Clinical features – Generalised Anxiety Disorder
Generalised Anxiety Disorder is defined as generalised, excessive anxiety persistent for more than 6 months
Alternative terms for Generalised Anxiety Disorder that may be used by Health Care Professionals and claimants are chronic anxiety state and chronic anxiety.
Generalised Anxiety Disorder usually develops in early adult life between the ages of 15 and 25. When anxiety begins after the age of 35, it is usually a consequence of another psychiatric disorder, for example depression.
Anxiety typically causes a combination of physical and psychological symptoms.
Feelings of anxiety are a normal physiological response to a situation in which an individual might be in danger, for example, being chased by an assailant – “the fight or flight” response. It is also normal to feel fearful or anxious in certain situations, such as answering the door to a stranger at night, attending a job interview or watching a horror film. The feelings may also be accompanied by physical sensations such as pounding of the heart, feeling breathless and increased perspiration. These are normal responses and serve a biological function in the face of certain stressful situations.
Symptoms of anxiety become part of a recognisable illness when they are disproportionate to the severity of the stressor, continue after the stressor has been removed, occur in the absence of any external stressor and persist for some time, several months or more. In addition they cause disabling effects such that a person’s normal daily routine is affected interfering with occupational functions and social life.
The symptoms of Generalised Anxiety Disorder are persistent and not restricted to, or markedly increased in any particular set of circumstances. There is usually a characteristic pattern comprising the following features:
- Worry and apprehension which are difficult to control and more prolonged than the ordinary worries and concerns of healthy people. The worries are widespread and not focussed on a specific issue.
- Irritability, poor concentration and sensitivity to noise. Some people complain of a poor memory, but this is due to poor concentration.
- Sweating, palpitations, dry mouth, upper abdominal discomfort and dizziness.
- Restlessness, trembling, inability to relax, headaches and aching in the shoulders and back, all due to muscle tension
- Hyperventilation, [over breathing] which may lead to dizziness, tingling in the extremities and a feeling of shortness of breath.
- Sleep disturbance, which includes difficulty in falling asleep and persistent, worrying thoughts. Sleep is often intermittent, un-refreshing and accompanied by unpleasant dreams.
- Other features include tiredness, depressive symptoms, obsessional symptoms, depersonalisation [person feels unreal, detached from his own experience and unable to feel emotion] and de-realisation [environmental objects and people appear unreal].
People have a classical appearance. The face appears strained, the brow is furrowed and the posture is tense. The person is restless and may tremble. The skin is pale and sweating is common. The person may look like they are ready to burst into tears.
Males and members of some cultures are more likely to complain of physical rather than psychological symptoms. It is important to understand that although these symptoms are real to the person, they have a psychological rather than a physical basis.
Click on the link for details of:
