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What Are The Symptoms Of Borderline Personality Disorder?

personality-disorder

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental health disorder. It is a complex psychological condition that is characterized by pervasive instability in moods, emotions, behaviors, and interpersonal relationships which interfere with one’s ability to function in everyday life. It can be difficult to determine who will develop borderline personality disorder as the cause of BPD remains unknown. The National Institute of Mental Health (NIH) alludes to research that “suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder.” BPD typically develops in early adulthood, often with more severe symptoms occurring in the early stages of onset.

Symptoms & Diagnostic Criteria

Borderline personality disorder directly affects how one feels about him or herself, one’s behavior as well as how an individual can relate to others. It is not uncommon for people with BPD to feel extremely intense emotions for extended periods of time. This makes returning to a stable emotional baseline far more challenging, especially after experiencing an emotionally triggering event. According to the DSM-5 key signs and symptoms of BPD may include:  

  • Unstable personal relationships that alternate between idealization and devaluation, sometimes referred to as splitting
  • Frantic efforts to avoid real or imagined abandonment by family and friends
  • Impulsive behaviors resulting in dangerous outcomes (e.g., engaging in unsafe sex, reckless driving, abuse of drugs, etc.)
  • Distorted and unstable self-image, affecting one’s moods, relationships, goals, values, and/ or opinions
  • Self-harming behavior (e.g., suicidal threats)
  • Chronic feelings of emptiness and/ or boredom
  • Periods of intense depressed mood, irritability and/ or anxiety lasting anywhere from a few hours to a few days long
  • Dissociative feelings
  • Intense, inappropriate, and/ or uncontrollable anger, typically followed by feelings of guilt and/ or shame

More specifically, the diagnostic criteria outlined in the DSM-5, indicates that to be clinically diagnosed with BPD an individual must experience five or more of the following symptoms, in a variety of contexts,

  1. Emotional instability
  2. Feelings of emptiness
  3. Efforts to avoid abandonment
  4. Impulsive behaviors
  5. Identity disturbances
  6. Inappropriate, irrational and/ or intense bouts of anger
  7. Transient paranoid and/ or dissociative symptoms
  8. Unstable interpersonal relationships
  9. Suicidal and/ or self-harming behaviors

Due to the quick changing nature of signs and symptoms associated with borderline personality disorder, it is notoriously known as a difficult to diagnose illness. The treatment for BPD often includes long-term participation in psychodynamic models of psychotherapy such as dialectical behavior therapy (DBT). DBT was developed by Marsha M. Linehan in the late 1980s, as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder. It is an evidence-based psychotherapy that combines techniques from western cognitive behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices to foster the systematic learning of new emotional coping skills. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

Main Cause Of Borderline Personality Disorder?

personality-disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) list ten standalone personality disorders based on similar characteristics, and each personality disorder is grouped into one of three categories (cluster A, cluster B, and cluster C). Borderline personality disorder (BPD) belongs to cluster B, which according to the Mayo Clinic are “characterized by dramatic, overly emotional or unpredictable thinking or behavior.” More specifically BPD is characterized by “a pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations, and impulsivity.” The symptoms associated with borderline personality disorder can pervasively interfere with an individual’s ability to function optimally in his or her daily life. Most commonly, BPD develops in early adulthood, often with more severe symptoms occurring in the early stages of onset

BPD Triggers & Risk Factors

A trigger, in the context of BPD typically refers to something that precipitates the exacerbation of one’s BPD symptoms. Johns Hopkins Medicine explains “triggers are external events or circumstances that may produce very uncomfortable emotional or psychiatric symptoms, such as anxiety, panic, discouragement, despair, or negative self-talk.” While BPD triggers can vary from person to person, there are some types of triggers that are more common in BPD, such as the following examples:

  • Perceived or real abandonment
  • Rejection of any kind
  • Loss of a job
  • Locations that invoke negative memories
  • Reminders of traumatic events
  • Ending a relationship

Many borderline personality disorder triggers arise from interpersonal distress. When it comes to understanding the specific cause of this disease, there is no solitary scientific reason behind why an individual develops borderline personality disorder. Rather there are several contributing factors that have been recognized as possibly playing a role in its development, potentially increasing one’s susceptibility to BPD. These factors may include, but are not limited to the following, provided by the National Institute of Mental Health

  • Genetics: people with a family history (e.g., parent, sibling, etc.) with BPD may be at increased risk of developing borderline personality disorder. Psychology Today assert that BPD is approximately five times more common among people with close biological relatives with BPD. 
  • Environmental factors: growing up in an unstable, neglectful, and/ or abusive environment could increase one’s risk for developing BPD. 
  • Brain factors: some studies have indicated that individuals diagnosed with BPD have structural and/ or functional abnormalities, specifically in the areas of the brain that reign emotional regulation and impulse control. Furthermore, deviations from typical serotonin (hormone that works to stabilize one’s mood, happiness, and feelings of well-being) production could increase one’s vulnerability to BPD. 

Although the above factors may contribute to the development of BPD, exposure to one or more risk factors does not indicate an individual will inevitably to go on to develop borderline personality disorder. Since the root of borderline personality disorder remains unknown, it is impossible to isolate a single cause that accurately and universally explains its development.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Does Dialectical Behavior Therapy Do?

dbt

Dialectical behavior therapy (DBT) is an evidence-based psychotherapeutic approach that is founded on the principals of cognitive behavioral therapy (CBT) and blends Eastern mindfulness techniques (e.g., awareness, mindfulness and attentiveness to current situations and emotional experiences) to encourage acceptance and change. In was developed by Marsha M. Linehan in the late 1980s, as a means to better treat individuals diagnosed with borderline personality disorder (BPD), suffering from pervasive suicidal ideation. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD, and has also become recognized as an effective therapeutic method of treatment for a wide range of other mental health conditions, such as depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder (SUD), eating disorders, and more. Dialectical behavior therapy helps individuals foster healthy coping mechanisms and useful techniques for managing stress, regulating emotions, and improving relationships with others.

DBT Skills

Dialectical behavior therapy is carried out in three distinct therapeutic settings, including weekly individual psychotherapy (one-on-one therapy) sessions; weekly DBT skills training group sessions, and access to twenty-four-hour support between sessions via phone coaching. DBT focuses on teaching skills in four primary areas, or four modules, which are:

  • Core mindfulness: focuses on improving an individual’s ability to accept and be present in any given moment. The skills in this module help individuals learn the importance and value of slowing down and taking pause instead of succumbing to intense emotions and acting in destructive ways. 
  • Distress tolerance: focuses on increasing an individual’s tolerance of negative emotion as opposed to attempting to avoid or escape from it. The skills in this module help individuals learn various techniques for handling crisis (e.g., distraction, self-soothing, improving the moment, etc.). 
  • Emotion regulation: focuses on helping an individual identify, name, understand the function of, and regulate their emotions. The skills taught in this module are intended to help an individual learn to decrease the intensity of their emotions, sit with and experience strong emotions that are causing problems in one’s life, without impulsively acting on them. 
  • Interpersonal effectiveness: focuses on increasing an individual’s communication strategies. The skills taught in this module help an individual learn to identify what their own needs are in a relationship and develop assertive and effective communication methods to ensure those needs are met in a healthy, nondestructive way. 

Behavioral Tech explains that “DBT works because it successfully increases clients’ ability to use effective

coping skills, particularly strategies for expressing, experiencing, and regulating intense emotions.” Studies have found that certain improvements, can be fully or partially attributed to learning and implementing DBT skills (e.g., improvements in emotion regulation, reduced experiential avoidance, minimized assertive anger, etc.). The DBT process is heavily influenced by the philosophical perspective of dialectics, or the balancing of opposites. DBT encourages an inclusive worldview and perspective (both- and) instead of an exclusive (either- or) outlook on life. It essentially shifts one’s perspective on life by helping individuals learn to identify ways to hold two seemingly opposite perspectives simultaneously. 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

Understanding Depression and Depressive Disorders

Understanding Depression and Depressive Disorders

Depression, also known as major depressive disorder or clinical depression is one of several mood disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Mood disorders, also known as affective disorders, according to Johns Hopkins Medicine “is a mental health class that health professionals use to broadly describe all types of depression and bipolar disorders.” Mood disorders severely impact one’s mood and its related functions. An individual with depression or a depressive disorder will likely have erratic mood shifts from extremely low (depressed) to extremely high (manic). To be properly treated an individual must be clinically and accurately diagnosed.

Most Common Mood Disorders

While there are several depressive disorders listed in the DSM-5, certain disorders are more common than others. According to the Cleveland Clinic, the most common depressive disorders include the following:

  • Bipolar disorder (manic-depressive disorder): characterized by periods of depression alternating with periods of mania (elevated mood)
    • Bipolar I disorder: characterized by at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes
    • Bipolar II disorder: characterized by at least one major depressive episode and at least one hypomania episode, and absence of manic episodes
  • Cyclothymic disorder (cyclothymia): characterized by fluctuating low-level depressive symptoms along with periods of mild mania (hypomania)

Based on the diagnostic interview data from National Comorbidity Survey Replication, the National Institute of Mental Health estimates approximately 21.4% of adults in the United States experience depression or a depressive disorder at some point in their lives. 

Signs and Symptoms

Mood disorders, as defined by the Mayo Clinic are characterized by a distortion of one’s general emotional state and/ or mood that is inconsistent with the current circumstances and interferes with one’s ability to function. Common examples of signs and symptoms that could be indicative of depression and depressive disorders could include, but are not limited to any combination of the following, provided by the American Psychiatric Association (APA):

  • Changes in appetite
  • Weight fluctuation
  • Loss of interest in previously enjoyed pastimes
  • Feelings of hopelessness and/ or pessimism
  • Difficulty sleeping or sleeping too much
  • Increased fatigue 
  • Feeling worthless and/ or guilty
  • Difficulty concentrating
  • Irritability
  • Persistent feelings of sadness
  • Moving and/ or talking more slowly than usual
  • Suicidal ideation

The symptoms associated with depressive disorders will differ, as they will depend on the individual, as well as the type of depressive disorder with which he or she is diagnosed. If left untreated, the symptoms of depression and depressive disorders can lead to severe short and long-term effects and in some cases could be life-threatening. 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Causes Depression?

What Causes Depression?

Depression is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a major depressive disorder, and is sometimes referred to as clinical depression. It is characterized by persistently depressed mood and/ or a loss of interest in previously enjoyed activities, impairing one’s ability to function in his or her daily life. The various symptoms associated with depression can range from mild to severe. While depression can develop at any age, symptoms commonly surface in adolescence and young adulthood. There is no single identifiable cause of depression, rather Harvard Health asserts that there are many possible causes of depression. The Cleveland Clinic provides examples of factors that may play a role in its development, including but not limited to the following:

  • Brain chemistry: Abnormalities in brain chemical levels may lead to depression.
  • Genetic vulnerability: A family history of depression can increase one’s propensity for developing depression.
  • Life events: Stress, the death of a loved one, upsetting events (trauma), isolation, and lack of support can cause depression.
  • Medical conditions: Ongoing physical pain and illnesses can cause depression. Depression is a common comorbidity of other illnesses such as diabetes, cancer, and Parkinson’s disease.
  • Medication: Depression is a side effect of some medications.
  • Recreational drug and alcohol use: can cause depression or exacerbate one’s depression.
  • Personality: People who are easily overwhelmed or have trouble coping may be prone to depression.

To be diagnosed with depression, a person’s symptoms must fit the criteria outlined in the DSM-5. An individual must be experiencing five or more of the following symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure:

  1. Depressed mood most of the day, nearly every day.
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  3. Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.
  4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  5. Fatigue or loss of energy nearly every day.
  6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

These symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

 

What Drugs Are Commonly Prescribed For Depression?

What Drugs Are Commonly Prescribed For Depression?

Major depressive disorder (MDD) or clinical depression, is listed as a medical illness in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and is recognized as a serious mood disorder. Mood disorders, also known as affective disorders, according to Johns Hopkins Medicine “is a mental health class that health professionals use to broadly describe all types of depression and bipolar disorders.” The World Health Organization (WHO) explains that severe depression is “characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities,” resulting in significant impairment in one’s daily life. According to the Centers for Disease Control and Prevention (CDC), depression affects nearly ten percent of the general population in America.

Antidepressant Medications

Antidepressants are medications prescribed to help treat moderate to severe depression. Treatment for depression typically includes integrating a combination of both psychotherapy and medication into one’s treatment plan. Every individual is different and not all antidepressant medications will work for everyone. The treatment plan for depression must consider the nuanced mental health needs of the individual and be customized accordingly. The two most common types of antidepressant medications prescribed for the treatment of depression include: 

  • Selective serotonin reuptake inhibitors (SSRIs): SSRIs work by slowing the re-absorption of and altering the brain’s chemical balance of serotonin. Serotonin is the chemical in one’s body that is directly related to one’s moods. Common examples of SSRIs that may be used to treat depression include, but are not limited to:
  • Selective norepinephrine reuptake inhibitors (SNRIs): SNRIs work to elevate one’s mood by interacting with both the serotonin and norepinephrine levels in one’s brain. They can be prescribed to treat anxiety, depression, and some chronic pain conditions. Common examples of SNRIs that may be used to treat MDD include:

As is true with taking any type of medication there are associated risks. The specific risks will vary from person to person, as they will depend on several contributing factors (e.g., the individual’s health history, the presence of any additional mental health ailments, substance abuse issues, genetics, etc.). The Food and Drug Administration (FDA) requires antidepressant medications to clearly display a black box warning label indicating the possibility of increased suicidal thoughts and behaviors when taken by some individuals under the age of 25. An individual that experiences adverse side effects is encouraged to consult his or her healthcare provider immediately. If left untreated, the symptoms of depression can lead to severe short and long-term effects and in some cases could be life-threatening. 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

 

What Is The Most Popular Drug For Depression?

What Is The Most Popular Drug For Depression?

The World Health Organization (WHO) explains that severe depression, clinically referred to in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), as major depressive disorder (MDD), is “characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities,” resulting in significant impairment in one’s daily life. Harvard Medical School explains that the most prominent symptoms of MDD include a severe and persistent low mood, profound sadness, or a sense of despair. Major depressive disorder is recognized as the leading cause of disability in America for individuals ages fifteen to forty-four. Findings from the 2020 National Survey on Drug Use and Health (NSDUH) indicate that 8.4% of all U.S. adults, which is equal to nearly 21 million people, had at least one major depressive episode. Major depressive disorder is a complex psychiatric disorder that affects mood, cognition, behavior, and impedes adaptive functioning. If left untreated, MDD can adversely affect one’s overall health and lead to short and long-term physiological complications.

Treatment

Obtaining an accurate diagnosis (concluded with results from a medical exam with blood work, and psychological evaluation) is essential to the recovery process for any mental health illness, including depression. There is no single treatment plan that is entirely effective for everyone that struggles with depression, as each person is unique. Hence, treatment for depression requires a customized treatment plan that is inclusive of a multidisciplinary approach. The American Academy of Family Physicians (AAFP) underscores common components that may make up one’s treatment plan for MDD, which typically include a variety of psychotherapeutic approaches such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), expressive arts therapy, interpersonal psychotherapy (IPT), and more. Some people diagnosed with severe major depressive disorder may also benefit from medication. Although there are several types of antidepressant medications used to treat MDD, the first line-treatment for depression is either of the following: 

  • Selective serotonin reuptake inhibitors (SSRIs): work by slowing the re-absorption of serotonin (the neurotransmitter known to help with mood regulation and anxiety) in one’s the brain. Common examples of SSRIs that may be used to treat depression include, but are not limited to:
  • Selective norepinephrine reuptake inhibitors (SNRIs): work by reducing the reabsorption of serotonin and norepinephrine in one’s brain. They can be prescribed to treat anxiety, depression, and some chronic pain conditions. Common examples of SNRIs that may be used treat MDD include:

As is true with taking any type of medication there are associated risks. The specific risks will vary from person to person, as they will depend on several contributing factors (e.g., the individual’s health history, the presence of any additional mental health ailments, substance abuse issues, genetics, etc.). The Food and Drug Administration (FDA) requires antidepressant medications to clearly display a black box warning label indicating the possibility of increased suicidal thoughts and behaviors when taken by some individuals under the age of 25. In most cases integrating a combination of both psychotherapy and medication into one’s treatment plan yields the most successful long-term results.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

How Do You Test For Generalized Anxiety Disorder?

How Do You Test For Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a mental illness. Mental Health America explains that GAD “is characterized by six months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience.” The diagnosis process for GAD typically begins with undergoing a physical exam along with complete medical history. There is currently no laboratory test or scans used to detect or diagnose a generalized anxiety disorder. There are, however, some tests (e.g., blood tests) that could be used in the diagnosis process to check for any other underlying conditions that may be causing symptoms. 

If no signs of physical illness are determined, the process continues with an additional assessment conducted by a mental health professional that specializes in diagnosing and treating mental illnesses (e.g., psychiatrist, psychologist, etc.). The American Family Physician explains that diagnosing GAD “requires a broad differential and caution to identify confounding variables and comorbid conditions.” Generalized anxiety disorder is known as a differential diagnosis. A differential diagnosis implies that there are other possible diagnoses, and requires the diagnostician to differentiate between these possibilities to determine the actual diagnosis and appropriate treatment plan. The mental health professional will ask in-depth questions about one’s reported symptoms (e.g., how long they last, how intense they are, etc.), how the symptoms interfere with one’s daily life, will make observations of one’s attitude and behavior, and may use psychological questionnaires such as the Hamilton test or the GAD-7 screening tool to help determine a diagnosis.

DSM-5 Diagnostic Criteria

The DSM-5 outlines specific criteria to help professionals diagnose a generalized anxiety disorder. When assessing for GAD, clinical professionals are looking for the following, provided by the Anxiety and Depression Association of America:

  1. The presence of excessive anxiety and worry about a variety of topics, events, or activities that presents more frequently than not for at least six months.
  2. The worry is experienced as very challenging to control. The worry in both adults and children may easily shift from one topic to another.
  3. The anxiety and worry are accompanied by at least three of the following physical or cognitive symptoms:
    1. Edginess or restlessness
    2. Tiring easily; more fatigued than usual
    3. Impaired concentration or feeling as though the mind goes blank
    4. Irritability (which may or may not be observable to others)
    5. Increased muscle aches or soreness
    6. Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep)

These symptoms must be unrelated to any other medical conditions and cannot be explained by a different mental disorder or by the effect of substance use, including prescription medication, alcohol, or recreational drugs. The diagnostic criteria are somewhat different for adults and children. An adult is diagnosed with a generalized anxiety disorder when at least three of the above symptoms persist for a minimum of six months. In younger people, however, only one symptom is needed for diagnosis, provided it has been exhibited somewhat regularly, spanning over a period of six months. The above criteria differentiate GAD from normal bouts of anxiety and/ or worry that may manifest from a specific set of stressors or for a more limited period.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

 

What Is The Most Effective Antidepressant For GAD?

What Is The Most Effective Antidepressant For GAD?

Generalized anxiety disorder (GAD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental health disorder. GAD is characterized by severe ongoing anxiety and exaggerated worry and tension (even when there is little or nothing to provoke it) that interferes with daily activities. According to the DSM-5 diagnostic criteria, a diagnosis of GAD currently implies chronic, excessive worry lasting at least six months and presenting with three of the possible six somatic or psychological symptoms (restlessness, fatigue, muscle tension, irritability, difficulty concentrating, and sleep disturbance). When posed with the question: What is the most effective antidepressant for an individual diagnosed with GAD? There is no universal answer, as the efficacy of each type of antidepressant medication will depend on each person’s distinct needs. 

Types of Medications for GAD

There are several types of antidepressant medications used to treat GAD, each with respective risks, benefits, and appropriate uses. The Mayo Clinic provides the following breakdown of the various options: 

  • Selective serotonin reuptake inhibitors (SSRIs): work by slowing the reabsorption of serotonin (the neurotransmitter known to help with mood regulation and anxiety) in one’s brain. Common examples of SSRIs that may be used to treat GAD include, but are not limited to:
  • Selective norepinephrine reuptake inhibitors (SNRIs): work by reducing the reabsorption of serotonin and norepinephrine in one’s brain. They can be prescribed to treat anxiety, depression, and some chronic pain conditions. Common examples of SNRIs that may be used to treat GAD include:
  • Tricyclic antidepressants (TCAs): are prescribed less frequently as they are an older class of antidepressants that can cause more side effects than other options. Some examples of TCAs that may be used to treat GAD include:
  • Benzodiazepines: a type of sedative that alleviates muscle tension and can reduce some of the physical symptoms of anxiety. They are often prescribed to help manage symptoms associated with short-term anxiety. Common examples of benzodiazepines that may be used to treat GAD include:

There are a variety of treatment options for individuals diagnosed with generalized anxiety disorder. As is true with taking any type of medication there are associated risks. The specific risks will vary from person to person, as they will depend on several contributing factors (e.g., the individual’s health history, the presence of any additional mental health ailments, substance abuse issues, genetics, etc.). The Food and Drug Administration (FDA) requires antidepressant medications to clearly display a black box warning label indicating the possibility of increased suicidal thoughts and behaviors when taken by some individuals under the age of 25. Not all medications will work for every person, but given the array of options, there is typically at least one antidepressant that can effectively reduce one’s symptoms associated with generalized anxiety disorder.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Triggers Generalized Anxiety Disorder?

What Triggers Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a mental illness and is characterized by “chronic anxiety, exaggerated worry, and tension, even when there is little or nothing to provoke it.” Perelman School of Medicine at the University of Pennsylvania asserts that the median age of onset of GAD is 30 years, although “a very broad range exists for the spread of age at the time of onset. Patients reporting a later onset of their GAD typically will say their symptoms developed in response to a significantly stressful event in their lives.” Johns Hopkins Medicine suggests that GAD can be triggered by situational circumstances such as family or environmental stress, chronic illness, or disease. Generalized anxiety disorder is not uncommon, and in any given year, GAD affects 6.8 million adults, which is equal to 3.1% of the U.S. population. The prevalence of GAD in children and adolescents ranges from 2.9% to 4.6%. GAD develops gradually and can begin at any age, but the years of highest risk are between childhood and middle age.

Signs and Symptoms

Generalized anxiety disorder can manifest as psychological symptoms, behavioral symptoms, and physical symptoms. Common examples of GAD symptoms may include any combination of the following:

  • Psychological symptoms:
    • Nervousness
    • Irritability
    • Nightmares 
    • A pervasive feeling of apprehension or dread
    • Intrusive thoughts 
    • Feeling edgy, restless, or jumpy
    • An inability to tolerate uncertainty
  • Behavioral symptoms:
    • Sleep disturbances
    • Ritualistic behaviors (e.g., repeatedly washing hands)
    • Inability to relax
    • Difficulty concentrating
    • Procrastinating 
    • Avoiding potentially anxiety-ridden situations
  • Physical symptoms:
    • Muscle tightness
    • Body aches
    • Fatigue
    • Sweating
    • Heart palpitations
    • Dry mouth
    • Cold or sweaty hands
    • Trembling
    • Shortness of breath
    • Nausea
    • Diarrhea 
    • Chronic headaches

Every individual is different, and the symptoms associated with GAD can vary in severity and duration and will be distinct to each person. 

Causes and Risk Factors

To conclusively understand the precise cause of generalized anxiety disorder, additional research is required, however, clinical findings do point to a combination of biological, environmental, and psychological factors contributing to its development. Risk factors that may increase an individual’s propensity for developing generalized anxiety disorder could include both environmental and genetic factors, such as the following, provided by Healthline

  • Family history of anxiety disorders
  • Recent or prolonged exposure to stressful situations, including personal or family illnesses
  • Excessive use of caffeine or tobacco can exacerbate existing anxiety
  • Childhood abuse or bullying
  • Certain health conditions such as thyroid problems or heart arrhythmias

The University of Rochester Medical Center asserts that an imbalance of two chemicals in the brain (norepinephrine and serotonin) most likely plays a part in the development of GAD. Experts suggest that “those living with GAD may experience certain activation in areas of the brain associated with mental activity and introspective thinking when they encounter situations that could cause worry.” According to Winchester Hospital, it is not uncommon for other anxiety disorders to co-occur in a person with generalized anxiety disorder. 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.