Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

GAD

The most common cause of disability in the United States is Generalized Anxiety Disorder (GAD) and affects almost 7 million adults in America each year (as contrasted to 2% of adults in Europe).

Individuals with GAD, for a period of at least six months, excessively worry about finances, health, interpersonal (family, friendship) problems, and difficulties at work. The worry is disproportionate to the challenges facing them. And it is this irrational worry that interferes with their daily functioning. Thus, their worrying about their daily lives actually is the cause of the impaired ability to function.gad

They not only have a range of physical complaints such as fatigue, restlessness, insomnia, and trembling, but they also complain of headaches, GI distress and headaches. They tend to research their physical disorder, fearing worst-case scenarios and may convince themselves that they do have a symptom simply because it is a possible complication.

These individuals are so overly concerned about matters of everyday living that they display marked difficulty in concentration. They simply anticipate disaster and create irrational scenarios where minor problems will become disasters and believe that they have absolutely no control over what is going to occur.

Such individuals when injured become finely tuned to their bodily responses. They are hypervigilent for all physical functions that, to them, feel like a new or worsening symptom. Since this creates muscle tension, their physical complaints (such as headaches, stomach pain and trembling) become quite real.

They have difficulty accepting input regarding diagnostic findings regarding their injury. They believe that there are other, and missed, diagnostic possibilities. They fear that those caring for them are largely indifferent to what may be larger and more complex problems. And these physical concerns then become interwoven into their financial, family and occupational problems. Every event, to them, appears larger and more complex and, often, unsolvable.

Gerenalized anxiety disorder is not caused by injury, but the treatment of an injury is compromised by the longstanding presence of generalized anxiety disorder. This is a treatable condition, when accurately diagnosed. Unfortunately, since anxiety is also a symptom of depression, it may be misdiagnosed as a mood disorder or merely a situational problem due to the newness of the injury. The presence of generalized anxiety disorder, however, once accurately diagnosed, can be effectively treated.

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