GENERALIZED ANXIETY DISORDER INFORMATION FOR CLIENTS AND FAMILIES

Transcription

1 GENERALIZED ANXIETY DISORDER INFORMATION FOR CLIENTS AND FAMILIES

2 WHAT IS GENERALIZED ANXIETY DISORDER? Generalized Anxiety Disorder (GAD) relates to strong, persistent and damaging anxiety. GAD means that the anxiety has, to some extent, taken control of your life. The Diagnostic and Statistical Manual, used by psychiatrists to diagnose, lists the following symptoms: Excessive anxiety and worry, occurring more days than not, for at least 6 months, about a number of events or activities, such as work, school and/or health Difficulty concentrating. and/or mind going blank Anxiety and worry are associated with 3 or more of the following 6 symptoms: * Restlessness, feeling keyed up or on edge * Being easily fatigued * Difficulty concentrating, mind going blank * Irritability * Muscle tension * Sleep disturbance (difficulty falling asleep, staying asleep, or restless sleep) Symptoms are not caused by another anxiety or mood disorder Anxiety, worry or physical symptoms cause significant distress or impairment in social or work life, or in other important parts of life The disturbance is not due to medication, substance use, a general medical condition. HOW COMMON IS GENERALIZED ANXIETY DISORDER? Approximately 5.1% of the general population will experience GAD at some point in their lifetime. Anxiety appears to be an equal-opportunity condition, occurring across all levels of socio-economic, racial, and ethnic backgrounds.

3 Women are more likely (than men) to be diagnosed and treated for Anxiety Disorders, however, social roles and expectations are likely contributing factors to this statistic. TREATMENT OF GENERALIZED ANXIETY DISORDER: The majority of people who experience GAD do not seek treatment. If they do speak to their physician, they are more likely to focus on their physical symptoms, leaving out vital information for proper diagnosis and treatment. GAD sufferers tend to regard themselves as chronic worriers (ie worry warts) and assume that nothing can be done to really help them. Cognitive Behavioural Therapy (CBT) CBT is one type of therapy that is helpful in the treatment of GAD. Anxiety is regarded as a stubborn cycle of belief, in which the individual over-estimates the likelihood that something bad will happen, and underestimates their ability to deal with difficult situations. CBT includes: Education, learning about Generalized Anxiety Disorder, as well as your personal triggers and how it has effected your life. Relaxation Skills: breathing exercises, progressive muscle relaxation, and meditation reduce physiological activation ( fight / flight / freeze response). Cognitive Therapy: stepping back from unrealistic, negative, avoidant, and self-defeating thinking patterns. Altering thoughts to promote health. Behavioral Therapy: instead of avoiding situations, it is important to face worries and fears gradually changing patterns of avoidance. Strategies of avoidance related to GAD include excessive worry, procrastination, reassurance seeking, people pleasing.

4 Monitoring progress: use of concrete measurement scales to identify areas of progress, as well as increasing awareness and perspective. Skill 1: Abdominal Breathing Lie quietly in a comfortable place with one hand on the upper part of your chest and the other on your upper abdomen. Lie with your knees bent. Breathe in slowly and deeply through your nose to fill your lungs to capacity. This will cause your lungs to push down on your diaphragm, and the lower hand will rise. The upper hand should move very little. Practice to become familiar with what is happening in your body. How does it feel? Practice Schedule: Choose a particular time and place; make a personal commitment to set aside minutes 2x/day. Practice for one week. After one week, check to see if you are able to do abdominal breathing while standing or sitting. Remember that the hand on your abdomen should move rather than the hand on your chest. Use breathing to cope with difficult situations and emotions, as they arise. 21 Day Experiment: Circle the calendar for day 1 and again three weeks later for day 21. As you become comfortable with abdominal breathing, try switching from anxious breathing (shallow, rapid) to abdominal deep breathing. Notice the difference in your body. Skill 2: Worry Time Not all worry is bad. One helpful skill in dealing with worry is scheduling your worry time. Select a worthwhile topic and schedule time for worry. Benefits are two-fold: you will learn the value in worry, as well as the value of shutting it off. As with every skill, this takes practice. * Pick a worthwhile topic to worry about. There can be many random little subjects that we may worry about, but they often

5 don t amount to much. Try to identify a topic that is worthwhile to spend some time with. It may involve a big decision you need to make. Or it may be your preparation for an important performance in school, work, or athletics. *Set aside fifteen or twenty minutes. Schedule a time and place. Using a time limited activity (a commute on train / bus, or a walk to work) offers a natural ending to worry time. * Keep your mind on the topic at hand. Try not to drift in and out. You want the benefit that comes from your mind having concentrated it s focus on the issue that is bothering you. And when the worry time is finished you will experience the relief of disengaging. * Don t dwell on the topic during non worry times. Postpone worries that come up over the course of your day. Save them for worry time. Gently let the topic go and remind yourself when the next worry time is scheduled. *Gradually decrease frequency / duration of worry time. As worry settles down, begin to reduce your practice of worry time; when worry starts becoming a problem again, schedule it in. Medication Medication, in conjunction with CBT, is helpful in reducing symptoms related to Generalized Anxiety Disorder (GAD). Medication is sometimes recommended as a temporary measure to relieve symptoms at the beginning of the treatment process, with counseling therapy the key to long-term progress. There are three types of medication are most commonly prescribed for GAD: Antidepressants are used in the treatment of GAD; it can take up to 3 months for these mediations to reach their full effect.

6 Buspirone This anti-anxiety drug, known as Buspar, is sometimes used to treat GAD. Unlike benzodiazepines, buspirone isn t sedating or addictive. Benzodiazepines These anti-anxiety drugs act very quickly (usually within 30 to 60 minutes). The rapid relief these medications provide is a major benefit but there are serious drawbacks, as well. Physical and psychological dependence are common after a few weeks of use. Tips for managing Anxiety Relaxation: Practice Diaphragmatic (belly) breathing, Progressive Muscle Relaxation, Meditation Change your thinking; try a worry time Exercise vigorously on a regular basis (early in the day) Modify your diet. Caffeine, sugar, and poor nutrition can aggravate symptoms of anxiety Reduce use of drugs / alcohol; these interfere with ability to cope with stress and distress Do things you enjoy Leave work at work Live in the present DO LESS, ENJOY MORE! Helping someone who struggles with anxiety Learn about anxiety from reliable sources Recognize and validate accomplishments Reduce expectations during stressful times Measure progress on the basis of effort Support and notice change and progress Try to maintain a normal routine

7 For more information:

8 ANXIETY & MOOD PROGRAMS A PARTNERSHIP OF SASKATOON HEALTH REGION ADULT MENTAL HEALTH & ADDICTION SERVICES AND DEPARTMENT OF PSYCHIATRY UNIVERSITY OF SASKATCHEWAN October, 2013