Generalized Anxiety Disorder

Generalized Anxiety Disorder overview and Definition

It is  characterized by the unpleasant state,worrisome thoughts,avoidance and panic and nervous behaviour.


It account for 20-30 % of the cases foe stress

Structure of Generalized Anxiety Disorder

Types of anxiety disorder:

Generalized anxiety disorder:

Generalized anxiety disorder (GAD) display excessive anxiety or worry, most days for at least 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life, such as social interactions, school, and work.

Symptoms include:

Feeling restlessness

Easily fatigued

Staying away from the crowd


Difficulty in concentration

Muscle tightness

Excessive worrying

Having sleep problems.

Panic Disorder:

      They tend to have recurrent panic  attacks.Panic attacks are sudden fear that comes into an act and reaches the peak within a minutes.These attacks can occur unexpextedly and also by triggering objects or subjects.


Heart palpitations


Shortness of breathe


Feeling of out of controls



Peoples suffering from panic attacks usually tend to have the fear regarding the next attack.The fear might be regarding any places,persons,situations.This in long run can lead to agyrophobia.

Phobia related disorders:

it is an aversion to specific objects or place or situation.


These people tend to worry /worry to encounter the next situations (phobic situations)

Take the necessary step to avoid the episodes of phobia

experience immediate anxiety / fear on encountering the objects which panics them.

Simple phobias:

Peoples tends to have fear regarding specific objects or specific situations.

Eg:flying, heights, fear to animals ,birds,  receiving injections and blood.

Social anxiety disorder: this is previously termed as social phobia. People with social phobia tend to have fear regarding the groups,social gatherings or social situations.they fear that their act would leads to the negatively evaluated by others and they fell so embrassed .they are mainly seen with social and school environments.


the peoples tends to have fear with one or two of the following:

Using public transport

Being in closed spaces

Being in enclosed areas

Standing in crows

Being outside of the home alone

Fear of strangers.

Separation anxiety disorder:this is more common among children but adults are also victim to it.

The person get fear of being separated from their attached ones.

 They often worry that some sort of harm or something untoward will happen to their attachment figures while they are separated


Selective mutism:

It is the rare form of anxious disorder.Inspite of having normal language skills peoples tends to get anxiety/fear in social situations.It occurs before 5 years of age and it is associated with shyness,embrassement,compulsive traits,hesitations and temper tantrums.



Anxiety disorder appears to be a genetically inherited neurochemical dysfunction that may involve autonomic imbalance; decreased GABA-ergic tone; allelic polymorphism of the catechol-O-methyltransferase (COMT) gene; increased adenosine receptor function; increased cortisol.

In the central nervous system (CNS), the major mediators of the symptoms of anxiety disorders appear to be norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid (GABA). Other neurotransmitters and peptides, such as corticotropin-releasing factor, may be involved. Peripherally, the autonomic nervous system, especially the sympathetic nervous system, mediates many of the symptoms. Increased flow in the right parahippocampal region and reduced serotonin type 1A receptor binding in the anterior and posterior cingulate and raphe of patients are the diagnostic factors for prevalence of anxiety disorder.

The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders. Anxiety processing in the basolateral amygdala has been implicated with expansion of dendritic arborization of the amygdaloid neurons. Potassium channels create inhibitory effects on action potential.

Increased anxiety levels leads to the higher amount of secreation of glutamate which in turn interferes with the brain function.

Clinical signs & symptoms

Feeling restlessness

Easily fatigued

Staying away from the crowd


Difficulty in concentration

Muscle tightness

Excessive worrying

Having sleep problem

Differential Diagnosis

Psychological evaluation:

During this evaluation the specialist might ask you regarding the familial background of anxiety and some other questionnaire to rule out the etiology of anxiety.By this the specialist comes to know that if anyother associated mental health problems such as depression or substance misuse is present.

Comparing the symptoms with the DSM-5:

Many specialist uses the diagnostic and statistic manual  of mental disorders(DSM-5) to rule out the anxiety disorder.

Complete physical examination:certain illness, any medications,caffeine consumption and hormonal changes should be ruled out.

Zung self rating anxiety state:

It is an questionnaire that asks you to rate your anxiety from a little of the time to most of the time with topics such as nervousness,anxiety,shaling,rapid heart beat,fainting, frequent urination,nightmares.

Hamilton anxiety scale:

It involve s14 questionnaire that includes your mood sings,mental ,physical,behavioural traits.

Generalized anxiety disorder (GAD)scale:seven question test screening tool for GAD.It maily focuses on the duration of the illness.

Socio phobia inventory(SPIN):

It consists of 17 questions.the rate varies from zero to four.Zero indicates no anxiety and four indicates extreme anxiety.


Avoid stressful situation

Limit the use of caffeine

Live a healthy lifestyle and have healthy diet practices

Practice yoga and medications and keep the mind calm.