Continuing our hugely popular column Medical Matters, Dr Ciaran Roarty of Scally/McDaid Medical Practice explains what Generalised Anxiety Disorder is, how it is diagnosed and how to treat it:
People who suffer from Generalised Anxiety Disorder (GAD) feel anxious most days of the week for a long time.
They describe feeling worried, tense and fearful and often have physical symptoms which come and go. These can include the sensation of a pounding heart, sweating, headaches, tummy upset, dizziness and muscle tension. The anxiety is related to day to day stresses at work or home and is often related to a fairly minor thing/things. Sometimes people cannot actually identify what exactly they feel worried about.
So how do we differentiate it from normal mild anxiety in an individual with an anxious personality? Generally if someone has GAD the symptoms will distress them and interfere with their daily life. They also may find it hard to concentrate, suffer from insomnia and describe a sense of restlessness or irritability.
It is thought to affect up to 2% of the population and is more common in women. Frequently it develops in your 20s but can be picked up later in life.
We are not entirely sure what causes it but we know that some people can have an anxious personality which seems to run in families. A major stress in life or childhood trauma may predispose someone to GAD and people often describe their symptoms persisting long after the stressful event has passed.
People who suffer from other mental health problems such as schizophrenia or depression may also develop GAD.
How will my doctor diagnose this condition?
Once again your doctor will take a thorough history of your symptoms and if they have been persistent for at least 6 months your doctor may make the diagnosis.
He or she may also suspect other conditions from your history such as panic disorder or depression if your story points towards this diagnosis as well. These diagnoses can overlap.
They may also wish to explore your symptoms further and do some tests to ensure that other causes of your physical symptoms are not present eg excessive caffeine intake, thyroid gland problems, prescribed or illicit drug side effects or heart conditions.
How is it treated?
Cognitive behavioural therapy helps us look at our thought processes and subsequent behaviours and tries to help us modify them by developing strategies to deal with them.
Counselling can also help particularly if concentrated on problem solving skills.
Certain areas may have access to anxiety management courses in which group support also plays a vital support.
There are also online sources of self-help advice, treatment and support which help us develop strategies to relieve stress and relax as well as CDs, DVDs and books.
Certain medications which were initially developed and prescribed for other conditions such as depression or epilepsy have been found to also be helpful for anxiety.0
Benzodiazepines such as valium used to be prescribed commonly for anxiety. The problem with this family of medications is that they are very addictive and often lose their effect within a few weeks. They are used much less frequently nowadays for persistent GAD for these reasons.It has also been suggested by some studies that their long-term use has been linked to an increased risk of Alzheimer’s. There are, however, some conflicting studies on this link.
Often a combination of CBT and medication may be prescribed as a treatment strategy.
What’s my prognosis doctor?
While it may resolve in some individuals, GAD tends to come and go, flaring up from time to time often during very stressful times in our life. Long-term medication is sometimes required and allows the individual live an otherwise normal life. Unfortunately some people tend to self-treat with excessive alcohol, smoking or illicit drugs. While these may seem to help in the short term they tend to make things worse overall and should be avoided.
The above information is intended as advice only and should you have any concerns please contact your own Doctor.
Dr Ciarán Roarty MB, BCh BAO MICGP DRCOG Grad. Cert. Obst. Ultrasound is a full-time GP at Scally McDaid Medical Practice , Scally Place, Letterkenny, Tel 0749164111
