Generalized Anxiety Disorder (GAD), Anxiety, Anxiety Disorders, Risk Factors , Signs and Symptoms of GAD, DSM V Diagnostic Criteria for Generalized Anxiety Disorder, ICD 10 CriteriaF41.1 Generalized anxiety disorder, Prevalence and Age of Onset, Treatment, Self-help Strategies For GAD

1. The Complexity of Anxiety
Disorders- Generalized Anxiety
Disorder (GAD)
Deva Pramod V B
M.Sc. Psychology
Department of Psychology
Bharathiar University, India
vbdevan.psy@gmail.com

2. What is Anxiety?
mood,
thoughts,
behaviors,
& body.
Anxiety is a medical
condition that affects a
person’s
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3. but only one-third of
those who suffer from it
receive treatment
Depressionoften
accompanies anxiety
disorders
Highly
Treatable
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4. Anxiety is Pathological if:
So intense become incapable of speech,
movement or thought
Occurs so frequently & unpredictably in an
attack-like manner
Persists over extended periods of time
(chronic)
Leads to avoidance behavior, ritualistic
behaviors, always feel uptight
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5. Contributors/Causes of Anxiety
Stress
Life Experiences
Brain Chemistry
Personality
Physical Illness
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6. Additional Contributing Factors
Heredity
Personality
Situations
Medical Conditions
Medications
Substance Abuse
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7. Anxiety Disorders
• Anxiety Disorders include disorders that share features of excessive
fear and anxiety and related behavioral disturbances
• Anxiety Disorder include :
• Intense and prolonged feelings of fear and distress that occur out of
proportion to the actual threat or danger
• Feelings of fear and distress that interfere with normal daily functioning
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8. The term “Anxiety Disorders” refers to
 Generalized Anxiety Disorder (GAD)
 Obsessive-Compulsive Disorder (OCD)
 Panic Disorder
 Posttraumatic Stress Disorder (PTSD)
 Social Anxiety Disorder, and
 Specific Phobias.
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9. Generalized Anxiety Disorder (GAD)
• General anxiety disorder (GAD) is a broad term covering several different forms
of abnormal, pathological anxiety, fears, phobias and nervous conditions,
which may have sudden onset or may occur gradually over a period of several
years
• GAD is an anxiety disorder marked by chronic, exaggerated worrying and
anxiety about everyday life. The worry is so severe that it interferes with their
ability to live their lives.
• Excessive uncontrollable worry about everyday things. This constant worry
affects daily functioning and can cause physical symptoms.
• GAD can occur with other anxiety disorders, depressive disorders, or substance
abuse. 9

10. Difference Between Normal Anxiety and GAD?
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11. Risk Factors
Factors that may increase the risk of GAD include:
 Family members with an anxiety disorder
 Increase in stress
 Exposure to physical or emotional trauma
 Unemployment, poverty
 Drug abuse
 Medical condition or disability
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12. What are the Signs and Symptoms of GAD?
Emotional symptoms of generalized anxiety disorder
 Constant worries running through your head
 Feeling like your anxiety is uncontrollable; there is nothing you can do
to stop the worrying
 Intrusive thoughts about things that make you anxious;
you try to avoid thinking about them, but you can’t
 An inability to tolerate uncertainty; you need to know
what’s going to happen in the future
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13. Behavioral symptoms of Generalized Anxiety Disorder
 Inability to relax, enjoy quiet time, or be by yourself
 Difficulty concentrating or focusing on things
 Putting things off because you feel overwhelmed
 Avoiding situations that make you anxious
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14. Physical symptoms of Generalized Anxiety Disorder
 Feeling tense; having muscle tightness or body aches
 Having trouble falling asleep or staying asleep because your mind
won’t quit
 Feeling edgy, restless, or jumpy
 Stomach problems, nausea, diarrhea
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15. DSM V
Diagnostic Criteria for Generalized Anxiety Disorder
A. Excessive anxiety and worry (apprehensive expectation), occurring
more days than not for at least 6 months, about a number of events or
activities (such as work or school performance).
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the
following six symptoms (with at least some symptoms having been
present for more days than not for the past 6 months);
Note: Only one item is required in children.
1. Restlessness or feeling keyed up or on edge.
2. Being easily fatigued
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16. 3. Difficulty concentrating or mind going blank.
4. Irritability.
5. Muscle tension.
6. Sleep disturbance (difficulty falling or staying asleep, or restless,
unsatisfying sleep).
D. The anxiety, worry, or physical symptoms cause clinically significant
distress or impairment in social, occupational, or other important areas
of functioning.
E. The disturbance is not attributable to the physiological effects of a
substance (e.g., a drug of abuse, a medication) or another medical
condition (e.g., hyperthyroidism).
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17. F. The disturbance is not better explained by another mental disorder
(e.g., anxiety or worry about having panic attacks in panic disorder,
negative evaluation in social anxiety disorder [social phobia],
contamination or other obsessions in obsessive-compulsive disorder,
separation from attachment figures in separation anxiety disorder,
reminders of traumatic events in posttraumatic stress disorder, gaining
weight in anorexia nervosa, physical complaints in somatic symptom
disorder, perceived appearance flaws in body dysmorphic disorder,
having a serious illness in illness anxiety disorder, or the content of
delusional beliefs in schizophrenia or delusional disorder).
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18. ICD 10 Criteria
F41.1 Generalized anxiety disorder
The essential feature is anxiety, which is generalized and persistent but not
restricted to, or even strongly predominating in, any particular
environmental circumstances (i.e. it is "free-floating"). As in other anxiety
disorders the dominant symptoms are highly variable, but complaints of
continuous feelings of nervousness, trembling, muscular tension, sweating,
lightheadedness, palpitations, dizziness, and epigastric discomfort are
common. Fears that the sufferer or a relative will shortly become ill or have
an accident are often expressed, together with a variety of other worries and
forebodings. This disorder is more common in women, and often related to
chronic environmental stress. Its course is variable but tends to be
fluctuating and chronic.
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19. Diagnostic guidelines
The sufferer must have primary symptoms of anxiety most days for at
least several weeks at a time, and usually for several months.
These symptoms should usually involve elements of:
(a)Apprehension (worries about future misfortunes, feeling "on edge",
difficulty in concentrating, etc.);
(b)Motor tension (restless fidgeting, tension headaches, trembling,
inability to relax); and
(c)Autonomic overactivity (lightheadedness, sweating, tachycardia or
tachypnoea, epigastric discomfort, dizziness, dry mouth, etc.).
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20. Associated Features Supporting Diagnosis
• Associated with
• muscle tension,
• There may be trembling,
• feeling shaky, and
• muscle aches or soreness
• Also experience somatic symptoms (e.g., sweating, nausea, diarrhea)
and an exaggerated startle response.
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21. Prevalence and Age of Onset
• It is a common condition; approximately 3 percent of the population
suffers from it in any 1-year period and 5.7 percent at some points in
their lives-National Co morbidity Survey-Replication.
• GAD is approximately twice as common in women as in men.
• People with GAD manage to function and are less likely to go to clinics
for psychological treatments though they do show up frequently in
physician’s offices with medical complaints.
• Age of onset is often difficult to determine. However recent studies
documented that GAD often occurs in older adults where it is the
most common anxiety disorder.
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22. Co-Morbidity with other disorders
• GAD often co-occurs with other Axis 1 disorders, especially other
anxiety and mood disorders such as panic disorder, social phobia,
specific phobia, and PTSD.
• Many of these people are mildly to moderately depressed as well as
chronically anxious.
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23. Treatment
Cognitive-Behavioral Therapy
• Self-monitoring, relaxation training
• Focus on controlling worry.
Medication
• Use medicine under registered medical perception
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24. Self-Management
 Changes in diet and nutrition.
 Regular exercise.
 Use relaxation strategies.
 Learning new problem solving strategies.
 Join support groups.
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25. Self-help Strategies For GAD
STEP 1: Learning about anxiety and GAD
STEP 2: Identifying and recognizing worry
STEP 3: Classifying your worries
• 1. Worries about current problems (for example, “what if I don’t have enough
money to pay the bills?”, “what if I don’t finish my report on time?)
• 2. Worries about hypothetical situations (for example, “what if the flight I’m
taking next month crashes?”)
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26. STEP 4: Building Worry Management Toolbox
• TOOL #1: Learning to calm anxiety by slowing down breathing
• TOOL #2: Learning how to calm your anxiety by relaxing the muscles in body
• TOOL #3: Learning to become comfortable with uncertainty
• TOOL #4: Rethinking the usefulness of worry
• TOOL #5: Improving problem-solving ability
• TOOL #6: Writing a worry script
STEP 5: Building on bravery
PRACTISE, PRACTISE, PRACTISE!!
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27. To Cope with Anxiety, Remember A-W-A-R-E
The key to switching out of an anxiety state is to accept it fully.
Remaining in the present and accepting your anxiety cause it to
disappear.
A: Accept the anxiety.
W: Watch your anxiety.
A: Act with the anxiety.
R: Repeat the steps.
E: Expect the best.
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28. Take Four
& Manage Your Anxiety
Exercise. Go for a
walk or jog.
Do yoga.Dance.
Just get moving!
Talk to someone …
spouse, significant other,
friend, child, or doctor.
Keep a daily journal.
Become aware of what
Triggers your anxiety.
Eat a balanced diet.
Don’t skip meals.
Avoid caffeine,drugs
and all which can trigger
anxiety symptoms
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29. Keywords
 Anxiety
 Anxiety Disorders
 Generalized Anxiety Disorder (GAD)
 Cognitive-Behavioral Therapy
 Medication
 Self-Management
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30. References
 Diagnostic and Statistical Manual for Mental Disorders (DSM-V). Fifth Edition,
Washington DC, the Division of Publications and Marketing, American Psychiatrist
Association.
 ICD-10. (2007). The ICD-10 Classification of Mental and Behavioral Disorders: Clinical
Descriptions and Diagnostic Guidelines, Geneva, World Health Organization, AITBS
Publishers in India.
 Carson.C.R, Butcher.N.J(2007).Abnormal Psychology; Dorling Kindersley: South Asia.
 Niraj Ahuja (2011),A Short Textbook Of Psychiatry 7th ed. Jaypee Brothers Medical
Publishers Pvt Ltd.
 Kaplan, H.I. & Sadock, B.J. (2007). Synopsis of Psychiatry – Behavioral Sciences/Clinical
Psychiatry. (10th Edn). NY: Williams & Wilkins.
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31. Thank You
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