Introduction
James developed generalized anxiety disorder after becoming an internal medicine resident. The cause of his anxiety began with mistakes they committed at work with his colleagues. He started avoiding those mistakes by missing work and giving excuses not to do some work due to fear of making mistakes. James ended up resigning and joining another area of work. He thought he could solve his anxiety problem by choosing a different job with reduced commitments, but his anxiety did not stop.
He ended up joining a biotechnology firm as a researcher. Unfortunately, he never performed well in this firm as well. James’s anxiety problem has affected his relationship with his family and girlfriend. He cannot control his worries. He becomes easily distracted, easily irritated by minor issues, and tense when faced with situations that worry him.
Generalized Anxiety Disorder
Generalized Anxiety Disorder is one of the anxiety disorders caused by abnormalities in the functioning of brain chemicals such as neurotransmitters. Neurotransmitters associated with this disorder are norepinephrine, gamma-aminobutyric acid (GABA), and serotonin. According to the Center for Addiction and Mental Health (CAMH), abnormal regulation or chemical imbalance of neurotransmitters in the brain leads to anxiety disorders (2008).
Neurotransmitters have two types of functions. They are either inhibitory or excitatory. Norepinephrine is excitatory, while serotonin and GABA are inhibitory neurotransmitters. Research scientists have revealed that increased activity in the locus ceruleus is linked to anxiety. The locus ceruleus is always concentrated with norepinephrine. This means that too much norepinephrine in the brain cells leads to stress. Research also indicates that reduced activity in the same area is linked to reduced anxiety (CAMH, 2008).
Unavailability of serotonin has also been associated with anxiety. Since serotonin performs inhibitory functions, the imbalance is caused by either excess norepinephrine or lack of serotonin. According to Little, reuptake of neurotransmitters before performing their operations leads to inadequacy hence abnormality (2006). This is the case with serotonin. Reuptake of this neurotransmitter before it performs its functions leads to anxiety. The interaction between these three neurotransmitters results in the brain’s normal functioning, hence no pressure. An imbalance leads to stress. Serotonin and GABA high levels are linked to reduced anxiety (Durand & Barlow, 2005).
Research has revealed that people with Generalized Anxiety Disorder have increased EEG beta. This, according to scientists, suggests that these people have powerful cognitive processing in their frontal lobes and especially in the left hemisphere. Suggestions also indicate that GAD patients use the left hemisphere for intense thinking without involving the right hemisphere, contributing to images accompanying their thoughts (Durand & Barlow, 2005).
Generalized Anxiety disorder, as indicated earlier, is associated with brain abnormalities. Durand & Barlow Indicated that very few chemicals or too much of brain chemicals affect the brain’s normal functioning (2005). The brain controls anxiety. That is, it is governed by the neurotransmitters mentioned above. Their imbalance (too much norepinephrine of lack of serotonin and GABA) leads to stress. Camp also noted that irregular blood flows of the cerebral or abnormal metabolism of various brain parts such as the occipital and frontal lobes lead to anxiety (2008).
Treatment of Generalized Anxiety Disorder
Generalized anxiety disorder can be treated using drugs and psychological therapy. However, drug use is temporary and is used primarily by therapists during the first stages of the therapy process (Durand & Barlow, 2005). According to Smith & Jaffe-Gill, therapy is the most effective way to treat Generalized Anxiety Disorder (2008). In addition, it is considered safe as it has no side effects compared to the use of drugs.
One type of therapy used to treat these people is cognitive-behavioral therapy. This therapy involves observing the factors that lead to too much worry in a person. According to the above description and even knowledge about Generalized Anxiety Disorder, the mentally affected always worry about the inability to do certain things or lack of confidence. It is not in all situations that these people will worry too much but most likely in many life cases. Therefore, the therapist should be able to examine such areas to begin treatment (Smith & Jaffe-Gill, 2008).
In the above case study, for example, James would be helped to identify what leads to his anxiety in his career and relationship with people. Cognitive-behavioral therapy involves five stages. The initial stage focuses on the patient getting knowledge about the disorder and learning how to accept their situation. Next, the patient is taught how to identify the necessary and the unnecessary worries, monitor their anxiety with identification of what leads to its activation, how severe it is, and how long it takes (Smith & Jaffe-Gill, 2008).
Other steps in cognitive behavioral therapy are strategies that can control anxiety, which are behavioral, physical, and mental. For example, stress is characterized by flight and fight responses, and the biological system is meant to reduce such reactions.
GAD is also characterized by specific behaviors such as avoiding situations one thinks will fail. Treatment of such behaviors is done by behavioral therapy, which helps the patient handle the problems without fear. The strategies make the patient feel in control hence reducing the anxiety.
GAD patients worry even in cases where they should not worry. For example, in the case study presented, James worries about his incompetency in performing his roles, yet he is well trained. He has a problem with being a perfectionist and worries when he commits very few mistakes. Cognitive and behavioral therapy has cognitive strategies that can assist people like James in thinking realistically by teaching them how to understand what regularly causes their abnormal thinking. It also helps eliminate negative thoughts about worrying in a patient (Smith & Jaffe-Gill, 2008).
GAD can also be treated using certain drugs. In most cases, antidepressants and anti-anxiety medications are used. Examples of such medications include Benzodiazepine and Buspirone, anti-anxiety (Smith & Jaffe-Gill, 2008), and Venlafaxine and duloxetine, classified as antidepressants (Sadock, 2008).
Buspirone is considered better than Benzodiazepine as it is non-addictive and not sedative. Benzodiazepines, however, are quick acting if compared to Buspirone and are usually preferred in severe cases (Smith & Jaffe-Gill, 2008). Venlafaxine is a selective norepinephrine reuptake inhibitor, and duloxetine, a selective serotonin reuptake inhibitor (Sadock, 2008).
Reference List
Centre for Addiction and Mental Health (camh). (2008). What Causes Anxiety
Disorders? Anxiety Disorders: An Information Guide. Web.
Durand, V. M. & Barlow, D. H. (2005). Essentials of Abnormal Psychology. (4th ed.). Stamford, US: Thomson Wadsworth.
Little, N. (2006). Neurotransmitters and Chemical Imbalance: What is a Neurotransmitter? Insight Journal. Web.
Sadock, V. A. (2008). Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. (3rded.).London, UK: Lippincott Williams & Wilkins.
Smith, M. M. A. & Jaffe-Gill, E. M.A. (2008). Generalized Anxiety Disorder (GAD):Symptoms, Treatment, and Self-Help. Web.