Generalized Anxiety Disorder (GAD)

Symptoms

- excessive anxiety and worry
- irritability
- muscle tension/body aches
- GI issues
- restlessness/sleeplessness
- exhaustion/fatigue
- difficulty concentrating

Treatment

- identification and treatment of underlying issues causing anxiety
- antianxiety/antidepressant medications
- psychotherapy

Typical Anxiety Pathway

Stimuli --> thalamus (relay center) --> cortex (analyzes stimuli and picks a response) --> amygdala (fear/emotional center) --> (if chronic anxiety) BNST (perpetuates fear response) --> locus ceruleus (activates sympathetic nervous system) --> hippocampus (memory center; stores info from senses + emotional tags from amygdala)

Shortcut Pathway

Stimuli --> thalamus (relay center) --> amygdala (fear/emotional center) --> locus ceruleus (activates sympathetic nervous system)

How is the sympathetic nervous system activated?

Hypothalamic-pituitary-adrenal axis; the hypothalamus signals the anterior pituitary gland with corticotropin-releasing hormone (CRH), the anterior pituitary gland then releases adrenocorticotropic hormone (ACTH) which causes the adrenal glands to produce epinephrine (adrenaline) and cortisol

Effects of Epinephrine and Cortisol on Body

- increased ventilation
- liver converts glycogen into glucose (releases energy)
- decreased digestion
- elevated blood pressure
- increased heart rate
- heightened senses
- muscle tension

Effects of Too Much Cortisol on the Brain

- damages/kills hippocampal cells making it difficult to organize memories and normally integrate stimuli in the future (positive feedback loop)
- decrease in brain-derived neurotrophic factor (BDNF)
- mood dysregulation (cause of association between GAD and MDD)

What factors make someone more likely to be predisposed to GAD?

- female gender
- genetics
- underlying unpredictable medical conditions