Generalized Anxiety Disorder Diagnosis and Treatment " Erin a 34-year-old married mother of two young children"

Case study ( 13185 views as of April 20, 2024 )

Erin is a 34-year-old married mother of two young children, and works as a store manager. She presents to her family doctor complaining that it is becoming increasingly difficult for her to function at work because she is constantly having trouble concentrating, and is also feeling exhausted all the time because she sleeps poorly at night. On further questioning, she reports that for the past year or so since her eldest child started going to school, she has been feeling very anxious about how he is doing in school, including whether she packed the right lunch for him, whether he has the right school materials, how he is interacting with the other kids, etc. This worrying has also spread to other parts of her life, and she has been fretting about her family’s finances, about the right foods to buy for her family, and also about issues at work. Her husband has been telling her that she worries way too much, and she acknowledges that there is no good reason why she should be worrying so much, but yet can’t seem to control these worries. These constant ruminations are what keep her up at night and prevent her from sleeping. She has also been feeling on-edge, irritable with her husband and children, and having a lot of stomach aches and loose stools.

Treatment: This patient is diagnosed with Generalized Anxiety Disorder. She is referred to a psychologist for Cognitive Behavioural Therapy (CBT).


Conversation based on: Generalized Anxiety Disorder Diagnosis and Treatment " Erin a 34-year-old married mother of two young children"

Generalized Anxiety Disorder Diagnosis and Treatment " Erin a 34-year-old married mother of two young children"

  • So anxiety is a normal human emotion. It's normal to worry or be scared of certain things in our environment but when we have phobias or we're worrying chronically, and it impacts our day to day functioning or things you wanna do then it's time to get help. For example, if you don't go to your best friend's wedding because you're scared of flying, that might be a problem or you turn down a job in a skyscraper because you're scared of heights. Those are times when you realize that what you want is being impacted by your fears and phobias.
  • If you tend to worry a lot, even when there’s no reason, you may have generalized anxiety disorder (GAD). GAD means that you are worrying constantly and can’t control the worrying. Healthcare providers diagnose GAD when your worrying happens on most days and for at least 6 months.
  • 7 Common Anxiety Symptoms People Experience Many people wonder what anxiety feels like. While it’s different for everyone, there are some common anxiety symptoms that people experience. 1. A Sense of Panic Some people even visit the emergency room during a panic attack because they’re convinced that they’re having a heart attack or are dying. Panic attack symptoms include dizziness, shortness of breath, tightness in your chest, a feeling of choking, nausea and a fear you’re going crazy. 2. Sleep Problems If you have generalized anxiety disorder (GAD), it can keep you up at night. You may stay awake overthinking and overanalyzing situations or get into a cycle where fatigue makes you more anxious as you get more and more overtired. 3. Muscle Pain When you feel stressed for an extended period of time, your body may start to tense up. During a panic attack, adrenaline often pumps through your body, constricting your blood vessels. If your muscles don’t receive proper blood flow, it can lead to aches and pains. 4. Restlessness People with anxiety are constantly responding to the fight or flight system, even though there is no real danger. With so much adrenaline coursing through your body, restlessness is generally the result. Restlessness can also be caused by a feeling of dread or danger, common during panic attacks. 5. Excessive Worrying Occasional anxiety is a normal part of life, whether you worry about family, your job or money. But if you have generalized anxiety disorder, you get into a cycle of constant worrying and negative thinking that interferes with your daily tasks. 6. Loss of Control One of the most common anxiety symptoms is a sense of losing control. You may feel that if you can’t control everything in your life that something bad will happen. Worrying can exacerbate your sense of losing control, such as worrying about what will happen if you lose your job or if a family member dies. 7. Difficulty Focusing If you have generalized anxiety disorder, the worrying and rapid thoughts can distract you from daily life. Sleep problems, restlessness and muscle pain can exhaust you physically, also making it hard to keep your mind on your job, family or hobbies.
  • I think that anxiety is a very misunderstood disorder. It's natural for everyone to feel anxious from time to time, and stress can definitely enhance that feeling. But a true anxiety condition is much more than being nervous before a test or roller coaster. True anxiety disorder is an uncontrollable level of anxiety over a small thing. My daughter has anxiety and has a panic attack every time we have to cut her toenails. She recognizes that it's an irrational fear but she has no control over the level of response her brain triggers.
    • I think you are right and its not so much that we get anxiety but how we deal with it.
    • @K.Michael - that must be so difficult for your daughter. Have you worked with anyone to help her with her anxiety? We took my daughter to a psychologist a year ago who started using a program to help her work through her anxiety and help develop coping strategies. The program was really interesting because it was designed specifically for children and is really age-appropriate with the methods and tools they use.
  • I recently read a study that suggested the Western diet (refined grains, fried foods, sugary foods etc.) may be associated with higher anxiety levels, compared to a traditional diet (fresh fruit/vegetables, whole grains, meat, fish). Other studies seem to pinpoint certain nutrients such as omega fatty acids and magnesium as being associated with depression/anxiety. Erin seems to be concerned about food choices to begin with, but would this be worthwhile for her to consider?
    • Should have clarified - these nutrients may be beneficial to those suffering with anxiety. My understanding is that in the case of omega-3 fatty acids, they may be anti-inflammatory in comparison to more commonly eaten saturated fats.
    • @AllieS - are omega fatty acids and magnesium supposed to be good or bad for anxiety and depression ?
    • I think there is strong coloration between foods and anxiety. It is said people eat for depression or go shopping for depression so I suspect strongly it works the same way here. I think people might e better of looking for exercise options to depression and anxiety. I am not trying to say exercise will cure all aliments like depression and anxiety but it can certainly help some times when I am feeling anxious.
  • Many individuals we know have an anxiety issue and over time have began to take medication. Is this something that will be ongoing or are there other treatments ? Getting off medication is the goal of a few of these individuals, however their doctors are telling them medication is the way to go.
    • There are some people with Bio- Polar tendencies that need mediation to get them back to a stable point or focus. Not everyone has the clarity to see straight or to know what is destructive belabour and what is good belabour.
    • In my experience people often find that the medication allows them to think through the anxiety. And that once they are able to do that they are able to go off the medication. I've been told that with mild anxiety medication might be just a short term need and not a long term solution
  • Is there a specific incident that could start the anxiety or does it just build up over time?
    • I believe there is often an event that triggers anxiety but as I have read anxiety builds up over time and then one event can increase its level in the body. Once that happens your norm coping tools might or not be enough to carry the day and get you back to a balanced place.
    • It depends. Some people experience something which causes anxiety. Others are born with it like any other medical condition.
  • Men who have depression will likely have sexual problems. The reason for this is that the depression tends to cause a generalized loss of sexual interest. It can affect your erections either in the morning, with self-stimulation, or with a partner.
    • I think Dr Elliott makes some great points about Men who have depression will likely have sexual problems. I think the point she makes about the reason for this is that the depression tends to cause a generalized loss of sexual interest. This makes sense in regards to how it can effect your erections either in the morning, with self-stimulation, or with a partner.
    • What can help with this issue ? Is medication the only way to treat lack of sexual desire ?
    • I could see that then leading to even more depression.
  • Health Canada and Statistics Canada have indicated that there’s a 1 in 10 chance over one’s lifetime to develop depression. U.S. survey shows up to 20 percent prevalence of depression in the population. It’s important that you speak to your physician about the symptoms of depression which differ than the symptoms of low mood based in time.
    • Do those stats include post partum depression?
  • I have similar symptoms and an antidepressant which is known to work well for generalized anxiety disorder changed my life
    • That is great that an antidepressant was able to help your anxiety symptoms and improve quality of life.
  • I thought it was interesting to learn from the videos that exercising 3 times per week could offer the same benefits as medication as a treatment for Generalized Anxiety Disorder. Do you think people who have been diagnosed and are on medication for the disorder would agree, though? Maybe there are some cases that are so severe that medication truly is the best option (along with diet, exercise, or other natural remedies).
    • I think in some cases the medication is needed as well. There are definitely people who exercise frequently that also have anxiety.
    • We have a family member who did not exercise at all and was on higher doses of medication. They recently started to walk for 45-60 mins per day. They started to eat healthier and cut down on sugars. Since doing this their medication dosage has been reduced. The doctor has suggested yoga and/or meditation as a way to release some of the anxiety.
  • After I had my first child and I was working full time, I had problems with sleep and feeling anxious all the time etc. Due to lack of sleep, I therefor was drinking coffee a couple of times a day. It took me a long time to figure out why I was feeling so anxious but interestingly as soon as I stopped drinking coffee I felt so much better. I stick to decaf coffee now and I don't have the same problems. Just something to think about if you are a coffee drinker and are feeling anxious a lot. Eliminating caffeine actually changed my life.
    • It is hard for moms of young children who don't get enough sleep to go without coffee! But it definitely adds to that anxious feeling!
    • This happened to my husband. A few years ago he would drink an espresso before heading off to work to give him the jolt he needed for the day. On the weekends he would not drink the espresso and noticed he would get headaches and feel anxious. After eliminating the morning espresso the headaches and anxiety stopped.
  • If you are on certain medications to treat depression for too long can it have an adverse effect ? How often should treatment / medications be reviewed with your doctor ?
    • A lot of doctors don't review it though, they just renew the anxiety medication prescription without much discussion.
    • I don't know the answer to that ShirlyG, but I think if a person is on a medication for depression or General Anxiety Disorder, I think re-evaluating medication type and dosage is part of regular appointments with their GP and/or psychiatrist - which could be 2 to 4 times per year (or more depending on the circumstances).
  • I have heard of eft for anxiety but never knew what it was. So you just tap with your hands??
    • This is interesting. I have not heard it called EFT but I have heard of self-release of tension and anxiety through pressure points. For example, squeezing the forefinger of one hand in the fist of your other hand for a minute is supposed be calming. It was suggested to me as a method to teach my occasionally impulsive son. Is this the same thing as EFT?
  • Yes, if someone is being triggered by something specific on a continual basis, then there is an imbalance in the person's system that is allowing for the trigger. So we would work on regaining balance and calming the mind so they do not get anxiety when they are experiencing the situation. Do you know what EFT "Emotional Freedom Technique" is? It is great to teach the patient/client how to move their own Qi through as they are in the midths of whatever it is that is the trigger. It is very helpful as it uses the tapping of special acupuncture points on the face, chest and hand while dialoging verbally how they are feeling to move Qi quickly which will release the anxiety.
  • @Julianne, do you have any experience with the benefits of acupuncture on situational anxiety?
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