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GENERALIZED ANXIETY DISORDER - Coggle Diagram
GENERALIZED ANXIETY DISORDER
DEFENITION, ETIOLOGY & RISK FACTOR
Defenition
Generalized anxiety disorder is a mental health disorder that produces fear, worry, and a constant feeling of being overwhelmed.
Characterized by persistent, excessive, and unrealistic worry about everyday things.
This worry could be multifocal such as finance, family, health, and the future.
It is excessive, difficult to control, and is often accompanied by many non-specific psychological and physical symptoms.
Etiology
Stress
A physical condition such as diabetes or other comorbidities such as depression
Genetic (25%)
Environmental factors, such as child abuse
Substance abuse, such as drugs
Risk Factor
Sex (Woman > Man)
Family history
smoking, alcohol
Medical Conditions
History of stressful life events
DIAGNOSIS APPROACH
Diagnostic Criteria
DSM
Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school
performance).
The individual finds it difficult to control the worry.
The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the
past 6 months):
Restlessness or feeling keyed up or on edge.
Being easily fatigued
Difficulty concentrating or mind going blank.
Irritability
Muscle tension
Sleep disturbance
The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
-The disturbance is not attributable to the physiological effects of a substance (e.g., a
drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
The disturbance is not better explained by another mental disorder
PPDGJ III
Penderita harus menunjukkan anxietas sebagai gejala primer yang berlangsung hampir setiap hari untuk beberapa minggu sampai beberapa bulan, yang tidak terbatas atau hanya menonjol pada keadaan situasi khusus tertentu saja (sifatnya "free floating" atau"mengambang")
Gejala-gejala tersebut biasanya mencakup unsur-unsur berikut:
1.kecemasan (khawatir akan nasib buruk, merasa seperti di ujung tanduk,sulit konsentrasi, dsb.)
ketegangan motorik (gelisah, sakit kepala, gemetaran, tidak dapat santai);dan
3.overaktivitas otonomik (kepala terasa ringan, berkeringat, jantung
berdebar-debar, sesak napas, keluhan lambung, pusing kepala, mulut kering, dsb.).
Pada anak-anak sering terJihat adanya kebutuhan berlebihan untuk
ditenangkan (reassurance) serta keluhankeluhan somatik berulang yang menonjol.
Adanya gejala-gejala lain yang sifatnya sementara
Evaluation
Initial assessment begins by addressing behavioral or somatic symptoms.
Evaluate for psychosocial stress, psychosocial difficulties, and developmental issues.
Review past medical history, including trauma, psychiatric conditions, and substance abuse.
The Generalized Anxiety Disorder 7-Item (GAD-7) Questionnaire is a screening tool that can also be used to monitor patients with generalized anxiety disorder.
TREATMENT
The two main treatments for generalized anxiety disorder are
cognitive behavioral therapy
and
medications.
Cognitive Behavioral Therapy : includes psychoeducation, changing maladaptive thought patterns, and gradual exposure to anxiety-provoking situations.
Medications :
Antidepressants : Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI).
Antipsychotics
Benzodiazepines : diazepam and clonazepam
Buspirone
All medications should be titrated slowly and continued for at least 4 weeks to determine if they work. Once symptoms are under control, the medications need to be used for at least 12 months before gradually tapering them.
EDUCATION & PREVENTION
Education
The triggers for anxiety should be managed like avoiding caffeine, alcohol, nicotine, stress)
Improving sleep.
Prevention
Social coping strategies
Emotional coping strategies
Physical coping strategies
PATHOPHYSIOLOGY
Noradrenergic, serotonergic, and other neurotransmitter systems appear to play a role in the body's response to stress.
The serotonin system and the noradrenergic systems are common pathways involved in anxiety.
DIFFERENTIAL DIAGNOSIS
Anxiety disorder due to another medical condition.
Substance/medication-induced anxiety disorder.
Social anxiety disorder.
Obsessive-compulsive disorder.
Posttraumatic stress disorder and adjustment disorders.
Depressive, bipolar, and psychotic disorders.
Hyperthyroidism
ISLAMIC VIEW IN DEALING WITH ANXIETY
Among other ways to treat GAD is through performing Solat (prayer). Solat stated in the Qur’an is among the ways to apply in the psychotherapy process. Solat is also regarded as a remedy for anxiety because itcan develop positive values such as patience, endurance, contentment and perseverance needed when facing hardship and turmoil in the world.
Zikir is an activity to remember Allah since ourthinking has been focused towards positive activities and thus, the feeling of anxiety can be reduced.
Reading Al-Quran
COMPLICATIONS & PROGNOSIS
Complications
Depressions
Insomnia
Drug or alcohol misuse
GI problems
Social isolation
Issues functioning at work/school
Impaired quality of life
Suicide potential
Prognosis
The prognosis for patients with generalized anxiety disorder is guarded.
Overall, the quality of life of these patients is poor.
