Psychological disorder: overview and classification

Generalized Anxiety Disorder in Film

Generalized anxiety disorder (GAD), as defined by the American Psychiatric Association (AMA), involves excessive worry and anxiety for a six-month period or longer (AMA 429). GAD is not typically associated with the more intense expressions of anxiety, such as panic attacks or panic disorder (Shelton S2), yet the degree of worry and anxiety experienced is easily recognized as disproportionate for the reality of the situation (AMA 473-475). A diagnosis depends in part on eliminating contributions from an underlying medical condition or the effects of a substance such as drugs or excessive caffeine, and the focus of the anxiety is not limited to a single concern, such as experiencing a panic attack or becoming deathly ill. The anxiety experienced therefore involves wide swaths of the patient's life.

Patients often report experiencing muscle tension, trembling, twitching, feeling shaky, muscle aches, soreness, sudden fatigue, irritability, and difficulty concentrating and sleeping (AMA 473, 476). Clinical symptoms may include sweating profusely, nausea, and diarrhea, but rapid heart rate, shortness of breath, and dizziness tend to be less prominent than in other anxiety disorders. Patients may also suffer from depression. These symptoms have to be present for most of a six-month period or longer and occur in response to various stressors, and largely out of the control of the patient. In addition, the severity of symptoms is sufficient to impair social and/or occupational functioning.

Common treatment options for persons suffering from GAD and other major anxiety disorders includes some form of talk therapy (Shelton S4). The most common is cognitive behavioral therapy, which focuses on identifying various stressors that trigger or exacerbate anxiety and then encourages patients to think rationally or realistically about their significance. Talk therapy is often used in combination with psychoactive medications. Prominent among the prescription medications used are antidepressants, in particular the selective serotonin reuptake inhibitors (SSRIs). Benzodiazepines have been shown to be effective in providing fast-acting relief from symptoms by promoting GABA neurotransmission. -- blockers, such as buspirone hydrochloride, have been shown to be particularly effective in reducing performance anxiety in GAD patients.