Clinical Scenario – Peter – Case Study

• Describe Generalised Anxiety Disorder and explain how it differs from Panic Disorder?

Anxiety is not unusual. It does not qualify as a disorder – it is part of our life. However, feelings of excessive worry or nervousness about every significant and insignificant aspect of everyday life qualifies as what is clinically known as the generalised anxiety disorder or GAD (NIH, 2016). About 14% of the Australian population experiences GAD annually, making it 1 in every 7 Australians (Beyond Blue, n.d.). 

Individuals suffering from GAD remain anxious about many things like family, work, health, finances, or others and are unable to control their excessive worrying. Although the factors leading to GAD cannot be definitively identified, a person’s family history, genetic factors and experiences of life are major contributors to the development of GAD (ADAA, n.d.). Some symptoms of GAD are (NIH, 2016):

• Excessive anxiousness over everyday matters
• Excessive sweating, breathlessness or feeling light-headed
• Inability to control worrying/anxiety/nervousness
• Difficulty sleeping
• Restlessness and inability to relax
• Prone to getting startled
• Tremble or twitch
• Feeling tired and exhausted always
• Headaches, muscle aches, stomach aches, or other unexplained pains
• Difficulty swallowing
• Tendency to urinate often
• Difficulty concentrating

An individual is diagnosed to have GAD when he/she cannot control his/her over worrying for 6 months at a minimum or has 3 or more of the above symptoms (ADAA, n.d.). The treatment for GAD is usually supportive with interpersonal counselling sessions and cognitive behavioural therapies (ibid). 

However, GAD is often confused with another common anxiety disorder – the panic disorder. According to the U.S. Department of Health & Human Services (2014), panic disorder is characterized by sudden and recurrent episodes of intense anxiety or fear, along with physical symptoms such as dizziness, chest pain, breathlessness, increased heart rates, excessive sweating, abdominal distress, nausea, trembling, etc. The overlapping symptoms often make differentiating GAD and panic disorder difficult. However, the main point of difference between the two is that panic disorders have sudden, unexpected triggers or attacks, while GAD is characterised by a general tendency to worry over everyday matters (Ankrom, 2019). As per DSM-5, panic disorder is diagnosed when an individual presents with at least 4 of the above symptoms (ibid). In panic disorder, panic attacks happen unexpectedly, peak within ten minutes before finally subsiding (NIH, 2018). GAD, on the contrary, do not have sudden upheavals, it generally manifests every day and in every little thing.

Given, this thin line of distinction, a correct and timely diagnosis is essential for early intervention and cure. The first line of treatment in GAD is psychotherapy and then pharmacotherapy, if severe (Beyond Blue, n.d.).