Generalized
Anxiety Disorder
The
patient with a generalized anxiety disorder worries excessively about everything
all the time. If this persists for more than at least 6 months, the psychiatrist
or psychologist will diagnose this disorder. The following conditions also have
to be met:1. the patient cannot control the worry. 2. at least three
items of the following list accompany the anxiety or worry: restlessness - tiring
easily - being irritated - muscle tension - sleep disturbance - concentration
problem. 3. the worries and anxiety may not be perceived by the patient
as"excessive", but on further questioning it is clear that it interferes
significantly with normal functioning in social situations, at work and in other
areas important to the patient's normal life activities. 4. the disorder
is not due to another mental illness and is not due to a substance or medical
illness. 5. the intensity, the time it lasts and the frequency of attacks
are completely out of proportion with how a normal person would react to the feared
event. Patients with generalized anxiety disorder tend to worry about ordinary
day to day responsibilities at home or at work. Symptoms of generalized
anxiety disorder: Patients with this disorder will complain about
muscular symptoms such as a feeling shaky, trembling, pain, soreness and twitching.
Patients may somatisize and complain of various symptoms such as cold hands and
feet, dryness in the mouth, diarrhea or nausea, a lump in the throat, frequency
of urination, sweating or clammy hands. Sometimes the doctor might find in addition
a medical condition such as irritable bowel syndrome or tension type headaches.
To complicate matters, generalized anxiety disorder can occur together with other
psychiatric conditions such as: 1. a mood disorders such as dysthymic or
major depressive disorder 2. panic disorder, social phobia or specific phobia 3.
a substance-related disorder (hypnotic, alcohol, anxiolytic dependency).
Treatment of generalized anxiety disorder: Many
treatment attempts with counseling have not yielded the desired good outcome.
It seems to be easier to simply put the patient on a small dosage of an anxiolytic
medication such as benzodiazepines like alprazolam (brand name: Xanax), clonazepam
(brand names: Rivotril, Klonopin), diazepam (brand names: Valium, Valrelease,
Zetran), lorazepam( brand name: Ativan) and oxazepam (brand name: Serax).
They
are all effective in controlling acute anxiety and generalized anxiety disorder.
However, on the long term there can be a problem with dependency on the medication
with these anxiolytics. Usually the literature quotes high dropout rates for people
with generalized anxiety disorder( Ref. 7). These authors found that the presence
of general anxiety disorder, when it coexisted with obsessive-compulsive disorder,
was the reason for dropping out of the behavior therapy for the obsessive-compulsive
disorder. However, it appears that with a combination of cognitive therapy and
behavior therapy the presence of generalized anxiety disorder in the treatment
of social phobia had a very good treatment outcome as the authors of Ref. 8 showed.
Analytical hypnotherapy can be used as another tool to help patients with generalized
anxiety disorder, but not every patient will get into a good trance. Once
patients get into a good trance and feel comfortable talking under hypnosis or
communicating with ideomotor signals (usually finger signals), then the root of
the psychiatric problem in the subconscious memory stores can be quickly identified
and alternative ways of coping with different life situations can be suggested.
It is often rewarding for the patient as well as the therapist to see that only
a few hypnotherapy sessions can solve a seemingly hopeless anxiety problem in
a short period of time. Once successfully treated with hypnotherapy the patient
stays symptom free from then onwards. This is so, because the subconscious pattern
of thinking that was disorderly before is normalized after the successful treatment.
Cognitive and behavioral therapy is useful as well, but it does not seem to penetrate
as deep into the subconscious (where the fears and anxieties are located) as hypnotherapy
does (Ref.5, 6 and 9). For more info about
generalized anxiety disorder, click here. |
