Najwa Bashir

I am a passionate and knowledgeable psychologist, with a Master of Philosophy (MPhil) in Psychology specializing in Counseling Psychology. Through my writing, I share my insights and thoughts on various psychiatric disorders, conduct analysis on films that touch on psychological issues, and explore other topics related to psychology, while also providing valuable information to psychology enthusiasts, students as well the general community.

Categories
Psychiatric Disorders

Prevalence, Diagnostic Criteria, and Features of Trichotillomania

Trichotillomania, also known as hair-pulling disorder, is an obsessive-compulsive disorder in which people repeatedly pull out hair from any part of their body. Studies reveal that there have not been many large epidemiological studies on this disorder, but estimates of its frequency show that between 0.5% and 2% of the general population has it. However, because some people with trichotillomania are ashamed of their disorder, the real number of people who have it may be higher. Epidemiologic data on children are not very common, but the total frequency is thought to be between 1% and 3%. The head, eyebrows, eyelashes, and pubic area are the most popular places to get rid of hair. The number of women with trichotillomania is four times that of men with the disorder in adults. Pediatric trichotillomania mostly affects girls between the ages of 9 and 13, and most of the time, they deny having the disorder. Moreover, as many as 80% of people who have trichotillomania also have another mental illness at some point in their lives. Anxiety, major sadness, drug abuse, eating disorders, PTSD, personality disorders, and body dysmorphic disorder are some of the most common disorders that go along with it. It has been linked to skin-picking and biting nails.

According to the empirical evidence, the severity of the situation can range from mild to serious. People usually start pulling their hair out in late childhood or early teens. Since the disorder starts so early in life, trichotillomania is often linked to low self-esteem, bad quality of life, and avoiding social events like getting a haircut, swimming, being outside on a windy day, sports, or going on dates. Stress, boredom, or “downtime” can all be signs that you should pull. Additionally, a lot of people don’t even realize they are pulling. This is called “automatic” pulling, and it is a more common form of the problem. Ten to twenty percent of people with trichotillomania eat their hair after pulling it out, a condition called trichophagia. This can block the digestive tract and cause hairballs to form in the intestines, which can be so big that they need surgery to remove.

Trichotillomania is a problem with many aspects that need to be treated in a number of different ways. Such treatments often involve specialists from different fields working together. The person could see a general care doctor, a dermatologist, a psychiatrist, or a qualified clinical psychologist. Part of the treatment is likely to be therapy, and drugs may also be used. Cognitive behavioral therapy (CBT) and habit reversal training are two types of therapy that are being studied right now as ways to treat trichotillomania.

However, proper diagnosis is required to identify the symptoms of trichotillomania so that the required treatment can be sought. The DSM 5 TR outlines the following criteria and diagnostic features for trichotillomania:

Diagnostic Criteria

A. Pulling out one’s hair over and over again which leads to hair loss.

B. Trying over and over to lose hair or stop pulling it out.

C. Pulling your hair out causes clinically significant distress or problems in important areas of working in social, professional, or other areas.

D. Neither hair-pulling nor hair loss is caused by another medical condition, like a skin disease.

E. The hair pulling cannot be explained by signs of another mental disease, like trying to fix what you think is wrong with your looks in body dysmorphic disorder.

Diagnostic Features

  • The main sign of trichotillomania (hair-pulling disorder) is repeatedly pulling out one’s own hair (Criterion A).
  • Hair pulling can happen anywhere on the body where hair grows, but it happens most often on the head, eyebrows, and eyes.
  • Less often, it happens in the axillary, face, pubic, and perirectal areas.
  • The places where people pull their hair may change over time.
  • People who pull out their hair may do it for short periods of time throughout the day, or they may do it less often but for longer periods of time that can last for hours.
  • This type of hair-pulling can last for months or even years.
  • Criterion A says that pulling out hair must cause hair loss.
  • However, people who have this problem may pull hair in a manner that makes it hard to see where they are pulling hair out (i.e., pulling single hairs from all over a site).
  • Some people may also try to hide or disguise their hair loss by wearing makeup, scarves, or wigs.
  • People who have trichotillomania have tried many times to cut down on or stop pulling out their hair (Criterion B).
  • Based on criterion C, hair pulling causes distress or problems in social, professional, or other important areas of performance that are clinically significant.
  • The word “distress” refers to the bad feelings that people who pull their hair out may have, like losing control, being embarrassed, or feeling ashamed.
  • People may have trouble working in a number of areas, such as socially, professionally, academically, and for fun.
  • This is partly because they avoid going to work, school, or other public places.
Categories
Psychiatric Disorders

Prevalence, Diagnostic Criteria, and Features of Obsessive Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is a common mental illness that affects 1-3% of the world’s population. It is marked by unwanted thoughts, or obsessions, doing the same things over and over again, or compulsions. These symptoms make patients’ lives very difficult because they take up a lot of time, make them very upset, and make it hard for them to do things.

According to sources, cognitive-behavioral theories have long said that obsessions often make people feel more anxious or uncomfortable and that compulsions are actions that people do because of their obsessions. There is some proof, though, that compulsive behavior is what starts it all and obsessions happen after the fact to explain these behaviors. This idea needs more research, though. Most people who have OCD are very aware that their obsessive symptoms are too much and wish they could control them better.

OCD may be caused by genetic, neural, behavioral, cognitive, and environmental factors. It appears as though OCD runs in families, which suggests a possible genetic link. Scientists are still looking into this. Brain imaging tests have also shown that people with OCD have brains that work in unique ways. Children with OCD may show signs after getting an illness, such as group A streptococcal diseases like strep throat, Lyme disease, or the H1N1 flu virus. This set of OCD symptoms in kids may be called pediatric acute-onset neuropsychiatric syndrome (PANS) by doctors. If a kid has PANS, their symptoms come on quickly and get worse over a few days.

Learning-based theories say that people with OCD learn to avoid things or situations that make them afraid by doing routines that make the perceived risk smaller. The first fear might start during a time of high stress, like after a stressful event or a big loss. When someone links a scary thing or situation with their OCD, they start to avoid that thing or situation in a way that defines their disorder. One more idea is that people get OCD when they get their thoughts wrong. Most people have unwanted or bothersome thoughts from time to time, but for people with OCD, these thoughts become more important or extreme.

Studies also report that it is still not clear if traumatic events and stressful life events can cause OCD on their own or if they can act as a trigger for people who are already more likely to have it.  Some things that can happen in the environment that might make OCD worse are problems during pregnancy or birth changes in reproduction that come with getting older, social and economic issues, hurt badly, or a very bad illness. Also, people with OCD may have post-traumatic stress disorder (PTSD). OCD is a mental illness typified by compulsive behaviors and obsessions. These obsessions and compulsions can take up a lot of time and make it hard to go about daily life and be with other people. Therefore, it is important to identify the signs and get the required treatment. The following are the diagnostic criteria and diagnostic features of OCD, as highlighted by DSM 5 TR:

Diagnostic Criteria

A. Existence of Obsessions, compulsions, or a combination of both
(1) and (2) describe what an obsession is:
1. Thinking, wanting, or seeing things over and over again that you find annoying and don’t want to be there; these thoughts, urges, or pictures usually cause a lot of worry or distress in people.
2. The person tries to avoid or push away these thoughts, urges, or pictures, or they try to cancel them out with a different thought or action (i.e. by doing a compulsion).
(1) and (2) explain what compulsions are:
1. Doing the same things over and over, like washing hands, putting things in order, or checking, or doing the same thoughts over and over, like praying, counting, or softly repeating words, because they feel like they have to or because of rules that must be followed exactly.
2. The actions or thoughts are meant to stop or lessen worry or discomfort, or to avoid a feared event or situation. However, these actions or thoughts are either not really related to what they are meant to stop or lessen, or they are clearly too much.
Note: Young children might not be able to explain why they are doing or thinking these things.

B. The compulsions or obsessions take up a lot of time—more than an hour a day, for example—or they significantly impede social, occupational, or other crucial areas of functioning, or they cause clinically substantial discomfort.

C. The obsessive-compulsive symptoms are not caused by the body reacting to a substance (like an illegal drug or a medicine) or another health problem.

D. The problem cannot be explained by signs of another mental illness, like worrying too much, like in generalized anxiety disorder, or being too focused on how you look, like in body dysmorphic disorder (for example, hoarding disorder involves throwing away or parting with things; trichotillomania (hair-pulling disorder) includes pulling at the skin; stereotypes (like in stereotypic movement disorder); regulated eating (like in eating disorders); obsession with drugs or gambling (like in substance-related and addictive disorders); obsession with having an illness (like in illness anxiety disorder); sexual urges or fantasies (like in paraphilic disorders); impulses (like in disruptive, impulse-control, and conduct disorders); culpable thoughts (for major depressive disorder); thought insertion or delusional preoccupations (for schizophrenia spectrum and other psychotic disorders); or recurring trends of action (for autism spectrum disorder).

Diagnostic Features

  • OCD induces thoughts and compulsions (Criterion A).
  • Obsessives repeat ideas, images, or sensations like “contamination” or “violent or horrific scenes” “to stab someone”.
  • Obsessions are unpleasant and generate tension and suffering in most individuals.
  • The individual attempts to forget or repress these urges or replace them with a new idea or behavior.
  • Compulsion sufferers repeat actions like checking, washing, mentally counting, or speaking words to themselves. They do these things because they are obsessive or have to obey regulations.
  • OCD sufferers often experience obsessions and compulsions.
  • Obsessions and compulsions frequently involve concern about getting filthy when you wash your hands or being wounded when you inspect something repeatedly.
  • Some believe they undertake compulsions to relieve tension from their habits or prevent becoming sick.
  • To prevent injury to a loved one, organizing things equally is not a good method to connect to the dreaded scenario.
  • However, daily lengthy showers are excessive. Compulsion sufferers don’t do them for enjoyment, but they may feel better.
  • Obsessions and compulsions vary by individual.
  • Some themes or aspects are prevalent. Cleaning, symmetry, forbidden thoughts, and harm are examples.
  • Some people have problems getting rid of things and wind up collecting them due to habits and compulsions like fear of hurting others.
  • These compulsions are distinct from the hoarding disorder’s core accumulation behaviors, which will be discussed later in this chapter.
  • These motifs are seen in many nations, persist in individuals with the disease, and may be connected to brain regions.
  • People typically have many indications.
  • Criterion B requires an addiction or habit to take up more than an hour a day or produce clinically substantial anxiety or impairment to be declared OCD.
  • These needs distinguish the disease from unpleasant thoughts or behaviors like double-checking the door latch. OCD sufferers have many and varied obsessions and compulsions.
  • Some have mild to moderate symptoms and obsess or compel one to three hours a day, while others have practically continual intrusive thoughts or compulsions that make it hard to perform anything.
Categories
Psychiatric Disorders

Prevalence, Diagnostic Criteria, and Features of Agoraphobia

Agoraphobia is the fear that someone will get hurt if they are in a public or busy place where they can’t easily get out or where help might not be easy to find. It is marked by the fear that a panic attack or signs similar to a panic attack could happen in these scenarios. People who have agoraphobia try to stay away from these kinds of places or events.

People with agoraphobia often also have panic disorder, which causes a lot of suffering. A study was done to look at the differences in symptoms and lengths of treatment between people with panic disorder (PD) and people without agoraphobia (PDA). The results showed that the PDA group had worse anxiety and mood problems than the PD group, according to the results. People who had PDA were more likely to be younger when the symptoms started, to take benzodiazepines for longer periods of time, and to be treated with antipsychotics for longer periods of time. The agoraphobia subscale was linked to panic attacks, sadness, anxiety, and the amount of time someone had been taking drugs. The results show that people with PDA had worse panic symptoms, more serious mental disorders, and a worse course of their illness than people with PD.

According to the National Institute of Mental Health, 1.3% of people experience agoraphobia at some point in their lives, and about 0.9% of people experience it each year. Agoraphobia affects about the same number of men and women each year: 0.8% of men and 0.9% of women.

Since this condition can be dreadful for those who experience it and it can have adverse effects, it is important to diagnose it and seek the required treatment as soon as possible. The following criteria and features, as highlighted by the DSM 5 TR, can help diagnose agoraphobia:

Diagnostic Criteria

A. A lot of worry or fear about two or more of the five events below:
1. Taking public transportation (like cars, buses, trains, ships, and planes).
2. Being in open places like shopping malls, bridges, parking lots, etc.
3. Being in small spaces (like stores, theaters, and movie houses).
4. Having to wait in line or be in a crowd.
5. Being by yourself outside the house.
B. The person avoids or fears these situations because they think it might be hard to get out of them or that they might not be able to get help if they start having panic-like symptoms or other symptoms that make them unable to do things or look bad, like fear of falling for older people or fear of urination.
C. Most of the time, agoraphobic situations make people feel scared or anxious.
D. The agoraphobic situations are actively avoided, need to be with someone else, or are experienced with a lot of fear or anxiety.
E. The person’s fear or worry is out of proportion to the danger they are in and the social and cultural setting.

F. The fear, worry, or reluctance doesn’t go away and usually lasts for at least six months.
It’s clinically significant discomfort or impairment in social, professional, or other important areas of performance because of fear, anxiety, or avoidance.
H. The fear, worry, or avoidance is too much if there is another medical condition present, such as inflammatory bowel disease or Parkinson’s disease.
I. The fear, anxiety, or avoidance isn’t better explained by the symptoms of another mental disorder. For example, the symptoms aren’t limited to a certain type of phobia or situational phobia; they don’t just happen in social situations (as in social anxiety disorder); they aren’t just about obsessions (as in obsessive-compulsive disorder); they aren’t just about perceived flaws or defects in physical appearance (as in body dysmorphic disorder); they aren’t just about body dysmorphic disorder; they can also be caused by traumatic events (as in post-traumatic stress disorder); or they are not just about fear of separation (as in separation anxiety disorder).

Note: Agoraphobia can be identified even if someone also has panic disorder. If a person shows signs of both panic disorder and agoraphobia, they should be given both labels.

Diagnostic Features

  • As a result of being in or thinking about many diverse circumstances, agoraphobia causes strong anxiety or worry (Criterion A).
  • Signs must appear in two of the five cases below to diagnose: 1) Public transportation like vehicles, buses, trains, ships, or aircraft; 2) Open areas like parking lots, markets, or bridges; 3) Closed locations like stores, theaters, or movie theaters; 4) Waiting in line or in a crowd; or 5) Being outside alone.
  • There are more examples than presented; one may be terrified in others.
  • When these occurrences produce anxiety and worry, people assume something unpleasant will happen (Criterion B).
  • Panic-like symptoms or other symptoms that make things hard or humiliating make individuals think they cannot get out of the circumstance or find help.
  • “Panic-like symptoms” are any of the 13 panic attack symptoms. These include dizziness, weakness, and death anxiety.
  • Other symptoms that make it hard to perform tasks or look beautiful include illness, inflammatory bowel symptoms, and, in older individuals, a fear of falling or, in youth, being lost and bewildered.
  • Dread can come before or during an agoraphobic circumstance and depends on how near someone is to the object they dread.
  • The dread or concern might manifest as a full- or limited-symptom panic attack.
  • The person feels anxiety or worry almost every time they encounter their phobia.
  • A person who only gets nervous once in five times when waiting in line is not diagnosed with agoraphobia.
  • The individual deliberately avoids the situation, needs to be with someone, or is afraid or worried if they cannot or will not.
  • Active avoidance is avoiding events that make individuals nervous.
  • People who avoid situations might adjust their daily habits, work near home to avoid public transit or order food delivery to avoid shops and supermarkets.
  • Mental avoidance includes employing diversions to cope with agoraphobia.
  • Avoidance can become so severe that the person cannot leave home.
  • With a spouse, friend, or health professional, people can better handle their fears.
  • The person may also sit near public transit exits or at the movies to feel safer in these scenarios.
  • The person must be fearful, worried, or avoid situations out of proportion to the threat and social and cultural environment (Criterion E).
  • Fears like not leaving the house during a storm are legitimate.
  • It is vital to distinguish between illogical, clinically relevant agoraphobic worries and unsafe scenarios like wandering in a parking lot or catching the bus in a high-crime neighborhood.
  • In diverse cultures and social contexts, avoidance can be difficult to define.
  • In certain countries, observant Muslim women can avoid leaving the house alone without being considered agoraphobic.
  • Second, older persons are more inclined to blame age-related constraints for their anxieties. Less likely to think their worries are disproportionate to the risk.
  • Third, panic attacks and other bodily symptoms make agoraphobics fear they are in danger.
  • Agoraphobia is only diagnosed if the fear, anxiety, or avoidance lasts (Criterion F) and interferes with social, professional, or other vital aspects of life (Criterion G).
  • “Usually lasting for 6 months or more” excludes short-term difficulties.
Categories
Psychiatric Disorders

Prevalence, Diagnostic Criteria, Features and Treatment of Selective Mutism

Selective mutism is a long-lasting and severely limiting mental illness in which a child is unable to speak when they should. Selective mutism is classified as an anxiety condition, but because it is so different and complex, it may be thought of as a neurodevelopmental disease. Children with selective mutism are very rare and have a lot of different symptoms. They usually show up when they are starting school.

According to the empirical evidence, researchers and therapists in both psychology and psychiatry have been puzzled by selective mutism’s dramatic symptoms for almost 150 years. Selective mutism was first thought of as a rebellious behavior disorder, as shown by the names that were used for these kids: “voluntary aphasia” and “elective mutism” which suggested that they choose to be quiet in certain settings or around certain people. The current point of view is less judgmental about children’s reasons. The word “selective” refers to the fact that children only don’t speak in certain situations. Also, most people think that the normal non-speaking behavior of kids with this disorder is caused by fear and nervousness which mostly happens in certain social situations. This is why selective mutism is now seen as an anxiety disorder.

Prevalence of Selective Mutism

Reports say that between 0.7% and 2% of people have selective mutism. The wide range of prevalence could be because of different sampling methods, like using clinical or community samples, sample traits, like age range or immigrant status, or the ways that the prevalence was measured. Selective mutism usually starts between the ages of 2 and 4, but parents often don’t notice until the child starts school. Selective mutism can become chronic if it is not addressed. It can affect a person’s ability to communicate, their mental health, and their quality of life as an adolescent and an adult.

Enuresis, encopresis, obsessive-compulsive disorder, depression, premorbid speech and language problems, developmental delay, and Asperger’s disorders are a few of the comorbidities that can accompany selective mutism. The exact symptoms and level of intensity of these comorbidities change from person to person.

Evidence suggests that a lot of the time, kids who have selective mutism also have social anxiety disorder. Due to this, these kids might need help making friends. Children who have selective mutism often have trouble making friends and are unable to behave normally. Children who have behavioral inhibition may be quiet and hide when they are in a setting that makes them feel anxious. Mutism may be a form of withdrawal that lets the child avoid talking to other people. A child with selective mutism might rather be alone because talking to other kids might make them feel too anxious. Peers may also not talk to a child who selectively mutates because they may not seem interested in playing. Also, kids with selective mutism are less socially adept than kids who are growing normally. Mutism often makes it hard to interact with other kids, and kids may tease those who are mute. On the Child Behavior Checklist, social problems measure, kids with selective mutism have been found to score much higher than the average child. There is a chance that long-term problems will arise with getting along with others and making friends. There are also rebellious and defiant traits that go along with selective mutism. People have said that children with selective mutism are rude, angry, disobedient, sulky, stubborn, negative, manipulating, suspicious, controlling, demanding, and hostile. Children who have selective mutism act defiant and hostile at school and home. Hence, most people think of selective mutism as a long-term problem with a bad result.

Since selective mutism can get in the way of social relationships, academic growth, and well-being, identifying it and getting the required treatment as soon as possible is important. According to the DSM 5 TR, the following criteria and features can help diagnose individuals with selective mutism:

Diagnostic Criteria

A. The person consistently fails to speak up in social settings where they are expected to (for example, at school), even though they do so in other situations.

B. The problem gets in the way of doing well at school, work, or social interactions.

C. The problem has been going on for at least one month, and not just the first month of school.

D. The person does not speak because they don’t know or feel comfortable with the spoken language that was expected in the social setting.

E. The problem is not better explained by a speech disorder (like childhood-onset fluency disorder) and does not only happen in people with autism spectrum disorder, schizophrenia, or another mental disorder.

Diagnostic Features

  • Children with selective mutism don’t talk to others or reply when others talk to them when they are in social activities with other people.
  • People don’t talk when they are with other people, like kids or adults.
  • If a child has selective mutism, they will only talk to close family members at home.
  • They will not talk to close friends or second-degree relatives like grandparents or uncles.
  • Most of the time, the problem is marked by a lot of social nervousness.
  • Selective mutism makes kids often refuse to speak at school, which hurts their grades because teachers have a hard time checking academic skills like reading.
  • People may find it hard to talk to others because they cannot speak.
  • However, kids with this disorder can sometimes communicate without words (for example, by grunting, pointing, or writing), and they may be happy to talk to others when they don’t have to (for example, by playing nonverbal roles in school plays).

Treatment of Selective Mutism

As selective mutism can show up in many different ways, there are also many different ways to treat it. Some of these are behavioral therapy, systemic desensitization, cognitive behavioral therapy, family therapy, and psychotherapy with drugs and anxiety medicines.

According to the sources, behavioral methods are an important part of helping people with selective mutism. Behavioral techniques try to get people to talk more, feel less anxious, and stop acting out or trying to get attention in unsuitable ways. Behavioral methods use positive feedback, stimulus fading, shaping, self-modeling, response start, vocal praise, video feed-forward, systematic desensitization, and revealing a desired prize. The goal of behavioral treatments is to stop rewarding quiet behavior and start rewarding talking behavior.

Systemic desensitization is another way to treat it. Systemic desensitization means learning how to handle and get through situations that make you feel more anxious over time. Peer relationships may be a big part of this type of therapy, which may work especially well for kids who are selectively mute. As a first step in systematic desensitization, a child with selective mutism may be given a job that is meant to make them feel little worry. If the kid is feeling nervous or overwhelmed, comfortable friends may be able to help and support them. One of the long-term goals of care for a child with selective mutism could be to help the child talk to their teacher and classmates without any problems. The discovery of good relationships between peers has implications for how well treatment works. In particular, talking to friends with whom the child is comfortable could help them use their speech with other people and in different places.

Categories
Psychiatric Disorders

Prevalence, Diagnostic Criteria, and Features of Specific Phobia

Specific phobia is an anxiety condition in which a person is overly afraid of a certain thing, situation, or action for no good reason. Anxiety is more than just being scared, it makes people avoid things. The level of fear is often too high compared to the real threat that the phobic trigger poses. For example, acrophobia is the fear of heights, arachnophobia is the fear of spiders, aviophobia is the fear of flying, and trypanophobia is the fear of needles. People with certain fears may have severe anxiety or panic attacks when they are around the thing or setting they are afraid of.

Studies show that between 3% and 15% of people around the world have unique phobias at some point in their lives. The most common phobias and fears are of heights and animals. According to the stages of development of phobias, which go from fear to avoidance to identification, stopping the stages of development could lower the number of people who have them. Some fears start in youth, but most people get them in middle age and old age. 10 to 30 percent of people with phobias have them for years or even decades, and they are a strong indicator of the development of other anxiety, mood, or substance-use problems. Since phobias are often linked to other mental disorders, especially after the fear starts, treating them early may also change the risk of other disorders.

Hence, early diagnosis and treatment of specific phobias is crucial. Mentioned below are the diagnostic criteria and features of specific phobia disorders in light of DSM 5 TR:

Diagnostic Criteria

A. A clear fear or worry about a certain thing or event, like flying, heights, animals, getting an injection, or seeing blood.

When kids are scared or anxious, they might cry, throw fits, freeze up, or stick to you.

B. The phobic thing or situation almost always makes the person feel scared or anxious right away.

C. The person or thing that causes the phobia is actively avoided or goes through it with a lot of fear or worry.

D. The worry or fear is too high compared to the real danger of the thing or situation and the social and cultural setting.

E. The fear, worry, or delay doesn’t go away and usually lasts for at least six months.

F. Fear, worry, or avoidance that makes it hard to function in social, professional, or other important areas of life is therapeutically significant.

G. It is not clear that the problem is caused by the signs of another mental disorder, like fear, anxiety, and avoiding situations that cause panic attacks or other symptoms that make it hard to do things (as in agoraphobia); objects or situations that cause obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in post-traumatic stress disorder); being away from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder).

Diagnostic Features

  • The syndrome is particularly notable for its confined dread or anxiety to a specific event or item (Criterion A), termed the phobic stimulus.
  • Many people have many phobias. The reaction must be different from usual, short-lived concerns to be diagnosed with a particular phobia.
  • For a diagnosis (Criterion A), fear or concern must be very severe (i.e., “marked”).
  • Depending on how near someone is to the object or circumstance they are scared of, they may feel fearful before, during, or after being around it.
  • A predicted or complete panic attack may also result from stress or dread.
  • A specific phobia is also characterized by feeling terrified or nervous virtually every time they see or hear the trigger (Criterion B). Thus, someone who only gets terrified when they see or hear an object or event (like on one out of five airline journeys) does not have a particular phobia.
  • Anxiety can range from anticipatory to complete panic attacks, depending on the individual and environment.
  • There are other people around them, the amount of time they are exposed to the phobic object or circumstance, and terrifying things like turbulence on a trip for flying phobics.
  • Children and adults express fear and concern differently.
  • To make matters worse, fear or concern begins when the phobic object or event is seen or experienced.
  • The individual avoids the circumstance or thing, or if they cannot, it scares them (Criterion C).
  • People who avoid phobic objects or circumstances do so intentionally. For instance, someone frightened of heights could take tunnels instead of bridges to work, someone afraid of spiders might avoid dark rooms, and someone terrified of spiders might not work in a phobic environment.
  • Avoidance tactics like not going to the doctor because of blood are obvious.
  • Sometimes they are unclear, like a snake-phobic person not looking at snake photographs.
  • Specific phobia sufferers have often moved to avoid the dreaded object or scenario.
  • Someone with an animal fear may migrate to a region without them. Their daily lives are no longer filled with anxiety and stress.
  • If there is no evident anxiety or fear, avoidance or refusal to do activities that would place the phobic person or item in a position may assist in establishing the diagnosis.
  • Rejecting work-related travel opportunities due to a fear of flying may indicate this.
  • The object or circumstance causes too much anxiety or worry or is stronger than necessary (Criteria D).
  • The therapist thinks that certain phobia sufferers’ emotions are out of proportion because they exaggerate how deadly their fears are.
  • In regions with high rates of violence, fear of the dark makes sense, while unjust fear of insects is stronger in places where people consume them.
  • The disorder is distinguished from typical, short-lived worries that most people feel, especially youngsters since the dread, worry, or avoidance lasts at least six months (Criterion E).
  • The specific phobia must produce clinical discomfort or issues in social, work, or other essential areas of functioning to identify the illness (Item F).
Categories
Psychiatric Disorders

Maladaptive Daydreaming

Have you seen people lost in themselves for hours and hours, unbothered by what is happening in the environment? Do you wonder why they act like they are living a life in a world of their own and are completely dissociated from the present world most of the time? Do you wish to know what is happening in their minds? Well, they are victims of maladaptive daydreaming.

Maladaptive daydreaming (MD) is a syndrome in which people think about imaginary things, stories, and feelings for hours on end, and they often use stereotypical moves and music to help them stay in their dreamlike state.

Even though MD is not officially accepted as a mental illness yet, more and more studies are showing how important it is in clinical settings. MD has been linked to several mental illnesses, such as ADHD, anxiety, and depression. Recently, MD has been suggested as a type of behavioral addiction because it is so satisfying and the person has to do it over and over again to avoid the bad effects of MD. In the same way, it has been linked to other harmful habits, like using social networking sites in a bad way.

Difference between Normal and Maladaptive Daydreaming

MD is not the same as normal daydreaming or mind-wandering, which is a general term for thinking about something other than what you are doing. Most of the time, daydreaming or mind-wandering is an unplanned break from a current job to think about the past or the future, like remembering something or making a list of things to do for the rest of the day. Mind-wandering symptoms that people report include not being able to focus or pay attention, having a scattered line of thought, making mistakes because of natural behavior, and not being aware of what is going on around them. Instead, MD is marked by making up stories and plots full of rich, magical details and a wide range of emotions. These stories and plots are often unrealistic and unrelated to the daydreamer’s real life. In addition, they generally change over an extended period, like a soap show. This is very different from common mind-wandering, whose content changes all the time. In MD, people feel driven to keep living their dream, similar to how many people feel when they watch their favorite TV show. A lot of people say that they start an MD episode on purpose and with awareness.

According to empirical evidence, MD is very different from normal thinking in terms of how much, what, how often, how hard it is to control, how much it hurts, and how much it gets in the way of living a normal life. Moreover, maladaptive daydreamers have much higher rates of attention deficit, obsessive-compulsive, and separation symptoms than controls.

Characteristics of Maladaptive Daydreaming

Researchers suggest that this addictive daydreaming is not helpful as it takes up a lot of time, makes you feel bad about yourself or guilty, gets in the way of completing short- and long-term chores or goals, and generally causes clinically significant distress and makes it hard to function in social or work settings. Maladaptive daydreamers say they have a strong drive to daydream whenever they can and are irritated when they cannot. They also say they have tried many times but failed to control, cut back on, or stop daydreaming, just like people who are addicted to other behaviors. After their daily thinking, they feel bad feelings. However mental health professionals often make fun of their condition, which leads to poor care and more loneliness and stress.

MD is a compulsive disorder in which people make up stories that do not happen, which causes a lot of stress and problems in many areas of their lives. The fake situations never end and are started by sound, pictures, and speech. From a neurobiological point of view, the thinking processes connected to this state start in the brain’s default mode network. MD helps people be creative, think about the future, and become more self-aware, but it also makes it hard to fully participate in daily activities by causing performance problems and being distracting. Psychodynamically, people who think too much have an attachment style called “ambivalent-fearful.” In some cases, this disease can show up as idolizing celebrities and changing the truth. Additionally, this particular kind of compulsivity has been newly designated as the main psychopathological trait of addictive mental diseases (PSNSU). There is proof that behavioral habits are linked to not being able to control your emotions well, which can happen after bad things have happened to a person as a child, like being abused or neglected. According to the model of compensatory internet use, people who are more likely to become dependent may develop addictive-like symptoms (e.g., PSNSU) as a way to deal with the bad feelings that come with having psychological problems or not meeting their real-life needs. In the same way, there is proof that people who have trouble controlling their emotions are more likely to use MD and other unhealthy ways of dealing.

Treatment of Maladaptive Daydreaming

A lot of maladaptive daydreamers on the Internet sites say they have gone to see a mental health professional for help, but most of them had never heard of the symptoms and seemed to play them down. Some people have been given a wide range of illnesses, such as Attention Deficit/Hyperactivity Disorder (ADHD) and Obsessive–Compulsive Disorder (OCD). This is not a surprise since MD is not a recognized mental illness and mental health workers do not use the term very often. Some disorders, like ADHD, have been linked to “normal” daydreaming along with other symptoms like not being able to focus or organize things. However, as of right now, no disorder in the Diagnostic and Statistical Manual of Mental Disorders or any other system lists highly structured and absorbing daydream worlds as a main symptom.

Conclusion

In conclusion, MD is a serious condition that requires attention and proper treatment as the severity of its symptoms can lead to adverse consequences one of which is dissociation from the current world and excessive interference in daily life tasks. Unfortunately, MD is a clinical condition that is not getting enough attention. It causes distress, makes it hard to live a normal life, and needs more science and clinical attention.

Categories
Psychiatric Disorders

Prevalence, Diagnostic Criteria, and Features of Separation Anxiety Disorder

One very common anxiety condition in kids is separation anxiety disorder (SAD). A person with SAD feels too much worry, concern, or even dread about being separated from an attachment figure, even if they are just going to be separated for a short time. It is normal for people to experience separation anxiety at certain stages of growth, but sometimes it shows up in the wrong way or at the wrong time. Separation anxiety that is normal for a child’s age shows up between 6 and 12 months. The normal or natural separation anxiety stays the same until the child is about 3 years old. It eventually goes away on its own, as it should. Large studies of whole populations show that up to 33.7% of people will experience an anxiety condition at some point in their lives. Other studies have shown that about one in four kids experiences worry as a child at some point between the ages of 13 and 18. On average, it starts around age 11 years. However, about 6% of kids ages 13 to 18 will have a serious anxiety condition at some point in their lives. In general, between 5.7% and 12.8% of children under 18 years old have it. Women are about twice as likely as guys to have this condition.

According to empirical evidence, separation anxiety disorder in youngsters makes both the child and the person caring for them feel bad. It can lead to excessive worry, social problems, sleep problems (like nightmares and peeing in bed), and several physical symptoms. If kids miss a lot of school, they might not do well in school and might not make friends. Adults with separation anxiety disorder may also develop other mental illnesses if they don’t get help.

Therefore, early detection and treatment of separation anxiety disorder is very important. This disorder can be detected with the help of the below-mentioned diagnostic criteria and features as outlined by DSM 5 TR:

Diagnostic Criteria

A. An excessive or developmentally inappropriate fear or worry about being away from the people they are close to, as shown by at least three of the following:

1. Recurrent excessive grief when expecting or having separation from residence or key attachment figures.

2. Constant and excessive worry about losing important people in your life or about harming them in some way, like getting sick, hurt, dying, or a natural disaster.

3. Constant and excessive worry about something bad happening (like getting lost, being taken, having an accident, or getting sick) that will separate them from a major attachment figure.

4. Reluctance or refusal to leave the house, whether it’s to school, work, or somewhere else, because of the fear of being alone.

5. Constant and strong anxiety or aversion to being by oneself or without important people in your life, whether at home or elsewhere.

6. Persistent unwillingness or refusal to sleep away from home or to go to sleep without being near a major attachment figure.

7. Repeated dreams involving the theme of separation.

8. Frequent reports of physical symptoms (such as headaches, stomachaches, nausea, and vomiting) when major attachment figures are going to be separated from the person or when they are already separated.

B. The fear, worry, or delay lasts for a long time; at least four weeks for kids and teens and usually six months or more for adults.

C. The disturbance leads to sadness or problems in social, academic, professional, or other important areas of functioning that are clinically relevant.

D. The problem cannot be explained by another mental condition, like refusing to leave the house because they don’t want to change too much if they have autism spectrum disorder or having delusions or dreams about being alone if they have schizophrenia.

For example, people with psychotic disorders might refuse to go outside without a trusted friend. People with a generalized anxiety disorder might worry that their loved ones will get sick or hurt, and people with an illness anxiety disorder might worry about getting sick themselves.

Diagnostic Features

  • Separation anxiety disorder is characterized by excessive concern or worry about being away from home or loved ones.
  • According to Criteria A, the person’s worry is excessive for their age and progress.
  • At least three of these signs indicate a separation anxiety disorder.
  • Traveling away from home or key people causes them too much worry (Criterion A1).
  • They worry about attachment figures’ health or death, especially while apart. They need to locate and communicate with their attachment figures (Criterion A2).
  • They also fear becoming lost, stolen, or having an accident and never seeing their primary bond figure again (Criterion A3).
  • Separation anxiety disorder sufferers fear being alone and won’t go out alone (Criterion A4).
  • They are continually and excessively terrified of being alone or without crucial home or outside connections.
  • Separation anxiety disorder might prevent kids from leaving a place alone. They may also be “clingy,” “shadowing” a parent about the house, or wanting company when they walk to another room (Criterion A5).
  • They always wish to sleep with a key bond figure or at home (Criterion A6).
  • This disorder makes it hard for kids to fall asleep, so they may require a caregiver. They may sleep in their parent’s bed or a close relative’s bed.
  • Kids may not want to camp, stay with friends, or do chores. Adults who travel alone and stay in hotels away from their families or loved ones may feel anxious.
  • Separation anxiety may cause repeated nightmares of the family being destroyed by fire, murder, or other disasters (Criterion A7).
  • When away from loved ones, children commonly experience headaches, stomachaches, nausea, and vomiting (Criterion A8).
  • Heart disorders including palpitations, weakness, and fainting are rare in children but can affect teenagers and adults.
  • Disturbance must continue for 4 weeks for children and teenagers under 18. It normally lasts 6 months for adults (Criterion B). However, the time necessary for persons should be considered as a guide with some leeway.
  • Criteria C requires the disruption to produce sadness or issues in social, academic, occupational, or other clinically relevant performance domains.
Categories
Psychiatric Disorders

Etiology, Prevalence, Diagnostic Criteria, and Features of Panic Disorder

A lot of people in the general community have panic disorder. It is one form of anxiety disorder that is characterized by recurrent, sudden panic attacks. Many ideas and models try to explain how panic disorder might start. Most of them point to a biological imbalance as a major cause, such as problems with gamma-aminobutyric acid, cortisol, and serotonin. Genetic and external factors are thought to play a part in how panic disorder can happen. Studies have found that bad experiences in childhood may cause panic disorder as an adult. Newer study suggests that neural circuits may play a bigger role in panic disorder. This means that some parts of a person’s brain are overactive, which makes them more likely to develop the disorder.

There are some studies that suggest genetics may have something to do with how panic disorder starts. People who are first-degree cousins of someone who already has the syndrome have a 40% chance of getting it themselves. There is also a high chance that people with panic disorder will develop other mental illnesses.

Lifetime rates of panic disorder in people in the US are estimated to be between 2% and 6%. 2.7% of people will have it in a year, and 44.8% will be considered “severe” cases. According to the empirical evidence, lifetime rates of panic disorder are pretty high; they are only slightly lower than rates of social anxiety disorder, PTSD, and generalized anxiety disorder. Notably, people with panic disorder are much more likely than the general population to have heart, lung, digestive, and other health problems throughout their lives. People from Europe are more likely to have panic disorder than people from Asia, Africa, or Latin America. Women are more likely to be impacted than guys. Teenagers and young adults are most likely to have panic disorder, while kids younger than 14 are less likely to have it.

Here is a clinical presentation of panic disorder.

The high prevalence of panic disorder signals early detection and treatment of the condition to avoid its harmful consequences. The following diagnostic criteria and features, as suggested by DSM 5 TR, can help diagnose panic disorder:

Diagnostic Criteria

A. Sudden panic attacks that happen over and over again. A panic attack is a sudden, strong feeling of fear or pain that gets worse quickly and lasts for minutes. During this time, four or more of the following signs happen:
Note: The sudden rise can happen whether you are calm or worried.
1. Palpitations, a racing heart, or a fast heart rate.

2. Sweating.

3. Shaking or trembling.

4. Having trouble breathing or feeling suffocated.

5. Sense of choking.

6. Pain or stiffness in the chest.

7. Feeling sick or having stomach problems.

8. Feeling dizzy, shaky, light-headed, or weak.

9. Feelings of chills or heat.

10. Paresthesias (feelings of numbness or tingle).

11. Feelings of not being in the real world or being cut off from oneself (depersonalization).

12. The worry that they will lose control or “go crazy.”

13. The fear of dying.

Note: Symptoms that are unique to a culture may show up, such as deafness, neck pain, headaches, or screaming or crying uncontrollably. These signs shouldn’t count as one of the four needed ones.

B. After at least one of the attacks, there was at least one of the following for at least one month:

1. Constant worry or fear of having more panic attacks or the bad things that could happen as a result, like losing control, having a heart attack, or “going crazy.”

2. An important change in behavior that isn’t helpful because of the attacks, like staying away from exercise or situations you’re not used to in order to avoid having them.

C. The problem is not caused by the body’s response to a substance (like an illegal drug or a prescription drug) or a medical situation (like hyperthyroidism or heart trouble).
D. Another mental disorder cannot explain the problem better. For example, panic attacks don’t only happen when people are afraid of social situations (social anxiety disorder), when they are afraid of specific objects or situations (specific phobia) when they are obsessed with something (obsessive-compulsive disorder), when they are reminded of a traumatic event (post-traumatic stress disorder), or when they are separated from people they care about (separation anxiety disorder).

Diagnostic Features

  • Recurrent, spontaneous panic attacks indicate panic disorders.
  • Panic attacks are brief, acute feelings of terror or discomfort that worsen to the last minute.
  • At least four of thirteen physical and mental indications must occur simultaneously.
  • Recurrent refers to many unexpected panic attacks.
  • A sudden panic attack has no known cause.
  • Nocturnal panic attacks occur when the person is resting or waking up.
  • When there is a clear indicator or reason, such as being in a panic attack-prone environment, expected panic attacks occur.
  • Clinicians decide if panic episodes are predictable or unexpected. They accomplish this by carefully interrogating the subject about events before or during the incident and if the attack appeared random.
  • The culture determines whether panic episodes are anticipated or surprising.
  • About half of US and European panic disorder sufferers have planned and spontaneous panic episodes.
  • Having predicted panic episodes does not rule out panic disorder.
  • Panic attacks can occur at many times and methods.
  • Attacks might occur daily or weekly for months.
  • Over many years, there may be weeks or months without episodes or attacks that occur twice a month.
  • People who do not suffer panic attacks frequently share indicators, demographics, co-occurring disorders, family background, and biological facts with those who do.
  • Panic disorder can cause full-symptom (four or more symptoms) and limited-symptom attacks.
  • Symptoms vary from attack to attack.
  • A person must experience many abrupt, full-blown panic attacks to be diagnosed with panic disorder.
  • Nighttime panic attacks are different from morning worries.
  • One-quarter to one-third of Americans with panic disorder have suffered a midnight panic episode.
  • Daytime panic episodes affect most of these folks.
  • Panic episodes throughout the day and at night are indicative of a more severe panic condition.
  • People who fear panic attacks worry about their health. They may fear their panic episodes indicate a life-threatening ailment like heart disease or seizure disorder. They also worry about social situations, such as being embarrassed or judged for their evident panic symptoms. They fear “going crazy” or losing control and their mental health. Panic disorder sufferers who fear death have more severe symptoms.
  • Bad behavior modifications are attempts to reduce or prevent panic episodes and their complications.
  • Avoiding physical activity, rearranging daily life so help is easy to find in case of a panic attack, limiting normal daily activities, and avoiding situations that make you think you have agoraphobia, like leaving the house, taking public transportation, or shopping, are examples.
  • Agoraphobia is diagnosed differently if present.
Categories
Psychiatric Disorders

Social Anxiety Disorder – Prevalence, Diagnostic Criteria and Diagnostic Features

Social anxiety disorder (SAD), also referred to as social phobia, is a very upsetting long-term mental illness that causes people to be afraid of going to social events because they think other people will judge them badly. People with this crippling illness are often not properly evaluated because some of the signs of SAD look like those of shyness. Normal shyness is not the same as social anxiety. Normal shyness is a normal state, but social anxiety can have detrimental consequences. This happens a lot to young people, and it can greatly affect their social development.

According to sources, people who have social anxiety disorder tend to have fewer friends and have more trouble getting along with their friends. They are less likely to get married, more likely to get divorced, and less likely to have kids. A lot of everyday things can be hard to do when one is afraid of other people, like going to stores, buying clothes, getting a haircut, and using the phone. Even though most people with social anxiety disorder have jobs, they say that their symptoms make them miss more work and be less effective. Giving speeches or shows at work may be something people avoid or even quit. People getting government benefits are 2.5 times more likely to be in this group than the general adult population. Moreover, according to the results of a survey, people with generalized SAD made 10% less money than the general community. Outpatient medical trips are also linked to social anxiety disorder.

The prevalence of social anxiety disorder is high. It has been estimated that about 12 million people have SAD. A prevalence study done in Saudi Arabia found SAD in almost 51% of the 5896 Saudi medicine students who took part in the study. Among them, 8.21% said they had severe SAD and 4.21% said they had very severe SAD. Students older than 18 had a lower chance of getting SAD. Women, students at private colleges, and students at colleges that use non-problem-based learning were more likely to get it. Also, students who had failed classes in the past and had a low GPA were much more likely to have SAD.

Additionally, a study that looked at how common social anxiety is in seven countries: the US, Vietnam, China, Indonesia, Brazil, and Russia, found that social anxiety is much more common than was thought before. More than one-third of those surveyed (36%) met the standards for having Social Anxiety Disorder (SAD). The number of people with social anxiety and how bad their symptoms did not change based on their gender, but they did change based on their age, country, job, level of schooling, and whether they lived in a city or a rural area. Also, 18% of those surveyed thought they did not have social anxiety, even though they met or passed the criteria for SAD. These statistics show that young people all over the world deal with social anxiety, and a lot of them don’t even realize how bad their problems may be. A lot of young people may be having big problems with their health and ability to work, which could be fixed with the right kind of education and help. However, to do that, one must be aware of the diagnostic features of SAD. The diagnostic criteria for SAD and its diagnostic features according to DSM 5 TR are explained next:

Diagnostic Criteria

A. A strong fear or worry about engaging in one or more social situations where others might be watching. These are examples of social interactions: talking to someone, meeting someone new, being watched while eating or drinking, and acting in front of other people: giving a speech.

Note: In the case of children, they must feel anxious when they are with their peers as well as when they are with adults.

B. The person is afraid that they will act or show anxiety signs that will make other people think badly of them, like being humiliated or embarrassed, or that they will be rejected or hurt others.

C. Most of the time, social settings make people scared or anxious.

Note: Children may show their fear or worry through crying, temper fits, freezing, clinging, shrinking, or not talking in public.

D. People avoid or go through social settings with a lot of fear or worry.

E. The fear or worry is far too high compared to the real danger that the social situation and culture bring.

F. The fear, anxiety, or avoidance does not go away and usually lasts for at least six months.

G. It is clinically significant discomfort or impairment in social, professional, or other important areas of performance because of fear, anxiety, or avoidance.

H. The fear, anxiety, or avoidance isn’t caused by the way a substance (like an illegal drug or a prescription drug) affects the body or by another medical condition.

I. It is not possible that another mental disease, like autism spectrum disorder, body dysmorphic disorder, or panic disorder causes fear, anxiety, or avoidance.

J. If there is another medical condition, like Parkinson’s disease, fat, or scarring from burns or injuries, the fear, anxiety, or avoidance has nothing to do with it and is too much.

Specify if:

Performance only: If the fear only happens when you have to speak or perform in public.

Diagnostic Features

  • Social anxiety disorder can make individuals fearful or uncomfortable in social situations when others may be watching.
  • Criteria A states that youngsters’ fear or anxiety must affect other kids and adults. They fear being judged poorly in these social contexts.
  • The individual fears being seen as concerned, weak, insane, foolish, uninteresting, scary, dirty, or unlikable.
  • The individual fears others will judge them if they act or appear a certain way or display anxiety symptoms like flushing, shivering, sweating, fumbling over words, or gazing.
  • Some worry about offending others or being rejected.
  • People from communities that emphasize community may worry about upsetting others by staring at them or exhibiting anxiety.
  • People who fear shaking their hands may not drink, eat, write, or point in public.
  • People who fear sweating may not shake hands or eat hot meals.
  • Public speaking, strong lights, and personal conversations may be avoided by blushers. Some people avoid public restrooms because they are fearful of others. This is paruresis, or “shy bladder syndrome.”
  • Social settings usually cause anxiety.
  • A person who gets apprehensive in social circumstances occasionally does not have social anxiety disorder.
  • However, dread and anxiety might vary (anticipatory anxiety vs. panic attacks).
  • When someone worries every day for weeks before a party or practices a speech for days, anticipatory anxiety begins.
  • In public, children may scream, throw tantrums, halt, cling, or withdraw out of fear or anxiety.
  • The person avoids social situations they fear. Instead, experiences are endured with worry or anxiety.
  • Avoidance may be huge (not going to parties or school) or tiny (writing down too much of a speech, focusing on other things, and avoiding establishing eye contact).
  • It is determined that the dread or anxiety does not match the likelihood of being poorly appraised or its repercussions.
  • When anxiety is tied to an actual threat, like being tormented or tortured, it may not be as bad. However, social anxiety sufferers sometimes exaggerate their social difficulties. This is why the therapist calls the person “out of proportion.”
  • Consider the person’s social and cultural background now. Social anxiety may be acceptable in some cultures as a show of respect.
  • The disruption usually lasts six months. This time constraint distinguishes the condition from common short-term social worries in children and society.
  • The individual’s dread, anxiety, and avoidance must interfere with their everyday life, education, job, social life, or relationships or cause clinically substantial suffering.
  • If they seldom speak in public at work or school and it does not bother them, someone who is terrified of it would not have social anxiety disorder.
  • However, criteria G is satisfied if the individual avoids or gets rejected for their dream career or school due to social anxiety.

Storybook: If you wish to see a representation of social anxiety in an individual, do check out this story.

Categories
Psychiatric Disorders

Prevalence, Diagnostic Criteria, and Diagnostic Features of Generalized Anxiety Disorder

Generalized anxiety disorder is a mental health condition that causes people to feel afraid, worried, and stressed all the time. It is marked by worrying too much, too often, and about things that do not matter. This worry could be about many things, such as money, family, health, or the future. Too much of it is hard to handle, and it is often followed by a lot of vague mental and physical symptoms. The main sign of generalized anxiety disorder is worrying too much.

A study shows that approximately 4.05% of the world’s population, or 301 million people, have an anxiety disorder. From 1990 to 2019, the number of people harmed has grown by more than 55%. Metrics for anxiety disorders show that the rates of frequency, incidence, and DALYs are all going up. The most common country is Portugal, with 8,671 cases per 100,000 people. Brazil, Iran, and New Zealand are next. The rate is higher in places with better incomes. Anxiety problems are 1.66 times more likely to happen to women than to men. Age-adjusted rates have stayed the same, which suggests that risk factors may also have stayed the same.

Empirical evidence also that the chances of getting GAD are much lower for men and people with better education. The chances of having present GAD are much higher for people who live in cities and are married. Depression (15.8%) and agoraphobia (9.4%), which are both mental illnesses, are the most common ones that happen together.

Moreover, according to genetic studies, many genes are probably involved in the development of GAD, but we still do not know much about this. Given this, if someone in the family has GAD, there is an increased probability that someone else will too, along with another anxiety disease. People with GAD often worry too much about everyday things like their health, finances, death, family, relationships, or work problems. Many times, worry gets in the way of daily life. Some of the signs that might be present are worry, nervousness, trouble sleeping, tiredness, irritability, trembling, and sweating a lot. Studies report that generalized anxiety disorder is linked to changes in the amygdala’s functional consistency and the way it handles fear and anxiety. Neurotransmitters, especially the GABA type, have been known for a long time to cause GAD by messing up the activity in the amygdala in the brain. For someone to be diagnosed with GAD, their anxiety, worry, or physical symptoms must make it very hard for them to function in social, academic, or professional settings.            

The diagnostic criteria and diagnostic features of GAD in the light of DSM 5 TR are discussed next:

Diagnostic Criteria

A. lot of stress and worry (apprehensive hope), most days for at least six months, about a number of things or events, like how well one will do at work or school.
B. The person has a hard time controlling their worry.
C. The stress and worry are linked to three or more of the six signs below (any one required for diagnosing children), and at least some of them have been present more days than not over the last six months:

1. antsy or feeling tense or on edge
2. getting tired quickly
3. having trouble focusing or your mind getting blank
4. being irritable
5. tense muscles
6. sleep disturbances including; having trouble going or staying asleep or having restless, poor sleep.

D. The worry, anxiety, or physical symptoms make it hard to function in social, work, or other important areas of life because they are clinically significant.

E. The problem is not caused by the side effects of a drug (like an illegal drug or a prescription drug) or a medical condition (like hyperthyroidism).

F. The problem cannot be explained by another mental disorder, like anxiety or worrying about having panic attacks in panic disorder, negative self-evaluation in social anxiety disorder, contamination or other obsessions in obsessive-compulsive disorder, separation anxiety disorder, gaining weight in anorexia nervosa, bodily complaints in somatic symptom disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder.

Diagnostic Features

  • Too much fear and anxiety (apprehensive expectation) about many different events or tasks is what defines generalized anxiety disorder.
  • The fear and anxiety are too strong, last too long, or happen too often compared to how likely or bad the expected event is.
  • The person has a hard time managing their worry and keeping their troubling thoughts from getting in the way of their work.
  • Generalized anxiety disorder makes adults think about things that happen in their daily lives, like possible job responsibilities, their health and finances, the health of family members, bad things happening to their children, or small things like doing chores or being late for meetings.
  • Kids with generalized anxiety disorder often think too much about how well they are doing or how competent they are.
  • As the disorder gets worse, the person may think about different things at different times.
  • Generalized anxiety disorder is different from normal anxiety in a number of ways.
  • First, the worries that come with generalized anxiety disorder are usually too much and get in the way of people’s ability to function in their social and psychological lives. On the other hand, daily worries are not too much and are seen as more doable, so they can be put off until more important things come up.
  • Second, the fears that come with generalized anxiety disorder are more widespread, intense, and upsetting. They also last longer and often happen without any clear cause. People are more likely to have signs of generalized anxiety disorder if they worry about a lot of different things in their lives, like money, their children’s safety, and how well they do at work.
  • Third, everyday worries are not as likely to be followed by physical signs like being antsy or feeling tense. Individuals with generalized anxiety disorder say they are in emotional pain because they are constantly worried and this makes it hard for them to function in social, professional, or other important areas of their lives.
  • Along with the worry and anxiety, there are at least three of the following other symptoms: restlessness or feeling tense or on edge, getting tired quickly, having trouble focusing or your mind going blank, being irritable, having muscle tightness, and having trouble sleeping.
  • For children, only one more sign is needed.