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How to stop worrying (part 1)

Dr. Henriette Smith July 2017

· Mind

Are you constantly worrying?

Even about the smallest things? Then you might be suffering from a condition called Generalized Anxiety Disorder (GAD). About 1 in 5 people suffer from an anxiety disorder, with GAD being the most common.
Generalized anxiety disorder (or GAD) is characterized by excessive, exaggerated anxiety and worry about everyday life events with no obvious reasons for worry. People with symptoms of generalized anxiety disorder tend to always expect disaster and can't stop worrying about health, money, family, work, or school. In people with GAD, the worry is often unrealistic or out of proportion for the situation. Daily life becomes a constant state of worry, fear, and dread. Eventually, the anxiety so dominates the person's thinking that it interferes with daily functioning, including work, school, social activities, and relationships.

The symptoms of GAD look as follows:

  • GAD affects the way a person thinks, but anxiety causes several physical symptoms as well:
  • Excessive anxiety and worry on most days about a number of events or activities for a period of at least 6 months
  • Constant worrying that you struggle to control
  • Restlessness or feeling keyed up or on edge
  • Being easily fatigued (you feel as if you have run the Comrades Marathon by the end of the day)
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Headaches
  • Sweating
  • Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)
  • An unrealistic view of problems
  • Nausea
  • The need to go to the bathroom frequently
  • Trembling
  • Being easily startled

What Causes GAD?

The exact cause of GAD is not fully known, but a number of factors -- including genetics, brain chemistry, and environmental stresses -- appear to contribute to its development.
Genetics: Some research suggests that family history plays a part in increasing the likelihood that a person will develop GAD. This means that the tendency to develop GAD may be passed on in families. The specific gene thought to be involved in many anxiety disorders is the gene that expresses the Serotonin Transporter(SERT).
Brain chemistry: GAD has been associated with abnormal functioning of certain nerve cell pathways that connect particular brain regions involved in thinking and emotion. These nerve cell connections depend on chemicals called neurotransmitters that transmit information from one nerve cell to the next. The specific neurotransmitter involved in GAD is serotonin.
Environmental factors: Trauma and stressful events, such as abuse, the death of a loved one, divorce, changing jobs or schools, may contribute to GAD. GAD also may become worse during periods of stress. The use of and withdrawal from addictive substances, including alcohol, caffeine, and nicotine, can also worsen anxiety.
So if you recognise yourself in the above symptoms, what do you do about it?
1. Get professional help
2. Teach yourself relaxation techniques
3. Exercise
4. Meditation/ mindfulness techniques
5. Medication
Treatments and drugs
The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.
Psychotherapy
Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for generalized anxiety disorder.
Cognitive behavioral therapy is one of the most effective forms of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.

Medications

Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects.
Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) classes, are the first-line medication treatments. Examples of antidepressants used to treat anxiety disorders include escitalopram (Cipralex), duloxetine (Cymbalta), venlafaxine (Efexor XR) and paroxetine (Aropax). Your doctor also may recommend other antidepressants.
Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective.
Benzodiazepines. In limited circumstances, your doctor may prescribe one of these sedatives for relief of anxiety symptoms. Examples include alprazolam (Xanor), diazepam (Valium) and lorazepam (Ativan). Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis, namely not longer than 2 weeks. They should be used only on an as needed basis for acute anxiety, never as the mainstay of treatment. Because they can be habit-forming, these medications aren't a good choice if you've had problems with alcohol or drug abuse. Benzodiazepines also cause depression, anxiety and forgetfulness if used longterm and are a risk factor for developing Alzheimer’s disease.
Alternative medicine
Some people are interested in trying alternative medicine (a nonconventional approach instead of conventional medicine) or complementary medicine (a nonconventional approach used along with conventional medicine).
Several herbal remedies have been studied as a treatment for anxiety, such as those listed below, but more research is needed to fully understand the risks and benefits. Here's what researchers know — and don't know:
Kava. Kava appeared to be a promising treatment for anxiety, but reports of serious liver damage — even with short-term use — caused several European countries and Canada to pull it off the market. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using kava until more rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.
Valerian. In some studies, people who used valerian reported less anxiety and stress, but in other studies, people reported no benefit. Discuss valerian with your doctor before trying it. While it's generally well-tolerated, there are a few case reports of people developing liver problems when taking preparations containing valerian. If you've been using valerian for a long time and want to stop using it, many authorities recommend that its use be tapered down to prevent withdrawal symptoms.
Passionflower. A few small clinical trials suggest that passionflower might help with anxiety. In many commercial products, passionflower is combined with other herbs, making it difficult to distinguish the unique qualities of each herb. Passionflower is generally considered safe when taken as directed, but some studies have found it can cause drowsiness, dizziness and confusion.
Theanine. This amino acid is found in green tea and may be found in some supplements. Preliminary evidence shows that theanine may make some people feel calmer, but there is limited evidence that it helps treat anxiety.
Before taking herbal remedies or supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

In our next blog, we will look a bit more closely at lifestyle changes and preventative mechanisms to keep GAD from dictating your life.

References

  1. Generalized anxiety disorder - Mayo Clinic
  2. www.mayoclinic.org
  3. http://www.webmd.com/anxiety-panic/guide/generalized-anxiety-disorder#1
  4. Learn More About General Anxiety Disorder
  5. www.webmd.com
  6. Anxiety - Open Path Psychotherapy Collective - Open Path Psychotherapy Collective
  7. oppc.mentalhealthexcellence.org
  8. http://gymlion.com/wp-content/uploads/2015/10/worry.png
  9. https://media.licdn.com/mpr/mpr/p/5/005/0ad/102/143f497.jpg
  10. https://1.bp.blogspot.com/-sLep2dKrKeM/Ty1FWPN3kHI/AAAAAAAABMc/feVSWN2-0zY/s1600/picsmeme-worry-quotes-09.jpg
  11. https://i.ytimg.com/vi/x56_Kn2nULg/maxresdefault.jpg

This post is for informational purposes only. It should not be considered therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local doctor/psychologist or psychiatrist or the SADAG Mental health Line on 011 234 4837. If necessary, please phone the Suicide Crisis Line on 0800 567 567 or sms 31393.

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This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local doctor/psychologist or psychiatrist or the SADAG Mental health Line on 011 234 4837. If necessary, please phone the Suicide Crisis Line on 0800 567 567 or sms 31393.