding the symptoms and interference with daily life. Sometimes, one consultation is not enough to determine a diagnosis. The more complete the information you provide, the easier it will be for a doctor/psychologist to diagnose this disorder.
Management
Managing generalized anxiety disorders involves both non-pharmacological (without medication) and pharmacological (with medication) methods. To achieve this, the cooperation of related health workers, the patient, and the people around them is essential. Non-pharmacological treatment can take the form of cognitive behavioral therapy. This therapy helps patients recognize and modify thought patterns and behaviors that may contribute to feelings of anxiety. It can also help you view things more realistically. Another option is to join a support group for this condition.
Apart from lifestyle changes, there are also other ways to overcome this condition:
- Regular exercise
- Yoga regularly
- Eat nutritious food
- Get enough sleep
- Avoid caffeine
- Avoid alcohol and drugs, especially NAPZA (narcotics, psychotropics and other addictive substances).
- Meditation, such as mindfulness meditation, aims to slow down the flow of thoughts, release negative thoughts and feelings, and calm the body and mind
- Relaxation therapy, such as breathing exercises
Treatment with the help of medication can only be carried out by a doctor/psychiatrist. These drugs are not intended to treat the condition but rather to control symptoms during therapy without medication being carried out or trained. Medications commonly used for generalized anxiety disorders include anti-anxiety and antidepressants. Anti-anxiety medications, if used continuously, can cause addiction. Therefore, the use of these medicines must be prescribed by a doctor. Meanwhile, antidepressant drugs have varying side effects, depending on the person taking them. People who take this drug may not experience any side effects, but some people tend to be sleepy and experience weight gain, nausea, or sexual problems.
Complications
Generalized anxiety disorder is a condition that can interfere with daily activities. One of the symptoms of this disorder is difficulty concentrating, which can prevent a person from carrying out their tasks effectively and efficiently. Additionally, anxiety can make it difficult for individuals to focus on other activities. Furthermore, unrealistic and negative thoughts can drain a lot of energy from the body and increase the risk of developing depressive disorders.
Generalized anxiety disorder can also worsen other health conditions, such as digestive problems (such as irritable bowel syndrome or ulcers), headaches (such as migraines), long-term pain and illness, sleep problems (such as insomnia), and heart problems.
Treatment with medication needs to be discussed with the health worker who treats you. Management of generalized anxiety disorders primarily aims to improve symptoms and strengthen your defense system (coping mechanism) in facing life's problems. Therefore, the preferred therapy for this disorder is drug-free therapy. These drugs are only given if the anxiety disorder cannot be controlled.
Effective treatment for anxiety disorders, like other mental health issues, often requires a sustained effort and a long-term commitment. It's possible to experiment with various combinations of the therapy options mentioned above to determine the best course of treatment for you. It's important to note that your therapy and that received by others may not be identical, as the treatment plan for this condition varies depending on the individual's biological, psychological, social, and environmental factors.
Prevention
There is no correct way to predict whether someone will suffer from this disorder or not. Prevention that you can do is as follows:
- Seek help early. Like other health problems, anxiety disorders will get worse if you delay getting help
- Maintain a daily journal to document your everyday life. Documenting your daily life can help you and your healthcare provider find out what is causing or even relieving stress in your life.
- Set priorities in your life. You can reduce feelings of anxiety by managing your daily allocation of time and energy
- Avoid using certain drugs or substances. Alcohol, caffeine, nicotine, and other drugs can cause or even worsen feelings of anxiety. If you stop using these substances suddenly, you may experience anxiety as a side effect. Therefore, if you plan to stop, the reduction can be done gradually or with the help of a health professional. Another alternative is to find a therapy program or support group to help you
When to see a doctor?
Anxiety is a natural feeling that occurs in life, but you need to see a doctor if you are too anxious that it interferes with your work and relationships with the people around you. Apart from that, you need to see a doctor if these feelings of anxiety cause you to feel sad and irritable, if these feelings are accompanied by the use of substances such as alcohol, caffeine, nicotine (cigarettes), or other substances, or if there are other mental problems. If you are having thoughts or making attempts to end your life, immediately go to the nearest emergency room.
These symptoms are unlikely to go away on their own and may even worsen over time. Seeking help promptly can result in faster treatment and relief.
- dr Anita Larasati Priyono
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Munir, S., & Takov, V. (2022). Generalized Anxiety Disorder. Retrieved 1 February 2022, from https://www.ncbi.nlm.nih.gov/books/NBK441870/