Sunday, January 31, 2010



In my outpatient psychology practice, I see eight things every
day--they show up again and again, presenting in one form or another.
One of the bigger and more negative experiences clients have is anxiety.
In addition, the first thing clients want to know is whether they have
an anxiety disorder, in this case Generalized Anxiety Disorder. Here
is a rather clinical description of what anxiety is, according to an
older but very accurate source, the Diagnostic and Statistical Manual
of Mental Disorders, Third Edition:

"...An apprehension, tension, or uneasiness that stems from the
anticipation of danger, which may be internal or external. Some
definitions of anxiety distinguish it from fear by limiting it to
anticipation of a danger whose source is largely unknown whereas fear
is the response to a consciously recognized and usually external threat
or danger. The manifestations of anxiety and fear are the same and
include motor tension, autonomic hyperactivity, apprehensive expectation,
vigilance and scanning. Anxiety may be focused on an object, situation,
or activity, which is avoided (phobia), or may be not focused
(free-floating anxiety). It may be experienced in discrete periods of
sudden onset and be accompanied by physical symptoms. When anxiety is
focused on physical signs or symptoms and causes preoccupation with the
fear or belief of having a disease, it is termed hypochondriasis."

And, here is how anxiety typically manifests (symptoms):

...Trembling, twitching, or feeling shaky, muscle tension and aches or
soreness (including chest pains), restlessness, easy fatiguing...or...
shortness of breath or smothering sensations, palpitations or accelerated
heart rate, sweating or cold clammy hands, dry mouth, dizziness or
lightheadedness, nausea, diarrhea, or other abdominal distress, flushing,
hot flashes, chills, frequent urinations, trouble swallowing, or...
feeling keyed up and on edge, exaggerated startle response, difficulty
concentrating or having your mind "going blank," trouble falling or
staying asleep, or being excessively irritable.

Generalized Anxiety Disorder (GAD) is one of many kinds or categories
of anxiety. I have written specifically about this and other versions
of anxiety in my ebook on How To Diagnose and Treat Your Anxiety.
This is a publication that shows you how to think about any anxiety,
disorder or not, how to assess your symptoms and more importantly,
what to do about it. Here is what I wrote about GAD:

"This category is characterized by an unrealistic or excessive worry
about two or more life circumstances (money problems, school grades, etc.).
Usually such worrying is chronic, not acute (as with panic attacks,
phobias or Post Traumatic Stress Disorders), and involves six or more of
the anxiety symptoms listed above and usually lasts at least six months.
Again, the individual symptoms need not be intense, although most people
probably would think the worry still is excessive. This category is
distinguished from the Worrisome Personality. Generally, there are more
symptoms and fewer areas of concern."

Anxiety pervades almost all of our experiences in every venue.
Most of the time, it is in the background. It turns out we need some
very basic "tension" to exist and a little more to be motivated to do
things. We psychologists call this ergic tension. You could not sit
up or read this article if you had no ergic tension. It is normal.

However, many people have more anxiety than this, which still could
be good in some circumstances, like in sports or just before an important
speech or even right before a major test in school. This keeps us
focused and helps us appropriately utilize the extra adrenaline that
accompanies such events. We are still in the normal range of anxiety
if we understand and can manage it during and then after the specific
event, presumably when our anxiety drops back to lower levels.

Some people have more anxiety than this, and it does not go back
to "mark headings." These are the folks who probably have an anxiety
disorder. Chronic worrying is in the second category. There are seven
major categories of anxiety disorders, depending upon the cluster of
symptoms and their manifestations. I also have written about these
in the same ebook referenced above. Here's the categories: Worrisome
Personality, then the more progressive and I think more serious clinical
categories follow: Generalized Anxiety Disorder, Adjustment Disorder
with Anxiety, Post Traumatic Stress Disorder, Panic Attacks,
Phobia Disorder and Obsessive Compulsive Disorder. I made up the first
category because I see this a lot in my practice, but it is not in the
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
(the latest version of this manuscript, which is the Bible of mental
health professionals). The last six categories are clinical categories
and are found in the DSM IV.

GAD sufferers have a relatively minor version of anxiety disorder,
but one that can still cause some discomfort. You have to think about
your symptoms in a very specific and different way to diagnose whether
or not you have ANY anxiety disorder, GAD included. I show you how,
step by step, in my ebook.

Dr. Griggs

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