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Depression and Anxiety

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Depression and Anxiety: Two Prevalent Disorders
Steve Davis
PSY/203
06/15/2015
Belky Schwartz

Depression and Anxiety: Two Prevalent Disorders Of the major categories of mental illness, mood disorders and anxiety disorders seem to be the most prevalent. Mental illnesses, like physical illnesses come in a wide range of severity. Millions of Americans suffer from mental disorders in any given year, however, very few actually seek treatment. The statistic most often quoted states that one in four adults will experience a mental disorder at some point in their lives. Stigma associated with mental disorders is still the leading reason people do not seek or retain treatment. Mental disorders are quite common, they are real and they are treatable. Out of the five major categories of mental illnesses, mood disorders and anxiety disorders are the most common. Of these two categories, I will cover Major Depressive Disorder (MDD), also called Clinical Depression, which is a mood disorder. And from the Anxiety Disorder category, I will cover Generalized Anxiety Disorder (GAD).
MAJOR DEPRESSIVE DISORDER (MDD) Depression is a normal human condition to an extent, but when do normal feelings of sadness, grief, or feeling “down in the dumps” become an illness? According to the Encyclopedia of Counseling, (Leong, 2008), there are two primary diagnostic criteria for major depressive disorder (MDD). These two diagnostic criteria are depressed mood and a loss of interest or pleasure in most activities. At least one of these symptoms must persist for a duration of two weeks. Along with these two comes many more indicators of MDD. People may experience a persistent sad mood, pessimism or feelings of hopelessness as well as feelings of helplessness, worthlessness or guilt. With increased severity, many people experience disruption of their sleep cycle and changes in appetite. Others with clinical depression may also experience fatigue, difficulty concentrating, remembering or making decisions. Depression can also manifest itself with physical symptoms as well. Many people with MDD may have physical symptoms that do not respond to treatment, such as: chronic pain, headaches and even digestive disorders. Not to diminish the severity of the above symptoms, the worst symptom of MDD must inevitably be thoughts of death or suicide. Carl Sherman of Clinical Psychiatry News reports that more than half of all suicide attempts occur in the context of depressive disorders and he also reports on a study claiming that a sampling of 136 patients hospitalized with major depression, 16% of these patients reported a suicide attempt within two years after being discharged. (Sherman, 2004). This should truly make clinicians pay closer attention to the relationship between depression and suicide.
Treatment options for MDD have progressed greatly over the years with the introduction of new medications. Tricyclic antidepressants, monoamine oxidase inhibitors and selective serotonin reuptake inhibitors (SSRIs) have been increasingly prescribed for MDD. Growing research seems to show that these medications in concert with short-term psychotherapy as the best route towards treatment success. Psychotherapy for MDD includes cognitive-behavioral, problem-solving and interpersonal approaches.
Lastly, it should be noted that alcoholism and other forms of drug abuse are often linked with depression. Whether the depression causes the substance abuse or the substances cause the depression, there seems to be an increase in dual diagnosis. It is a vicious spiral that can occur in these situations.

GENERALIZED ANXIETY DISORDER We all have those times when we worry about things such as money, family problems, or even our health. But with someone suffering from generalized anxiety disorder, these worries become much more pronounced. Per Dr. JF Hayes of the University College London, Generalized Anxiety Disorder (GAD) is defined as excessive worry or tension about everyday events and problems, on most days, for at least six months, to the point where the patient experiences distress or has marked difficulty performing day to day task. (Hayes, 2011). The anxiety is generalized and persistent but not restricted to any particular environment. GAD can impact all areas of a person’s life. There are many symptoms that can accompany generalized anxiety. As with other illnesses they can vary in severity. People with GAD don’t seem to be able to get rid of their problems even though they often realize that their anxiety is much more intense than the problems warrant. GAD comes with a long list of symptoms as well. One may experience palpitations, trembling, dry mouth and sweating as well as difficulty breathing. Symptoms can be more severe as well as in a feeling of choking, fear of losing control or dying. In a clinical setting many tools are used to diagnose the severity of anxiety to help determine a threshold for treatment.
Generalized anxiety disorder can develop slowly over time. It often starts out in the teen and early adult years of a person’s life. According to the National Institute of Mental Health (NIHM), generalized anxiety disorder affects about 3.1% of American adults aged eighteen or older with the average age of onset being 31 years of age. The NIMH also states that GAD affects about 6.8 million Americans, including twice as many woman than men. (NIMH, 2014).
As with many other mental illnesses, the exact cause of GAD is not known. One thing with GAD is that it seems to have a genetic component to it as well. Genetics is certainly one risk factor that exist in developing GAD. A person’s personality type can have an effect as well. And as noted earlier, woman are more likely to be diagnosed with GAD than men.
Having generalized anxiety disorder can greatly hinder one’s ability to perform everyday task quickly and efficiently, because in can make you have trouble concentrating. It can exhaust your energy as well as lead to disturbances in sleep. GAD has been known to lead to and/or worsen other problems as well such as depression. Depression often occurs with GAD. GAD may lead to substance abuse as well, just as noted with MDD.
As with many other mental disorders, medication and psychotherapy are both treatment options for GAD. Psychological counseling or psychotherapy works well in the treatment of GAD. Cognitive behavioral therapy is one of the most effective forms of therapy for generalized anxiety. Several medications as well can be used in the treatment of GAD. Antidepressants can be used for treatment such as serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI). These are usually the front line drugs that are used in treatment. Another medication option is Buspirone, which can be used on an ongoing basis. In some cases of GAD, Benzodiazepines may be used as well. Xanax, Librium, Klonopin, or Valiums are in the latter class. These are usually used for more acute cases and are generally used on a short term basis.

References
Hayes, J. (2011, December). Generalized Anxiety Disorder. Sage. Retrieved from http://http://ino.sagepub.com.contentproxy.phoenix.edu/content/4/12/685.full#boxed-text-3
Leong, F., Hopko, D., & Robertson, S. (2008, June). Encyclopedia of Counseling. Depression, 558-562. doi:http:/dx.doi.org.contentproxy.phoenix.edu/10.4135/9781412963978.n180
National Institute of Mental Health. (2015). NIHM. Retrieved from http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml
Sherman, C. (2004, July). Depression and suicide. Retrieved from http://galenet.galegroup.com.contentproxy.phoenix.edu/servlet/HWRC/hits?docNum=A120462779&year2=&year1=&index3=KE&index2=KE&index1=RN&tcit=0_1_0_0_0_0&index=BA&locID=uphoenix_uopx&rlt=2&text3=&text2=&origSearch=true&text1=A120462779&op2=AND&op1=AND&t=RK&s=11&r=d&o=&secondary=false&n=10&day2=&l=d&day1=&month2=&month1=&searchTerm=2NTA&c=1&bucket=per…...

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