At the beginning of the 21st century, there was a global epidemic of mental health problems and related disorders. Despite everything, although depression is the leading cause of disability worldwide, it is not the most common mental health problem. Anxiety , however, takes this unwelcome prize.
Anxiety disorders affect an estimated 275 million people worldwide. This equates to about 4% of the world’s population, with populations ranging between 2.5% and 6.5% in each country. The female sex represents around 62% of anxiety patients (170 million), compared to 105 million males.
Anxiety disorders are extremely curable , but only 36.9% of people with them receive help. People with anxiety disorders are three to five times more likely to see a psychiatrist and six times more likely to be hospitalized for psychiatric problems than those without.
Anxiety is not the problem, Generalized Anxiety Disorder (GAD) is
We have all experienced anxiety at some point in our lives. Moreover, it is completely normal that in certain threatening or stressful situations a feeling of nervousness , concern , or even discomfort appears. For example, it is not surprising that anxiety appears when someone faces economic, family, health problems, or even an exam.
Anxiety is a sudden and profound feeling of fear , despair, and restlessness. It can make you sweat, feel nervous and tense, and make your heart race.
This is because anxiety is a natural adaptive response that allows us to alert ourselves to compromising or threatening events. A certain degree of anxiety keeps us alert to dangerous situations, and moderate anxiety helps us stay focused and face the challenges ahead.
The problem is that, although it is a normal human experience, it can become pathological if the discomfort occurs frequently, at inappropriate times for no apparent reason, or is so intense and long-lasting that it negatively affects a person’s daily life. In these cases , the concerns can become irrational or disproportionate with respect to the situation that originates them. This is known as generalized anxiety disorder (GAD) , and it makes anxiety go from being something beneficial, momentary and controlled, to something pathological, unpredictable and recurring. Worry, fear and dread become part of everyday life, and the feeling of anxiety can end up taking over a person’s thoughts, to the point of not being the person able to carry out their usual tasks, to function with normality, be it at work, socially, etc.
Therefore, anxiety is a common term, anyone can suffer from it in stressful situations. But Generalized Anxiety Disorder (GAD) is a medical condition that can affect your daily life. The difference between the two lies in the severity and frequency with which they occur .
Types of anxiety disorder
There are several types of anxiety disorders , since it can manifest itself differently in each person. Specifically, some of the main anxiety or related disorders are: generalized anxiety disorder ( GAD ), separation anxiety, specific phobias , panic disorder, social phobia, agoraphobia or selective mutism .
Some time ago, obsessive-compulsive disorder (OCD) was considered within the classifications of anxiety disorders . However, both OCD and post- traumatic stress disorder (PTSD), among others, now constitute their own group of illnesses, although their relationship with anxiety disorders is still accepted.
Symptoms
Anxiety is a broad term and generalized anxiety disorder falls under it. Thus, both anxiety and generalized anxiety have similar manifestations or signs, but one is more exaggerated than the other.
GAD affects a person’s thinking , usually their ability to live their daily lives normally, and can lead to physical symptoms. To diagnose GAD, professionals use a series of criteria. For example, there is a temporary criterion , according to which those symptoms must last at least 6 months and must not be caused by another medical illness or other ailment. This is because generalized anxiety disorder is a rule-out diagnosis , meaning that other possible causes of the symptoms must be ruled out before arriving at this as the main diagnosis.
Some other criteria to consider are excessive and ongoing worry and stress, problems seen from an unrealistic perspective, restlessness, or a feeling of “jitters”. In addition, concentration problems, easy tiredness or exhaustion, increased irritability or bad mood, insomnia , muscle tension, non-specific generalized pain and general malaise may occur.
Causes
It is difficult to point to a single cause as the origin of the different anxiety disorders. What we do know is that there are several factors that can contribute to its appearance , such as brain function, genetics, environmental factors, substance use, or other conditions.
As for brain function , they may be related to the malfunction of brain circuits that regulate fear and emotions, according to some studies.
We also know that, genetically speaking, there is a higher prevalence in first-degree relatives. It would be a polygenic condition, since several candidate genes have been identified and are currently under study. However, let us not forget that the relationships that are located are unlikely to be causal in nature. That is, it is probably not just a genetic issue to suffer from an anxiety disorder, but perhaps it facilitates some trait of our personality that makes us more prone to it. At least this is one of the most current lines of research.
GAD can also be related to various environmental factors . This relates to tense situations that you have witnessed or experienced. Childhood abuse and neglect, the loss of a loved one, or even being attacked or assaulted or seeing violence are common triggers for anxiety disorders. In this case, indeed, we could also be talking about a post-traumatic stress disorder. Of course, these disquisitions correspond to a qualified professional to carry them out.
Substance abuse can also play a role, as some medications can be used to mask or reduce anxiety symptoms. It is true that there is a clear increase in anxiety disorders frequently coexisting with alcohol and substance abuse.
Certain conditions of the heart, lungs, and thyroid gland can mimic the symptoms of anxiety disorders or exacerbate them. For this reason, when you talk to your doctor for the first time about what could be an anxiety disorder, the doctor may consider that you should carry out a physical check-up and/or complementary tests to help him in his evaluation.
References:
Anxiety Disorders (s.f.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/anxiety-disorders
Barnhill, JW (2020). Introduction to anxiety disorders. MSD Manuals. https://www.msdmanuals.com/en/home/mental-health-disorders/anxiety-and-stress-related-disorders/introducci%C3%B3n-a- anxiety-disorders
Barnhill, JW (2020). Generalized anxiety disorder. MSD Manuals. https://www.msdmanuals.com/en/home/mental-health-disorders/anxiety-and-stress-related-disorders/generalized-anxiety-disorder
Generalized Anxiety Disorder (2021). WebMD. https://www.webmd.com/anxiety-panic/guide/generalized-anxiety-disorder
Blue Globule (2018). Anxiety: the dangers it hides and what you should know [Video]. Youtube. https://www.youtube.com/watch?v=MU8JZUnIj5w
