Anxiety is an emotion similar to fear. Patients describe this as a feeling of "as if something bad will happen at any moment or they will receive important news", a distress of unknown origin, and they may feel something fluttering in the upper part of their abdomen. Fear is felt towards a certain thing. The difference between anxiety and fear is that it does not have an object.
The anxiety experienced by a GAD patient is far beyond normal anxiety. For example, it is normal for a student to be worried about exams, but being afraid of failing a class even though he constantly gets good grades is typical of GAD. Some patients are aware that the anxiety they feel is excessive, but they state that they cannot prevent it. However, although most patients are disturbed by the anxiety they experience, they feel justified in worrying.
People with Generalized Anxiety Disorder usually have a state of anxiety that has continued for years. They feel extreme anxiety and sadness (anxious expectations) about many issues. The person has difficulty controlling his sadness and cannot stop worrying about it. He experiences restlessness, overexcitability, easy fatigue, lack of concentration, restlessness and irritability, muscle tension, and sleep disturbance. Anxiety and physical complaints cause significant stress or impairment in social, professional, etc. areas.
GAD 4% It is seen at -5 frequency, that is, it is quite common.
GAD patients generally and primarily consult physicians other than psychiatrists due to accompanying physical symptoms and physical disorders.
GAD patients are anxious people, they are worried about minor problems they may encounter in daily life. They even obsess over things and exaggerate them. Bad possibilities about every situation come to their mind and they are afraid of it happening. For example, thinking that their child might have an accident whenever they leave the house, constantly fearing that their work will be disrupted without any significant reason, concerns about the health of themselves or their relatives, being late for appointments, and similar thoughts preoccupy the person's mind to the extent that they affect his/her life and working capacity.
GAD patients are constantly stressed, both mentally and physically. These people, who look like a tense spring, may suddenly jump when they hear a sound, or they may get angry and overreact for minor reasons. rler. When they go to bed at night, various thoughts invade their minds. They cannot get rid of these and fall asleep, or they wake up frequently. Teeth grinding during sleep due to muscle tension or jaw pain may occur due to jaw joint diseases. Because their muscles are constantly tense, they ache all over and feel tired. They have difficulty concentrating on what they are doing. For all these reasons, their work success decreases and they may experience problems in human relations.
GAD symptoms worsen in case of stress. The person claims the stress he is experiencing as the reason for the symptoms. Some patients can be quite convincing about how worrying the situation is. In such a situation, the doctor may mistakenly think that the solution is to eliminate the situation that worries the patient. For example, the siblings of a patient of mine, who was worried that the business he was running with his siblings might go bad at any moment and the checks would not be paid, explained that there was a general stagnation in the market, but their condition was not bad at all.
The reason for these patients to consult a doctor is usually muscle pain, tremors, and palpitations. Physical symptoms such as sweating, dry mouth, nausea, difficulty swallowing, feeling of a lump in the throat, numbness, frequent urination and diarrhea. In addition, physical disorders such as irritable bowel syndrome (spastic colon), fibromyalgia, headache, hypertension and gastritis are also common in these patients. For this reason, patients first apply to general practitioners or branches such as internal medicine, PTR, neurology and cardiology. If the underlying psychiatric disorder is not recognized, adequate treatment cannot be given.
GAD usually begins at a young age and fluctuates throughout life. Patients may see this situation as their character. It is twice as common in women than in men.
It is quite common for GAD to occur together with other psychiatric disorders. Chief among these are depression and other anxiety disorders (panic disorder, phobias, obsessive-compulsive disorder) and alcoholism.
Patients with alcohol addiction experience intense anxiety when they do not drink alcohol. On the other hand, GAD patients may use alcohol to suppress their anxiety. Since GAD is chronic, alcohol consumption becomes continuous and tolerance develops over time. The cycle of use and discontinuation It further aggravates the anxiety disorder.
Treatment of GAD is very successful with the combination of medication and cognitive behavioral psychotherapy.
Physicians other than psychiatrists believe that there is a psychiatric disorder underlying the physical symptoms. They may realize that the disorder is underlying, consider it as a personality disorder or the patient acting out, and may not take the patient seriously, labeling it as "neurosis". As I mentioned above, most of these patients recover with appropriate psychopharmacological treatment.
Before initiating appropriate drug treatment, it should be explained to the patient that the source of the disorder is psychiatric and that no physical disorder was detected in the examinations and examinations. Psychiatric medication should never be given to the patient by saying "there is nothing wrong". In this case, the patient thinks that he is not understood, considered crazy, or not believed, and does not use the treatment. However, psychiatric diseases are also “a thing”. Some doctors think that just by telling the patient that there is nothing wrong and "don't worry about it", the patient will get better. However, this advice only makes many patients angry. Because the patient either already knows this but cannot do it, or does not accept that his anxiety is excessive. It should be explained to the patient that his complaints are due to the irregular functioning of some secretions in the nervous system. It should be explained that the psychiatric medications given are regulatory.
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