How Generalized Anxiety Disorder Is Diagnosed

The GAD-2 questionnaire consists of two questions, which ask patients how frequently they experienced symptoms of anxiety over the preceding two weeks. The GAD-7 questionnaire is a self-administered tool that consists of 7 questions that ask about the frequency and severity of anxiety symptoms over the past two weeks. It scores each symptom on a scale from 0 to 3 with the total score ranging from 0 to 21. Higher scores indicate more severe anxiety symptoms. Scores of 5, 10, and 15 are used as cutoff points for mild, moderate, and severe anxiety, respectively. In the diagnosis code “F41.1” , an ICD-10 (International Classification of Diseases, Tenth Revision) code that is assigned to an individual who meets the criteria for experiencing ongoing, excessive, and unrealistic worry or anxiety about everyday events and situations.

Common Triggers Of GAD

    Generalized anxiety disorder (GAD) is a mental illness because it involves a significant impairment in a person's emotional, behavioral, and cognitive functioning, which is caused by the presence of persistent and excessive worry and anxiety.  GAD is classified as a mental illness under the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).  An individual can experience an intense sense of apprehension, dread, or fear without any clear reason. They often have difficulty controlling their anxiety and may feel overwhelmed by worries about things like health, money, work, or family. 

Here are some common triggers of GAD:
-Genetics. I believe that my mom passed on her genes with mental illness to me.
-Trauma. My first trauma that I believe started my journey into mental illness, was my first grade teacher. As I mentioned in another post, she used to pull me out of my chair by my hair. I was so young that I didn’t know what to do. I just let it happen over and over. Although, I never told anybody until right before my mother past away. I guess back then, maybe I thought it was normal. I have a different stance on it now that I’ve grown up. I believe if someone did that to me now, I would have punched them in the face, even if I got in trouble. Years later, I have become very defensive about anybody picking on me because of all the emotional abuse I endured.
-Medical conditions. Certain medical conditions, such as thyroid disorders, can be associated with anxiety symptoms.
-Drug or alcohol abuse. I was one of the lucky ones, I never got mixed up with drugs or alcohol. Although, I know of people trying to drown out their feelings with it.
-Major life changes. This might be disgusting to some of the guys out there, but I started my menstrual cycle earlier than the other girls in my class. They were very painful. I was never diagnosed as having endometriosis, but I thought it might be that.
-Family conflicts. My family conflict was with my mother. She had suffered with mental illness most of her life. Then when I started having problems, I blamed her. I hated her so much back then. We used to get into fist fights and my dad would have to stand in between us to stop it. I came to terms with it after my mom passed away.
-Financial problems. I’ve had financial problems most of my life. I would go on shopping sprees because of the bipolar. Nowadays, I’ve started to save my money.
-Sleep disturbances. When I started to have trouble sleeping, my doctor put me on Trazodone. That was like a miracle drug for me because I started sleeping better. After switching to several different doctors, I was taken off of it. I did good for a while, but then my sleeping problems came back.

Treatments For Generalized Anxiety Disorder

-Cognitive-behavioral therapy (CBT). It identifies and challenges negative thought patterns. CBT also helps individuals with GAD to identify the negative thoughts and beliefs that contribute to their anxiety. This is a very helpful tool. It allows you to reframe your thoughts and not jump to the wrong conclusions right after the initial thought. CBT teaches coping skills to manage your anxiety. It also promotes exposure therapy, which is to help individuals confront and overcome their fears and anxieties by gradually exposing them to stimuli that trigger their anxiety in a safe, controlled environment.
-Medications. Here are some medications and how they help with anxiety:
-Antidepressants. By increasing the levels of neurotransmitters, they can help reduce symptoms associated with anxiety, such as worry, fear, and panic attacks. Here are a couple of examples:
-Lexapro, which is an SSRI (Selective Serotonin Reuptake Inhibitor), is shown to be effective in reducing worry, tension, and other symptoms of anxiety. It works by specifically blocking the reuptake of serotonin, a neurotransmitter in the brain that is involved in mood regulation.
-Effexor, which is an SNRI (Serotonin – Norepinephrine Reuptake Inhibitor), works by increasing the availability of serotonin in the brain. Additionally, it contributes to the availability of norepinephrine, which also helps to improve mood and reduce anxiety symptoms. I was on this one a few years back and I didn’t like it. One of the side effects (for me) was diminished thought process. If somebody asked me a question, my thought process to answer that question was slow. I couldn’t think straight. Literally, I was having problems communicating with other people.
-Benzodiazepines. Long-term use can carry significant risks such as dependence, withdrawal, cognitive effects (memory, attention, and problem-solving abilities), Increased risk of falls and accidents, tolerance (may need to take higher doses to achieve the same result), increasing the risk of dependence.

Some common Benzodiazepines are:
– Xanax is typically used to treat acute anxiety symptoms, such as panic attacks.
– Ativan works by increasing the activity of GABA (gamma-aminobutyric acid) in the brain, which can help to reduce anxiety symptoms. I’m on this one right now and it’s working pretty good.

-Mindfulness meditation.
-Increases awareness of the present moment. I used this during an interview recently. I started to have a panic attack and so I focused my attention to my five senses (touch, hearing, seeing, taste, and smell). It brought me out of the panic attack and I was able to continue the interview.
-Decreases reactivity. An individual can become less reactive to anxiety-provoking situations. Meditation also helps individuals develop the skills of observing their thoughts and emotions without becoming too caught up in them.
-Reduces rumination. You learn to observe thoughts as they arise, and let them pass by without attaching to them or becoming stuck in a spiral of negative thinking.
– Increases self-compassion. This is probably the most important idea to master.. If you have no self-compassion, your going to be stuck in this loop that just keeps going round and round putting yourself down. Don’t put yourself down trying to beat the other person to it because you think they’re going to put you down. You don’t know that! I’ve fallen into this trap many times.
– Reduces negative physiological responses. Reduces physiological symptoms of anxiety, such as increased heart rate, muscle, and shallow breathing.
-Exercise. I just started exercising again by going for walks. A few years back, I was walking for an hour and a half and getting my 10,000 steps in for each day. Several things happened, and I stopped. I could feel the difference, both physically and emotionally.
-Breathing techniques. When I’m having a panic attack, I focus on my breathing. I take slow breaths in through the nose, and slow breaths out through the mouth. You would be surprised how well that works.
-Yoga. I tried yoga, but I have such poor balance because of Parkinson’s Disease.
-Nutrition and supplements. I take supplements because I don’t eat right. Lately, I have been having problems eating. Now, I have gone to the extreme of hardly eating. I think part of it is because I am over weight and I don’t want to gain anymore weight.
-Massage therapy. I used to be a massage therapist until I was diagnosed with Parkinson’s Disease. I loved getting a massage. They’re not the cheapest thing in the world, but if you have the money, get one.
-Acupuncture. I’ve never had acupuncture before. Some people think that it would hurt, but the needles are so small, I don’t think it would. I’m all in to try it one of these days.
-Support groups. Here are 5 groups:

   - Anxiety and Depression Association of America (ADAA).  ADAA's mission is to promote the prevention, treatment, and cure of anxiety and depression through education, research, and support. 

   - NAMI (National Alliance on Mental Illness).  NAMI's mission is to improve the lives of individuals and families affected by mental illness through support, education, and advocacy.

   - No More Panic.   UK-based organization that provides information, support, and resources. They offer online support groups that are moderated by trained volunteers.

   - SMART Recovery.  Organization that provides support groups for individuals with substance use disorders as well as other addictive behaviors. 

   - SupportGroups.com.  This is an online platform that offers a wide range of support groups for individuals with various mental health conditions, including GAD.

Articles

“Generalized Anxiety Disorder Treatment.” (https://www.helpguide.org/articles/anxiety/generalized-anxiety-disorder-gad.htm)

“Overcoming Generalized Anxiety Disorder.” (https://www.psychologytoday.com/us/conditions/generalized-anxiety-disorder)

“Generalized Anxiety Disorder (GAD) Statistics.” (https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad/symptoms)

“Generalized Anxiety Disorder (GAD).” (https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803)

    

       The support groups are very helpful. When I was in the hospital a couple of times,  people from NAMI came to talk to us.  It was very informative.  As always, I have learned a lot while researching for this post.  In my next post, I might go into more depths with panic attacks and recount some of my experiences with them.  Some of the thoughts and actions are a little wild.  Sooner or later I'll cover schizoaffective disorder, another one my many labels.  Labels are just that, labels. They don't define who I REALLY am!

Have A Good One,

Cindee, One Voice – Unstoppable