Crystla24
Jedi
Well, I pulled the following up from Wikipedia about GAD (Generalized Anxiety Disorder), if you visit the site http://en.wikipedia.org/wiki/Generalized_anxiety_disorder you can also find links to others types of anxiety. I did scroll through the 36 pages of the health and diet section and did not see this addressed. If I missed it somewhere, I apolagize for the repeat. Anyway, I am new hear and had gone off on quite a rant about anything and everything. I have, I could not quite find on the internet, something my doctor explains to me is called a "cloaking" in my chest. When my anxiety swells really high, my chest starts getting heavy and feels as if it is closing in, and almost exactly replicates the feel of drowning! This causes me to feel a sense of urgency all the while flaring my anxiety to extreme heights. I am new here and plan on starting EE breathing this weekend, because I believe helping myself in this natural way could be very beneficial! I also know to avoid caffeine and try soothing decaffinated teas. When I become under alot of pressure my anxiety will flare causing me to stutter and get frusterated and eventually not talk to alot of people that I should. I had gone to a phyciastrist about this, and she explained to me that GAD is genetic (i also have angoraphobia that has run in my family) and that I will never be completely rid of it. She had prescribed me Clonazopam (Klonopin) which has done wonders. Below is says it is a Benzodiazepine drug. I'm not quite sure how this forum feels about any type of prescription drug, but Clonazopam shows instant relief without the "long-term" treatment. I do not at all like any type of the SSRI (Selective Serotonin Untake Inhibitors). While I do suffer anxiety, I have overrcome most depression, and/or bi-polar like symtoms in my life and stay postive and have a pretty healthy train of thought. Doctors like to hand these out like candy and coming off of them does cause severe phycological side effects, I seen another post about this in this diet and health section. If this sounds like you, I would recommend asking your doctor about Clonazapam, if you would like to have more control over it yourself, instead of the SSRI's that mess up your serotonin levels. Doctors don't like giving this out unless you really ask and are genuine, because it is a drug that has a history of abuse and dependency. You can grow tolerant and need higher doses for it to work. I usually take about 2 a week instead of 2 a day/or as needed the bottle says. Because I use them selectively when I know I will have a stressful day, because they actually help me, I use them few and far between as not to grow a tolerance to begin with :) I like controling my own brain, not letting a pill do it for me. Anyway, aside from the breathing, maybe meditating, I would like to hear from people who understand or have advice of their own or I hope this helps.
Last thing, I came across this link trying to Google anxiety and cloaking and this interesting book came across with a sample page. I really think I may look into this book. Has anyone heard of the author Rollo May? Thanks guys! http://books.google.com/books?id=zxAN9KvG-REC&pg=PA47&lpg=PA47&dq=cloaking+anxiety&source=bl&ots=_4mdWp_1X_&sig=dU8qJwlx_cHmaYusgFWMBqA2Wms&hl=en&ei=IFOwTazcEsOutwfw08zfCw&sa=X&oi=book_result&ct=result&resnum=3&ved=0CCcQ6AEwAg#v=onepage&q=cloaking%20anxiety&f=false
Generalized anxiety disorderFrom Wikipedia, the free encyclopediaJump to: navigation, search
Generalized anxiety disorder
Classification and external resources
ICD-10 F41.1
ICD-9 300.02
Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry. This excessive worry often interferes with daily functioning, as individuals suffering GAD typically anticipate disaster, and are overly concerned about everyday matters such as health issues, money, death, family problems, friend problems, relationship problems or work difficulties.[1]. Individuals often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety. (ICD-10).[2] These symptoms must be consistent and on-going, persisting at least 6 months, for a formal diagnosis of GAD to be introduced.[1] Generalised anxiety disorder is estimated to occur in 5% of the general population. Women are generally more affected than men.[3]
Standardized rating scales such as GAD-7 can be used to assess severity of generalized anxiety disorder symptoms.[4] It is the most common cause of disability in the workplace in the United States.[5]
Contents [hide]
1 Prevalence
1.1 Epidemiology
2 Potential causes
2.1 Substance induced
2.2 Neurology
3 Diagnosis
3.1 DSM-IV-TR criteria
3.2 ICD-10 criteria
4 Treatment
4.1 Cognitive behavioral therapy
4.2 SSRIs
4.3 Pregabalin
4.4 Other drugs
4.4.1 Benzodiazepines
5 GAD and comorbid depression
6 See also
7 References
8 Further reading
9 External links
PrevalenceThe World Health Organization's Global Burden of Disease project did not include generalized anxiety disorders.[6] In lieu of global statistics, here are some prevalence rates from around the world:
Australia: 3 percent of adults[6]
Canada: Between 3-5 percent of adults[citation needed]
Italy: 2.9 percent[7]
Taiwan: 0.4 percent[7]
United States: approx. 3.1 percent of people age 18 and over in a given year (9.5 million) [8]
55 to 60 percent of people diagnosed in clinical settings are women.[citation needed]
EpidemiologyThe usual age of onset is variable - from childhood to late adulthood, with the median age of onset being approximately 31 (Kessler, Berguland, et al., 2005). Most studies find that GAD is associated with an earlier and more gradual onset than the other anxiety disorders.
Women are two to three times more likely to suffer from generalized anxiety disorder than men, although this finding appears to be restricted to only developed countries, the spread of GAD is somewhat equal in developing nations. GAD is also common in the elderly population.[9]
Potential causesSome research suggests that GAD may run in families,[10] and it may also grow worse during stress. GAD usually begins at an earlier age and symptoms may manifest themselves more slowly than in most other anxiety disorders.[11] Some people with GAD report onset in early adulthood, usually in response to a life stressor. Once GAD develops, it can be chronic, but can be managed, if not all-but-alleviated, with proper treatment.[12]
Substance inducedLong-term use of benzodiazepines can worsen underlying anxiety.[13][14] with evidence that reduction of benzodiazepines can lead to a lessening of anxiety symptoms.[15] Similarly, long-term alcohol use is associated with anxiety disorders,[16] with evidence that prolonged abstinence can result in a disappearance of anxiety symptoms.[17]
In one study in 1988–1990, illness in approximately half of patients attending mental health services at British hospital psychiatric clinic, for conditions including anxiety disorders such as panic disorder or social phobia, was determined to be the result of alcohol or benzodiazepine dependence. In these patients, anxiety symptoms, while worsening initially during the withdrawal phase, disappeared with abstinence from benzodiazepines or alcohol. Sometimes anxiety pre-existed alcohol or benzodiazepine dependence but the dependence was acting to keep the anxiety disorders going and often progressively making them worse. Recovery from benzodiazepines tends to take a lot longer than recovery from alcohol but people can regain their previous good health.[18]
NeurologyGeneralized anxiety disorder has been linked to disrupted functional connectivity of the amygdala and its processing of fear and anxiety.[19] Sensory information enters the amygdala through the nuclei of the basolateral complex (consisting of lateral, basal, and accessory basal nuclei). The basolateral complex processes sensory-related fear memories and communicate their threat importance to memory and sensory processing elsewhere in the brain such as the medial prefrontal cortex and sensory cortices. Another area the adjacent central nucleus of the amygdala that controls species-specific fear responses its connections brainstem, hypothalamus, and cerebellum areas. In those with general anxiety disorder these connections functionally seem to be less distinct and there is greater gray matter in the central nucleus. Another difference is that the amygdala areas have decreased connectivity with the insula and cingulate areas that control general stimulus salience while having greater connectivity with the parietal cortex and prefrontal cortex circuits that underlie executive functions.[19] The latter suggests a compensation strategy for dysfunctional amygdala processing of anxiety. This is consistent with cognitive theories that suggest the use in this disorder of attempts to reduce the involvement of emotions with compensatory cognitive strategies.[19]
DiagnosisDSM-IV-TR criteriaDSM-IV-TR diagnostic criteria for generalized anxiety disorder are as follows:
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 person 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 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 (difficulty falling or staying asleep, or restless unsatisfying sleep)
The focus of the anxiety and worry is not confined to features of other Axis I disorder (such as social phobia, OCD, PTSD etc.)
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 due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism)[20]
ICD-10 criteriaTreatmentA meta-analysis of 35 studies[21] shows cognitive behavioral therapy to be more effective in the long term than pharmacologic treatment (drugs such as SSRIs), and while both treatments reduce anxiety, CBT is more effective in reducing depression.
Cognitive behavioral therapyMain article: Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a psychological method of treatment for GAD that involves a therapist working with the patient to understand how thoughts and feelings influence behavior.[22] The goal of the therapy is to change negative thought patterns that lead to the patient's anxiety, replacing them with positive, more realistic ones. Elements of the therapy include exposure strategies to allow the patient to gradually confront their anxieties and feel more comfortable in anxiety-provoking situations, as well as to practice the skills they have learned. CBT can be used alone or in conjunction with medication.[23]
CBT usually helps one third of the patients substantially, whilst another third does not respond at all to treatment.[24]
SSRIsMain article: Selective serotonin reuptake inhibitor
Pharmaceutical treatments for GAD include selective serotonin reuptake inhibitors (SSRIs),[23] which are antidepressants that influence brain chemistry to block the reabsorption of serotonin in the brain.[25] SSRIs are mainly indicated for clinical depression, but are also very effective in treating anxiety disorders.[23] Common side effects include nausea, sexual dysfunction, headache, diarrhea, constipation, among others. Common SSRIs prescribed for GAD include:
fluoxetine (Prozac, Sarafem)
paroxetine (Paxil, Aropax)
escitalopram (Lexapro, Cipralex)
sertraline (Zoloft)
PregabalinMain article: Pregabalin
Pregabalin (Lyrica) acts on the voltage-dependent calcium channel in order to decrease the release of neurotransmitters such as glutamate, noradrenaline and substance P. Its therapeutic effect appears after 1 week of use and is similar in effectiveness to lorazepam, alprazolam and venlafaxine but pregabalin has demonstrated superiority by producing more consistent therapeutic effects for psychic and somatic anxiety symptoms. Long-term trials have shown continued effectiveness without the development of tolerance and additionally unlike benzodiazepines it does not disrupt sleep architecture and produces less severe cognitive and psychomotor impairment; it also has a low potential for abuse and dependence and may be preferred over the benzodiazepines for these reasons.[26][27]
Other drugsBuspirone (BuSpar) is a serotonin receptor partial agonist belonging to the azaspirodecanedione class of compounds.
Duloxetine (Cymbalta)
Imipramine (Tofranil) is a tricyclic antidepressant (TCA). TCAs are thought to act on serotonin, norepinephrine, and dopamine in the brain.
Venlafaxine (Effexor, Effexor XR) is a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs, a class of drugs related to the SSRIs, alter the chemistries of both norepinephrine and serotonin in the brain.
Propranolol (Inderal) - Sympatholytic
Guanfacine - Sympatholytic
Prazosin - Sympatholytic
Clonidine - Sympatholytic
BenzodiazepinesMain article: Benzodiazepine
Benzodiazepines (or "benzos") are fast-acting hypnotic sedative depressants that are also used to treat GAD and other anxiety disorders.[23] Benzodiazepines are prescribed for generalized anxiety disorder and show beneficial effects in the short term. However, they have long term adverse effects and for this reason the FDA has only approved them for short term usage (6-12 weeks). The World Council of Anxiety does not recommend the long-term use of benzodiazepines because they are associated with the development of tolerance, psychomotor impairment, cognitive and memory impairments, physical dependence and a withdrawal syndrome.[28][29] Side effects include drowsiness, reduced motor coordination and problems with equilibrioception. Common benzodiazepines used to treat GAD include[23]:
alprazolam (Xanax, Xanax XR, Niravam)
chlordiazepoxide (Librium)
clonazepam (Klonopin)
clorazepate (Tranxene)
diazepam (Valium)
lorazepam (Ativan)
GAD and comorbid depressionIn the National Comorbidity Survey (2005), 58% of patients diagnosed with major depression were found to have an anxiety disorder; among these patients, the rate of comorbidity with GAD was 17.2%, and with panic disorder, 9.9%. Patients with a diagnosed anxiety disorder also had high rates of comorbid depression, including 22.4% of patients with social phobia, 9.4% with agoraphobia, and 2.3% with panic disorder. For many, the symptoms of both depression and anxiety are not severe enough (i.e. are subsyndromal) to justify a primary diagnosis of either major depressive disorder (MDD) or an anxiety disorder. However, Dysthymic Disorder is the most prevalent comorbid diagnosis of GAD clients.
Patients can also be categorized as having mixed anxiety-depressive disorder, and they are at significantly increased risk of developing full-blown depression or anxiety.
Accumulating evidence indicates that patients with comorbid depression and anxiety tend to have greater illness severity and a lower treatment response than those with either disorder alone.[30] In addition, social function and quality of life are more greatly impaired.
In addition to coexisting with depression, research shows that GAD often coexists with substance abuse or other conditions associated with stress, such as irritable bowel syndrome.[31] Patients with physical symptoms such as insomnia or headaches should also tell their doctors about their feelings of worry and tension. This will help the patient's health care provider to recognize whether the person is suffering from GAD.
See alsoAnxiety disorder
Social anxiety disorder
Clinical depression
Cognitive behavioral therapy
Anxiety Disorders Association of America
Last thing, I came across this link trying to Google anxiety and cloaking and this interesting book came across with a sample page. I really think I may look into this book. Has anyone heard of the author Rollo May? Thanks guys! http://books.google.com/books?id=zxAN9KvG-REC&pg=PA47&lpg=PA47&dq=cloaking+anxiety&source=bl&ots=_4mdWp_1X_&sig=dU8qJwlx_cHmaYusgFWMBqA2Wms&hl=en&ei=IFOwTazcEsOutwfw08zfCw&sa=X&oi=book_result&ct=result&resnum=3&ved=0CCcQ6AEwAg#v=onepage&q=cloaking%20anxiety&f=false
Generalized anxiety disorderFrom Wikipedia, the free encyclopediaJump to: navigation, search
Generalized anxiety disorder
Classification and external resources
ICD-10 F41.1
ICD-9 300.02
Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry. This excessive worry often interferes with daily functioning, as individuals suffering GAD typically anticipate disaster, and are overly concerned about everyday matters such as health issues, money, death, family problems, friend problems, relationship problems or work difficulties.[1]. Individuals often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety. (ICD-10).[2] These symptoms must be consistent and on-going, persisting at least 6 months, for a formal diagnosis of GAD to be introduced.[1] Generalised anxiety disorder is estimated to occur in 5% of the general population. Women are generally more affected than men.[3]
Standardized rating scales such as GAD-7 can be used to assess severity of generalized anxiety disorder symptoms.[4] It is the most common cause of disability in the workplace in the United States.[5]
Contents [hide]
1 Prevalence
1.1 Epidemiology
2 Potential causes
2.1 Substance induced
2.2 Neurology
3 Diagnosis
3.1 DSM-IV-TR criteria
3.2 ICD-10 criteria
4 Treatment
4.1 Cognitive behavioral therapy
4.2 SSRIs
4.3 Pregabalin
4.4 Other drugs
4.4.1 Benzodiazepines
5 GAD and comorbid depression
6 See also
7 References
8 Further reading
9 External links
PrevalenceThe World Health Organization's Global Burden of Disease project did not include generalized anxiety disorders.[6] In lieu of global statistics, here are some prevalence rates from around the world:
Australia: 3 percent of adults[6]
Canada: Between 3-5 percent of adults[citation needed]
Italy: 2.9 percent[7]
Taiwan: 0.4 percent[7]
United States: approx. 3.1 percent of people age 18 and over in a given year (9.5 million) [8]
55 to 60 percent of people diagnosed in clinical settings are women.[citation needed]
EpidemiologyThe usual age of onset is variable - from childhood to late adulthood, with the median age of onset being approximately 31 (Kessler, Berguland, et al., 2005). Most studies find that GAD is associated with an earlier and more gradual onset than the other anxiety disorders.
Women are two to three times more likely to suffer from generalized anxiety disorder than men, although this finding appears to be restricted to only developed countries, the spread of GAD is somewhat equal in developing nations. GAD is also common in the elderly population.[9]
Potential causesSome research suggests that GAD may run in families,[10] and it may also grow worse during stress. GAD usually begins at an earlier age and symptoms may manifest themselves more slowly than in most other anxiety disorders.[11] Some people with GAD report onset in early adulthood, usually in response to a life stressor. Once GAD develops, it can be chronic, but can be managed, if not all-but-alleviated, with proper treatment.[12]
Substance inducedLong-term use of benzodiazepines can worsen underlying anxiety.[13][14] with evidence that reduction of benzodiazepines can lead to a lessening of anxiety symptoms.[15] Similarly, long-term alcohol use is associated with anxiety disorders,[16] with evidence that prolonged abstinence can result in a disappearance of anxiety symptoms.[17]
In one study in 1988–1990, illness in approximately half of patients attending mental health services at British hospital psychiatric clinic, for conditions including anxiety disorders such as panic disorder or social phobia, was determined to be the result of alcohol or benzodiazepine dependence. In these patients, anxiety symptoms, while worsening initially during the withdrawal phase, disappeared with abstinence from benzodiazepines or alcohol. Sometimes anxiety pre-existed alcohol or benzodiazepine dependence but the dependence was acting to keep the anxiety disorders going and often progressively making them worse. Recovery from benzodiazepines tends to take a lot longer than recovery from alcohol but people can regain their previous good health.[18]
NeurologyGeneralized anxiety disorder has been linked to disrupted functional connectivity of the amygdala and its processing of fear and anxiety.[19] Sensory information enters the amygdala through the nuclei of the basolateral complex (consisting of lateral, basal, and accessory basal nuclei). The basolateral complex processes sensory-related fear memories and communicate their threat importance to memory and sensory processing elsewhere in the brain such as the medial prefrontal cortex and sensory cortices. Another area the adjacent central nucleus of the amygdala that controls species-specific fear responses its connections brainstem, hypothalamus, and cerebellum areas. In those with general anxiety disorder these connections functionally seem to be less distinct and there is greater gray matter in the central nucleus. Another difference is that the amygdala areas have decreased connectivity with the insula and cingulate areas that control general stimulus salience while having greater connectivity with the parietal cortex and prefrontal cortex circuits that underlie executive functions.[19] The latter suggests a compensation strategy for dysfunctional amygdala processing of anxiety. This is consistent with cognitive theories that suggest the use in this disorder of attempts to reduce the involvement of emotions with compensatory cognitive strategies.[19]
DiagnosisDSM-IV-TR criteriaDSM-IV-TR diagnostic criteria for generalized anxiety disorder are as follows:
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 person 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 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 (difficulty falling or staying asleep, or restless unsatisfying sleep)
The focus of the anxiety and worry is not confined to features of other Axis I disorder (such as social phobia, OCD, PTSD etc.)
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 due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism)[20]
ICD-10 criteriaTreatmentA meta-analysis of 35 studies[21] shows cognitive behavioral therapy to be more effective in the long term than pharmacologic treatment (drugs such as SSRIs), and while both treatments reduce anxiety, CBT is more effective in reducing depression.
Cognitive behavioral therapyMain article: Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a psychological method of treatment for GAD that involves a therapist working with the patient to understand how thoughts and feelings influence behavior.[22] The goal of the therapy is to change negative thought patterns that lead to the patient's anxiety, replacing them with positive, more realistic ones. Elements of the therapy include exposure strategies to allow the patient to gradually confront their anxieties and feel more comfortable in anxiety-provoking situations, as well as to practice the skills they have learned. CBT can be used alone or in conjunction with medication.[23]
CBT usually helps one third of the patients substantially, whilst another third does not respond at all to treatment.[24]
SSRIsMain article: Selective serotonin reuptake inhibitor
Pharmaceutical treatments for GAD include selective serotonin reuptake inhibitors (SSRIs),[23] which are antidepressants that influence brain chemistry to block the reabsorption of serotonin in the brain.[25] SSRIs are mainly indicated for clinical depression, but are also very effective in treating anxiety disorders.[23] Common side effects include nausea, sexual dysfunction, headache, diarrhea, constipation, among others. Common SSRIs prescribed for GAD include:
fluoxetine (Prozac, Sarafem)
paroxetine (Paxil, Aropax)
escitalopram (Lexapro, Cipralex)
sertraline (Zoloft)
PregabalinMain article: Pregabalin
Pregabalin (Lyrica) acts on the voltage-dependent calcium channel in order to decrease the release of neurotransmitters such as glutamate, noradrenaline and substance P. Its therapeutic effect appears after 1 week of use and is similar in effectiveness to lorazepam, alprazolam and venlafaxine but pregabalin has demonstrated superiority by producing more consistent therapeutic effects for psychic and somatic anxiety symptoms. Long-term trials have shown continued effectiveness without the development of tolerance and additionally unlike benzodiazepines it does not disrupt sleep architecture and produces less severe cognitive and psychomotor impairment; it also has a low potential for abuse and dependence and may be preferred over the benzodiazepines for these reasons.[26][27]
Other drugsBuspirone (BuSpar) is a serotonin receptor partial agonist belonging to the azaspirodecanedione class of compounds.
Duloxetine (Cymbalta)
Imipramine (Tofranil) is a tricyclic antidepressant (TCA). TCAs are thought to act on serotonin, norepinephrine, and dopamine in the brain.
Venlafaxine (Effexor, Effexor XR) is a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs, a class of drugs related to the SSRIs, alter the chemistries of both norepinephrine and serotonin in the brain.
Propranolol (Inderal) - Sympatholytic
Guanfacine - Sympatholytic
Prazosin - Sympatholytic
Clonidine - Sympatholytic
BenzodiazepinesMain article: Benzodiazepine
Benzodiazepines (or "benzos") are fast-acting hypnotic sedative depressants that are also used to treat GAD and other anxiety disorders.[23] Benzodiazepines are prescribed for generalized anxiety disorder and show beneficial effects in the short term. However, they have long term adverse effects and for this reason the FDA has only approved them for short term usage (6-12 weeks). The World Council of Anxiety does not recommend the long-term use of benzodiazepines because they are associated with the development of tolerance, psychomotor impairment, cognitive and memory impairments, physical dependence and a withdrawal syndrome.[28][29] Side effects include drowsiness, reduced motor coordination and problems with equilibrioception. Common benzodiazepines used to treat GAD include[23]:
alprazolam (Xanax, Xanax XR, Niravam)
chlordiazepoxide (Librium)
clonazepam (Klonopin)
clorazepate (Tranxene)
diazepam (Valium)
lorazepam (Ativan)
GAD and comorbid depressionIn the National Comorbidity Survey (2005), 58% of patients diagnosed with major depression were found to have an anxiety disorder; among these patients, the rate of comorbidity with GAD was 17.2%, and with panic disorder, 9.9%. Patients with a diagnosed anxiety disorder also had high rates of comorbid depression, including 22.4% of patients with social phobia, 9.4% with agoraphobia, and 2.3% with panic disorder. For many, the symptoms of both depression and anxiety are not severe enough (i.e. are subsyndromal) to justify a primary diagnosis of either major depressive disorder (MDD) or an anxiety disorder. However, Dysthymic Disorder is the most prevalent comorbid diagnosis of GAD clients.
Patients can also be categorized as having mixed anxiety-depressive disorder, and they are at significantly increased risk of developing full-blown depression or anxiety.
Accumulating evidence indicates that patients with comorbid depression and anxiety tend to have greater illness severity and a lower treatment response than those with either disorder alone.[30] In addition, social function and quality of life are more greatly impaired.
In addition to coexisting with depression, research shows that GAD often coexists with substance abuse or other conditions associated with stress, such as irritable bowel syndrome.[31] Patients with physical symptoms such as insomnia or headaches should also tell their doctors about their feelings of worry and tension. This will help the patient's health care provider to recognize whether the person is suffering from GAD.
See alsoAnxiety disorder
Social anxiety disorder
Clinical depression
Cognitive behavioral therapy
Anxiety Disorders Association of America
