Posted by blueboy on July 18, 2008, at 10:18:06
In reply to Is it truly Generalized Anxiety Disorder ? (GAD), posted by Mike_Cohen_2 on July 14, 2008, at 15:28:15
Bottom line: Yes, it is truly generalized anxiety disorder. No, it is not "GAD" as defined in the DSM IV.
This is one of the biggest failings of the DSM IV and part of the utter denseness of the mental health establishment, IMHO.
I think the worst general anxiety does not involve any direct cognitive fear. So if you take a checklist test, based on the DSM model, you might have a terrible, crippling case of general anxiety and score as "mild", because you are going to answer "no" to the seminal questions:
"Are you troubled by:
1) Excessive worry, occurring more days than not, for a least six months?
2) Unreasonable worry about a number of events or activities, such as work or school and/or health?"See, e.g., http://www.adaa.org/public/selftest_gad.htm
"The trait of excessive worry was identified [by the DMS IV] as the core symptom of GAD."
http://www.medscape.com/viewarticle/431268_2So, what most of us would consider the most generalized of anxiety disorders is very different from the technical definition of "GAD" in the DSM IV. In fact, this crippling disease is not defined anywhere in the DSM IV.
I have a word of hope. No good experienced psychiatrist or psychologist is going to be fooled. They know the DSM definition of GAD is a crock and will prescribe benzo's for our disorder (and, hopefully, try a long-term course of imipramine or some other tricyclic with good norephinedrine reuptake inhibition). For diagnostic purposes they will find the closest definition they can to put down on paper.
By the way, the primary reason that "GAD" and "panic disorder" were differentiated, in the change from DSM III to DSM IV, is that panic disorder responds well to imipramine while GAD does not and requires a benzo. Even this has been discredited by subsequent research, however.
We were better off with the DSM III, where the primary symptom of "GAD" was "general anxiety". The primary symptom of GAD in DSM IV was changed to "excessive worry".)
Anyway, be assured that you are not alone in this. A lot of people have symptoms that are impossible to describe and difficult to treat with the current state of psychiatry and psychopharmacology. My diagnosis has changed and my GAD is now considered secondary to Bipolar II. Big deal. The approved drugs to treat Bipolar disorders don't dent the anxiety I feel. So my pdoc prescribes clonazepam for me.
I think that, at least in my case, the anxiety is tied to total stress. It could be partly pschological. It could be that my brain has a chemical or structural malfunction. It could be that my brain is normal except for a weakness in handling some chemical, no more difficult to understand than a degnerative muscular disease, or perhaps more akin to something like insulin resistance and diabetes. Who knows?
poster:blueboy
thread:839698
URL: http://www.dr-bob.org/babble/20080718/msgs/840429.html