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Generalized Anxiety Disorder (GAD) - Coggle Diagram
Generalized Anxiety Disorder (GAD)
Complications
Cardiovascular
High blood pressure
Heart attack
Depression
Increased risk of suicide
Side effects of medications
Type 2 Diabetes
Chronic pain
Causes
Dysregulation of worry
Not well understood
Environment
External stressors
Personal Stressor
Financial Stressor
Job stress
Genetics
Irregularities in brain structure
Persistent activation of brain areas
Excessive interpersonal thinking
Dysregulation in Amygdala
Polymorphic Variation
Serotonin 1-A receptor gene
Low Serotonin system activity
Signs and Symptoms
Worry
Persistent
Uncontrollable
Unrealistic
"What if"
Excessive
Constant
3-10 hours out of the day
About everyday activities
Physical Symptoms
Restlessness
Fatigue
Insomnia
Upset Stomach
Headache
Muscle tension
Sleep disturbances
Irritable
Decreased fuction
Apprehension
Shortness of Breath
Cognitive/ Social Symptoms
Distress
Social Anxiety
Thought distortions
Views of risk
Views of threats
Diagnostics
Differential Diagnosis
Hyperthyroidism
Overactive thyroid
Hormones make changes to brain chemistry
Anxiety
Panic attacks
Panic Disorder
Recurrent and unexpected panic attacks
Drug abuse
Withdrawals
Panic
Anxiety
COPD
Shortness of breath
Distress
Anxiety
Panic
Cardiac arrythmias
Heart palpitations
Other mental disorders
Major Depressive Disorder
PTSD
OCD
Screening Tools
GAD- 7
Score: >10
Questionairre
Severity Measure
Symptoms must occur for > 6 months
Rule out causes for physical symtoms
Lab work
Urinalysis
Done with caution
Must impair normal life
No other mental illness
DSM-IV Criteria
Excessive worry and anxiety
6 months
Worry difficult to control
Plus 3 or more of the following
Restlessness
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance
Treatments
Pharmacoligcal
SSRI-1st choice
Increase Serotonin to brain
Lexapro
Prozac
Benzodiazapines
Increase effect of GABA
Clonazepam
MAOIs
Reduce activity of MAO
Nardil
Antidepressants/Antipsycotics
Increase serotonin
Amitriptyline
Blocks dopamine receptors
Seroquel
SNRIs
Block reabsorption into nerve cells
Cymbalta
Non-Pharmacological
Cognitive Behavior Therapy
Learn how to respond to stress
Learn new coping strategies
Worry exposure
Relaxation
Problem solving
Guided imagery
Psycotherapy
Acceptance
Commitment
Complementary Alternative Treatments
Botanicals and Supplements
Kava
Lavender oil
Passion flower
Specific for each patient
Physical activity
Psych referral
Characteristics
May see multiple providers
seen as attention seeking
Find someone to listen to them
Source of anxiety may be unclear
Prevelant in Women
Age 45-59
Interferes with daily activities
Depression diagnosis may also be present
Continuous
Somatic symptoms
Underdiagnosed
Multiple symptoms
Stigma
References
Allgulander, C. (2012). Generalized anxiety disorder: A review of recent findings. Journal of Experimental & Clinical Medicine, 4(2), 88–91.
https://doi.org/10.1016/j.jecm.2012.01.006
Anxiety and Depression Association of America. (2015). Clinical practice review for GAD [Clinical Practice Guideline].
Locke, A. (2015). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician, 91(9), 617–624.
Norris, T. L. (2020). Porth's essentials of pathophysiology (5th ed.). Wolters Kluwer.
Hoge, E. A., Ivkovic, A., & Fricchione, G. L. (2012). Generalized anxiety disorder: Diagnosis and treatment. BMJ, 345(nov27 2), e7500–e7500.
https://doi.org/10.1136/bmj.e7500