Understanding Generalized Anxiety Disorder

This assignment explores the multifaceted nature of generalized anxiety disorder (GAD), encompassing its causes, symptoms, and various treatment approaches. It examines both psychological and pharmacological interventions, highlighting the importance of understanding stigma and promoting mental well-being. The provided literature references delve into topics like cognitive-behavioral therapy, relaxation techniques, antidepressants, and the Tripartite Model of Anxiety and Depression. The assignment emphasizes personal recovery and encourages a holistic perspective on managing GAD.

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MENTAL HEALTH: GENERALIZED ANXIETY DISORDER
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This essay will start by establishing the concept of mental health. The paper will try to
identify various clarifications that can lead to mental illnesses and then support the explanations
based on Georgia's case study of anxiety. A description of the causes and symptoms of the
chosen illness will be clarified, and the relevant information about the possible mode of
treatment will be presented. To correctly understand the case study under consideration,
variations in the mental state of the patient will be explored to point out the difference between a
person suffering from depression and an individual who is mentally healthy .(Rogers &Pilgrim,
2014, p.130). The case study chosen for this essay is the mental illness in regards to anxiety.
World Health Organization (WHO) define mental health as a state of well-being in which
an individual is capable of realizing their abilities, can adapt to the normal stresses encountered
in everyday life, can perform productively and fruitfully and make a contribution to the
community (World Health Organization, 2001, pp.120-124). Based on this, mental fitness is the
basis for well-being and the input of an individual to the society. World Health Organization
describe psychological illness as a standard, medically diagnosable illness that arise from a
substantial break down of a person's cognitive, practical and relational abilities (World Health
Organization, 2001, pp.120-124).
Although, mental health and mental illness are often used interchangeably, the two terms
do not mean the same thing, but at the same time, they are not mutually exclusive. The key
difference between the two terms is that everyone at any given point has some level of mental
health, the same way as physical health, however, it is possible to be without mental illness
(Keyes, 2005, p. 539). Health and mental illness are based on several interacting social,
behavioral, psychological and biological factors, the same way as health and illness in general
(Anthony, 1993, p.11).

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The primary characteristics of a mental illness are that it; is acknowledged, medically
diagnosable illness, can arise from biological, psychosocial and developmental factors, can cause
substantial cognitive, relational or affective damages, and can be managed from physical disease
perspectives (Anthony, 1993, p.11). Examples of the most common mental sicknesses include
mood disorders, anxiety disorders, psychotic disorders, concurrent disorders, and personality
disorders. Generalized anxiety disorder is clarified as too much worry about many everyday
activities for six months and above. According to the case study, Georgia has been feeling
distraught and stressed for the last six months, and it is becoming even worse with each passing
day; therefore, we can establish that Georgia is suffering from generalized anxiety disorder.
Mental health involves four primary capacities; the ability to develop psychologically,
intellectually, spiritually and emotionally, the ability to start, improve and keep satisfying
personal relationships, the ability to become aware of people around and sympathize or
empathize with them, and the ability to transform psychological distress into a stepping stone for
development process (McHorney, 1993, pp.247-263). These four concepts will be used to
establish whether or not Georgia is mentally ill.
Generalized anxiety disorder (GAD) is recognized through the physical symptoms such
as muscle aches, trembling, nausea, sweating, dizziness, restlessness, feeling tired all the time,
rapid heartbeat, shortness of breath and insomnia (Slade, 2009, pp.20-23). Additionally, children
and adolescents suffering from GAD are characterized by excessive worries about school
performance, punctuality, and other related events. GAD patients struggle with the notion to ‘fit
in,' be a perfectionist and attempt for approval (McHorney, 1993, pp.247-263). Georgia happens
to have most of these symptoms, which establishes that she is suffering from GAD.

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The impacts of GAD are entirely in agreement with its symptom as aforementioned,
making recognition process easier. Due to mental fatigue, an individual will have difficulty in
concentrating on a particular task at hand (McHorney, 1993, pp.247-263). Georgia has trouble
concentrating in her studies. Whenever she has exams or assignments, she gets anxious that she
will fail the test, accompanied by a feeling of impending doom. She even switched from full time
to part-time course study as she is overwhelmed with the workload. Another characteristic of a
person having GAD is that they quickly get annoyed causing harm to relationships, jobs or
people around them. This makes it difficult for the victim to find a job or maintain it, make
friends, or start and maintain relationships McHorney, 1993, pp.247-263). Georgia does not
relate well to people around her, especially within the last four weeks she has not invited anyone
in her apartment. It is also indicated that she has not had a romantic relationship for more than
two years. People in this condition live in a constant state of fear and worries. Their worries
make them reach all kinds of conclusion in their heads, and they rarely share what they think
with people around them McHorney, 1993, pp.247-263). Georgia shows fear of losing control
and concluding that she will fail in her exams and assignments. She also does not believe that she
can pass the driving test after she failed the last test.
Another impact of GAD on patients is poor connectedness in relationships. Due to
consistent worries and fear among these individuals, their minds and spirit are not connected.
This is evident in conversations where they often do not pay attention but wonder in their
imaginary world. When this state, they can quickly get into accidents because their minds are not
concentrated on the roads (Crone & Guy, 2008, pp.197-207). In the case study, Georgia stays
alone in a small apartment out of the college, demonstrating poor connectedness with her friends.

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However, it is important to note that mental disorder is just like any other condition such
as diabetes or a broken leg- one can live with it and even recover from it. Recovery does not
imply that the individual no longer has the condition, it means that the person has stabilized and
redeemed their role in society. Hence, there is hope that Georgia will recover and resume her
studies usually as well as start and maintain a satisfying relationship with people around her
(Corrigon& Watson, 2002, p.16).
Management of GAD requires both medication and cognitive-behavioral therapy.
Patients with GAD are usually unwilling and embarrassed to try medicines due to the stigma
involved (Gorman, 2017, p.150). Such kinds of patients should be reminded that GAD interferes
with their brain neurochemistry and that treatment may help in the improvement of the illness.
They should be encouraged to view the disorder as one of the diseases with available medication.
Physicians should also play a role in ensuring that patients comply with the treatment (Durham,
2007, pp.183-187).
Cognitive-behavioral therapy (CBT) examines distortion from the usual perspective of
looking at the world. The therapist helps the patient to pinpoint the original cause of the anxiety
(Struzik, 2004, pp.285-294). For instance, in the case study, we can start by examining the
source of fear in Georgia and the contributing factors. CBT consists of five components:
education, monitoring, physical control strategies, cognitive control strategies and behavioral
strategies. Training involves learning about GAD. It also helps the patient to distinguish between
essential and unhelpful worries (Borkovec& Costello, 1993, p611). Once the patient has
understood the implication of the disease, the next step follows. The patient is then encouraged
to monitor the anxiety regarding what triggers the fear and worries and the duration of the
occurrence of the GAD. Under physical control strategies, the therapist trains the patient about

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different relaxation techniques to help in reducing physical symptoms of GAD. Cognitive control
strategies are vital in evaluating and altering the thinking patterns that result to GAD. As the
negative thoughts get challenged, fear and worries begin to subside. Finally, under the behavioral
strategies, the therapist trains the patient on how to face the fearful situations rather than
escaping them. The patient can start by visioning things that he or she is afraid of, to feel more in
control of the situation and less nervous (Rickels et al., 1993, pp.884-895).
Medication for GAD is usually recommended during the early stages of managing the
anxiety condition. It is used temporarily to alleviate the patients from the symptoms associated
with GAD. The therapist can either prescribe Buspirone, Benzodiazepines or Anti-depressants.
Buspirone, also called Buspar is considered the safest drug for the GAD, although, it does not
eliminate the anxiety (Borkovec& Costello, 1993, p611). Benzodiazepines are highly efficient
(the patient feels better within 30 minutes or one hour). However, the drugs are associated with
psychological and physical dependence after few weeks of use. Only severe GAD patients are
recommended to use them. Antidepressant takes up-to six weeks to make the full effect. They are
associated with insomnia and nausea (Suls&Bunde, 2005, p.260).
Regarding the impact on future practice, comorbidity requires that nurses familiarize
themselves with multiple roles for the achievement of a comprehensive level of care (Spitzer et
al., 2006, pp.1092-1097).A non-judgmental, objective-based approach should be executed in
recognition and management of general anxiety disorder. Proper communication skills between
the professionals and the patient are required to eliminate GAD. Training is necessary to deliver
comprehensive GAD-based programs through developing skills in cognitive behavioral therapy,
which is fundamental in managing GAD (Clark & Watson, 1991, p.316).

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General anxiety disorder is a common psychiatric illness that is often overlooked.
Anxiety disorders are unsuitable conditions that interfere with an individual's daily activities.
General anxiety disorder occurs in conjunction with other anxiety disorders such as depression.
Individuals present varying degrees of behavioral and physical symptoms, which are essential in
diagnosing and treatment of GAD. Physicians can help the patients in managing the GAD though
medication and cognitive-behavioral therapy.

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References
Anthony, W.A., 1993. Recovery from mental illness: The guiding vision of the mental health
service system in the 1990s. Psychosocial rehabilitation journal, 16(4), p.11.
Borkovec, T.D. and Costello, E., 1993. Efficacy of applied relaxation and cognitive-behavioral
therapy in the treatment of generalized anxiety disorder. Journal of consulting and
clinical psychology, 61(4), p.611.
Clark, L.A. and Watson, D., 1991. Tripartite model of anxiety and depression: psychometric
evidence and taxonomic implications. Journal of abnormal psychology, 100(3), p.316.
Corrigan, P.W. and Watson, A.C., 2002. Understanding the impact of stigma on people with
mental illness. World psychiatry, 1(1), p.16.
Crone, D. and Guy, H., 2008. ‘I know it is only exercise, but to me it is something that keeps me
going': a qualitative approach to understanding mental health service users' experiences
of sports therapy. International journal of mental health nursing, 17(3), pp.197-207.
Durham, R.C., 2007. Treatment of generalized anxiety disorder. Psychiatry, 6(5), pp.183-187.
Gorman, J.M., 2002. Treatment of generalized anxiety disorder. The Journal of clinical
psychiatry.
Keyes, C.L., 2005. Mental illness and/or mental health? Investigating axioms of the complete
state model of health. Journal of consulting and clinical psychology, 73(3), p.539.
McHorney, C.A., Ware Jr, J.E. and Raczek, A.E., 1993. The MOS 36-Item Short-Form Health
Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and
mental health constructs. Medical care, pp.247-263.

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Rickels, K., Downing, R., Schweizer, E. and Hassman, H., 1993. Antidepressants for the
treatment of generalized anxiety disorder: a placebo-controlled comparison of
imipramine, trazodone, and diazepam. Archives of General Psychiatry, 50(11), pp.884-
895.
Rogers, A. and Pilgrim, D., 2014. A sociology of mental health and illness. McGraw-Hill
Education (UK), p.130.
Slade, M., 2009. Personal recovery and mental illness: A guide for mental health professionals.
Cambridge University Press, pp.20-23.
Spitzer, R.L., Kroenke, K., Williams, J.B. and Löwe, B., 2006. A brief measure for assessing
generalized anxiety disorder: the GAD-7. Archives of internal medicine, 166(10),
pp.1092-1097.
Struzik, L., Vermani, M., Coonerty-Femiano, A. and Katzman, M.A., 2004. Treatments for
generalized anxiety disorder. Expert review of neurotherapeutics, 4(2), pp.285-294.
Suls, J. and Bunde, J., 2005. Anger, anxiety, and depression as risk factors for cardiovascular
disease: the problems and implications of overlapping affective dispositions.
Psychological bulletin, 131(2), p.260.
World Health Organization, 2001. The World Health Report 2001: Mental health: new
understanding, new hope. World Health Organization, pp.120-124