Generalized Anxiety Disorder and Post Traumatic Stress Disorder
It may be shocking to learn that 21% of American adults suffer from some sort of anxiety disorder (National Institute of Mental Health Statistics). Do you know the differences between the two major types of anxiety disorder? The two major types of anxiety are Post Traumatic Stress Disorder (PTSD) and Generalized Anxiety Disorder (GAD). While many may think PTSD and GAD are one in the same, you may be surprised that they vastly differ in cause and symptoms with their only similarity being their treatment.
According to the PTSD Fact Sheet ”PTSD was once considered a psychological condition of combat veterans who were “shocked” by and unable to face their experiences on the battle field” (Fact Sheet Page 1). Over the years with additional research and discoveries PTSD has now become a much more common diagnosis for many anxiety sufferers. According to the National Center for PTSD “Anyone who has gone through a life-threatening even can develop PTSD. These events can include: combat or military exposure, child sexual or physical abuse, terrorist attacks, sexual or physical assault, serious accidents such as a car wreck, or natural disasters.” (National Center for PTSD). Each individual is different and not everyone who lives through a traumatic event will developed PTSD. Some of the determination factors if an individual will develop PTSD vary based on how intense a trauma was, if the individual lost someone they were close with, how strong the individuals reaction was and how much support the individual received after the event. (National Center for PTSD)
Unlike PTSD, Generalized Anxiety Disorder (GAD) is not necessarily associated with a particular event and therefore can appear to come from nowhere. According to the article Generalized Anxiety Disorder “Generalized anxiety disorder is characterized by excessive, almost daily anxiety and worry for over 6 months about many activities and events with an unknown cause”. (Merck Manual Professional). GAD is very common and can affect anyone although women are affected twice as often as men. Anyone from small children to elderly suffer from GAD. A GAD sufferer may suffer from for a short time or may suffer from it for all their life.
Doctors need to determine which anxiety disorder an individual has in order to formulate the best treatment. There are four main types of PTSD symptoms. The first symptom is that the “individual will relive the event” (National Center for PTSD). Bad memories of an event may come back at any time through nightmares or flashbacks. PTSD suffers may hear a noise, see something or read a report about something that my cause these flash backs. (National Center of PTSD) Some examples of this is hearing a car backfire may cause a veteran to go back to the time they heard the gun fire that killed their friend. Another example would be a sexual abuse victim hearing a news story about someone who is was sexually abused and having flashbacks to their experience. The second type of symptom of PTSD is “Avoiding situations that remind you of the event” (National Center for PTSD). Examples of this would be someone who was raped in a dark alley will avoid being out after dark for fear they same thing will happen. The third type of symptom is “Feeling Numb” (National Center for PTSD). The individual will try to hold their feelings in as a way to avoid the memories. They may also lose all interest in activities they use to enjoy because they do not want to feel happiness. The last type of symptom is “feeling keyed up” (National Center for PTSD). The individuals will feel many symptoms of anxiety and panic attacks such as being angry, not sleeping, having a hard time settling or concentrating.
Unlike PTSD which has very definite types of symptoms , GAD sufferers may have very different symptoms from each other.(Merck Manual Professional) Most common GAD symptoms can vary from acute to sever and can fluctuate over time. Having panic attack like symptoms such as heart racing, shortness of breath, numbness, etc are common symptoms of GAD suffers. Along with the panic attack symptoms GAD sufferers may experience embarrassment in public, have multiple worries and may suffer from severely from depression. (Merck Manual Professional) In extreme cases of GAD an individual may develop such strong fears of public embarrassment that they may suffer from agoraphobia. Agoraphobia is an extreme case of GAD where individuals are hermit like and do not leave their homes for fear of public situations.
Successful treatment of PTSD really relies on the individual and their commitment to wanting to get better. Treatment for PTSD may vary by individual and severity, however, according to van der Kolk in the article Approaches to the treatment of PTSD there are three principles components for treating PTSD. “Processing and coming to terms with the horrifying and overwhelming experience, controlling and mastering physiological and biological stress reactions and re-establishing secure social connections and interpersonal efficacy.” (Kolk 1995). In order to overcome PTSD there are options that individuals have and each case should be handles on an individual basis. The common treatments for PTSD include Psychotherapeutic Interventions, Group Psychotherapy and Psychopharmacological Treatment. Psychotherapeutic Interventions focus on reconditioning the anxiety associated with the trauma and the recognition of the effects that trauma has on the individual. Psychotherapy is talk therapy with a licensed social worker, counselor, psychologist or psychiatrist. Group Psychotherapy will incorporate the same basics of individual psychotherapy but in a group setting with others that have experienced the same situations. The final way to treat PTSD is Psychopharmacological treatment which incorporates antidepressant medications such as MAO inhibitors along with the psychotherapy.
Similar to PTSD the successfulness of treatment is in the hands of the sufferer. PTSD and GAD share many treatments such as are individual psychotherapy, group psychotherapy and psychopharmacological treatment. GAD suffers use individual or group psychotherapy to work through their psychological issues that may be causing them anxiety such as their marriage, money, public embarrassment etc. Using antidepressants are common in conjunction with psychotherapy to help the individuals with the physical symptoms of anxiety while they work through the psychological aspects of their GAD. Unlike PTSD, cognitive behavior therapy has been proven to help with GAD. According to the article Cognitive behavioral therapy (CBT) for depression, panic disorder and generalized anxiety disorder: a meta-regression of factors that may predict outcome, “CBT has been shown to be an effective treatment for depression and GAD”. (Haby, Donnelly, Corry, Vos, 2006). CBT is a form of psychotherapy that makes the individual aware of their thinking and helps them realize their thinking contributes to their anxiety.
Although treatment is similar in both PTSD and GAD causes and symptoms can drastically vary from one individual to the next. Both disorders can be anywhere from slightly annoying to completely debilitating to sufferers and therefore treatment of their disorder is key. Even though both PTSD and GAD are considered anxiety disorders it is clear that a correct diagnosis will help a physician create the correct therapy and treatment plan to help their patient get the best success rate.
- Greist John H MD, Jefferson James W. MD. “Generalized Anxiety Disorder.” Merck Manual Professional. Aug 2007.
- Haby Michelle, Donnelly Maria, Corry Justine, Vos Theo “Cognitive behavioral therapy for depression, panic disorder and generalized anxiety disorder: a meta-regression of factors that may predict outcome.” Australian and New Zealand Journal of Psychiatry. 2006. Print. Pages 9-19.
- National Center for PTSD. “What is PTSD?” United States Department of Veterans Affairs”. Web. 01 Jan 2007. Web. 26 June 2011.
- National Institute of Mental Health Statistics. Web. 26 June, 2011.
- Post-Traumatic Stress Disorder (PTSD) Fact Sheet. “National Institutes of Health”. Oct 2010. Web. 26 June 2011.
- Van der kolk Bessel A MD, van der Hart Onno PH.D, Burbridge, Jennifer M.A. “Approaches to the Treatment of PTSD”. Print. 1995.
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