The therapy appointment ended. I paid-up and was handed a receipt with 300.02 written at the bottom. I had no idea what it meant, so I inquired. The doc replied, “It’s the diagnostic code for generalized anxiety disorder.” And 30 years later, it stands. Does it belong on your receipt?
GADs most prominent symptom is persistent, excessive, and irrational worry about everyday things. Finances, health, death, family, relationships, work – they’re all fair game.
When I was lost in the woods, I found comfort in identifying and understanding that from which I suffered. I mean, having at least an explanation removed so much mystery and fear from my soul. And it really helped with treating and tolerating the symptoms that were ripping me up.
Now, even though I’m into the insight that comes with disorder identification, I never let a “label” define me. Speaking of which, how ’bout this from Canadian physician and co-founding professor of Johns Hopkins Hospital, Sir William Osler?
It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.
Not too shabby.
What Is Generalized Anxiety Disorder?
In the spirit of diminished mystery and fear, as well as identification and understanding, let’s discuss generalized anxiety disorder (GAD) – a troubling constellation of symptoms that doesn’t get its due.
And that’s a shame because GAD affects some 2% of American and European adults in any given year. Women are twice as likely to be impacted. By the way, GAD is the most common cause of disability in the U.S. workplace.
GADs most prominent symptom is persistent, excessive, and irrational worry about everyday things. Finances, health, death, family, relationships, work – they’re all fair game.
One who’s enduring GAD most often expects the worst, even when there’s no reason for concern. I mean, it’s like “hyper-catastrophizing.” And when things really get crankin’, the thought of getting through the day brings-on dread and yet more anxiety.
‘Course, the individual knows their anxiety is more intense than circumstances indicate. Still, putting the brakes on the worry cycle seems impossible.
GAD comes on gradually and can commence throughout the lifespan. Sure, it can become a chronic disorder; however, it can be managed – even eliminated – with proper treatment.
But Generalized Anxiety Disorder Is More Than Just Worry
As we get more deeply into symptoms, it’s important to understand they have to cause significant distress or impairment in functioning for right at six months before a formal GAD call can be made. And one symptom won’t cut it. In addition to worry and anxiety, we’re looking at, say, four or more.
Okay, the ICD-10 has a sweet way of organizing GAD symptoms…
- Autonomic Arousal Symptoms: Palpitations or pounding heart, accelerated heart rate, sweating, trembling/shaking, dry mouth
- Symptoms Concerning Chest and Abdomen: Difficulty breathing, feeling of choking, chest pain or discomfort, abdominal distress, nausea, vomiting, diarrhea
- Symptoms Concerning Brain and Mind: Feeling dizzy/unsteady/faint/light-headed, derealization, depersonalization, fear of losing control/going crazy/passing-out, fear of dying
- General Symptoms: Hot flashes, chills, numbness/tingling sensations, rashes, headache, fatigue
- Symptoms of Tension: Muscle tension/aches and pains, restlessness/inability to relax, feeling fidgety, feeling keyed-up/on edge/mentally tense, sensation of a lump in the throat, difficulty with swallowing
- Other Non-Specific Symptoms: Exaggerated response to minor surprises/being startled, difficulty in concentrating/mind going blank because of worry or anxiety, persistent irritability, difficulty achieving or maintaining sleep because of worrying
Certainly, that roster isn’t all inclusive. Trust me, when it comes to GAD, I can’t think of (m)any physical symptoms that would surprise me.
What Causes All the Hubbub?
When discussing the cause of GAD, we find ourselves in the same bind as with any other emotional/mental disorder. Who really knows?
Still, there are plenty of suspects. Here are but a few in the GAD nature vs. nurture dance…
It’s believed genes are responsible for one-third of GAD risk. And it appears that some of the same genes related to panic disorder and PTSD are tied to GAD. That said, GAD is thought to have a unique genetic foundation.
And then there are environmental factors, such as trauma and stress. Research tells us that many enduring GAD report experiencing more than their fair share of both. However, it isn’t a 100% lock that either actually cause GAD. And that’s because researchers look at characteristics of people after GAD has been diagnosed.
How ’bout this angle? Some researchers believe people with GAD worry as they do in an effort to distract themselves from trauma/stress memories.
It’s even possible that early trauma/stress events trigger a pattern of thinking that generalizes to an endless variety of situations.
Now to the cognitive side of the fence, where irrational beliefs have to loom large in GAD. Here are just two, according to Albert Ellis…
- The idea that it is a dire necessity for adults to be loved by significant others for almost everything they do
- The idea that if something is or may be dangerous or fearsome we should be terribly upset and endlessly obsess about it
If you’d like to check-out 12 of Ellis’ irrational beliefs, with disputing statements, here ya’ go.
Let’s wrap-up our cause discussion with a tad more biology. It’s possible that those enduring GAD have low supplies of gamma-Aminobutyric acid (GABA) or insufficient GABA receptor sites. GABA is our most abundant inhibitory (decreases action potential) neurotransmitter. Serotonin and dopamine are likely players, as well.
Worthy of mention is the hypothalamic-pituitary-adrenal axis (HPA-axis), which controls reactions to stress and regulates many body processes.
And how could we forget the role of the amygdala? In this case, disrupted functional connectivity and faulty processing of fear and anxiety.
That’ll Do It
Absolutely, I had no idea what 300.02 meant all those years ago. And even when the doc told me “generalized anxiety disorder,” I still didn’t really understand.
But I kept working toward identification and understanding, because it’s the only way I knew to resolve mystery and fear. And, yes, GAD is still a factor in my life; however, that’s very much okay now.
I wonder if anything we’ve reviewed hit home. If so, are you up to doing something about it? Believe me, you don’t have to live like that anymore.
Hey! Be sure to read about the treatment side of the GAD fence. Part 2 is ready to roll.
672 Chipur titles await your perusal. Please indulge.
