Generalized anxiety disorder
Worry: The norm today
Typically nervousness and worry form a part of everyday small matters like work, finances, relationships, health and safety of loved ones; school or college assignments, job stresses, presentations and other routine tasks. The focus of worry usually keeps shifting from one task to another. Normally everyone is able to keep control over bothersome thoughts and impending trials; and life’s uncertainties ordinarily don’t seem to be getting out of hand. But sometimes, defenses don’t match up to the stressors; demand overruns the supply of personal energies, and troubles do get out of subjective individual control.
When anxiety attacks
The attack on the defenses is the point when worry gets the better of us. Thoughts get focused on some or the other object of concern and then catastrophic feelings stem up effortlessly. These become difficult to overpower. Usually the psychological defenses come in hand and we can use coping strategies to ward off the negative thoughts. Usually one can challenge the anxiety and convince oneself that it is baseless. But in the pathological anxiety state, the person is helpless. All defenses are overpowered by the angst provoking situation; putting up a fight is no longer an option. What prevails is fright (fear) and flight (escape).
Anxiety and the body
The apprehension response is accompanied by tremulousness, shakiness, with backache, headache, chest pain, irritability, insomnia, fatigue, dryness of mouth, sweating, nausea and at times even physical manifestations like stomach cramps and diarrhea. A simple classical example of this is the anxiety felt by the school going child just before the examination. These are physical expressions of turmoil in the mind. They don’t have a physical cause but are felt with the same intensity as if there was some problem in the body.
Out of control: Panic attack
In extreme cases this anxiety can progress to a panic attack, which resembles a heart attack and may have to be looked upon as an emergency. This restlessness, nervousness, ill at ease feeling is not just a usual worry anymore. It points towards a generalized anxiety disorder, which warrants expert evaluation. Panic attacks can be very distressing and one may develop a phobia of the same because they come in unexpectedly without warning. They cannot be prevented because they don’t have precedents. One may stop social contact and avoid social situations due to the fear of an anxious breakdown. Life doesn’t seem normal anymore and depression sets in easily in such situations.
Genes and the environment
Anxiety is well known to run in families. The neurotransmitter systems (chemicals in the brain), predominantly adrenaline and others like serotonin and GABA get deranged in anxiety. Some or the other external stress factor acts as the antecedent culprit, which in a susceptible person deranges the brain neurotransmitters and prompts the anxiety response. Stressful life events play an important role in transforming relaxed individuals into worried, troubled, apprehensive and anxious personalities.
What we can do
Anxiety is long lasting and disabling. Medication can be used to reduce the physiological (bodily) symptoms, but dealing with the worrisome thoughts is the challenge. Cognitive therapy (CBT) helps correct faulty cognitions that direct to undue worries. Behavior therapy reduces apprehensive performances. Emotive therapies (REBT) help to correct incorrect emotions. Supportive psychotherapy, relaxation, and biofeedback help in managing the physiological angst component. MINDFRAMES uses combination therapy to target both physiological and psychological anxiety components. Medical conditions are ruled out and cognitive behavior therapy programs are initiated to target a worry free existence. There is a lot that is out of our hands but there is also a whole lot that is within human control. It is wise to make the most of that ability.