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DiseaseANXIETY AND RELATED DISORDERS
  
Quotation“Anxiety does not empty tomorrow of its sorrow, but only empties today of its strength”
  
DefinitionGeneralized Anxiety Disorder (GAD) with excessive worry and tension on most days for at least 6 months, together with somatic symptoms and signs.
  
PrognosisGAD is a long term condition, beginning at an young age, is life long and spontaneous remission is rare. Short term anxiety disorders including panic disorders can be very adequately controlled with active treatment. But obsessive, compulsive and post-traumatic stress disorders are more difficult to control and might need prolonged therapy.
  
General MeasuresPsychological therapy in collaboration with with psychiatrist. Cognitive behavioural therapy reduces the frequency and symptoms, and improves sleep and social interactions. Stress reduction by Relaxation techniques, bio-feed back, Yoga, Meditation, etc. (see unit on ‘stress reduction”)Regular exercise programe. Aerobic forms of exercise appear tobe more helpful, and daily exercise for at least 20 minutes would appear necessary. It takes 10 weeks before significant reduction in anxiety occurs. Identify any coexistent substance ause, and remedial measures, if any. Personal and family counseling. Judicious reassurance that other serious medial disorders have been ruled out.
  
Advice to PatientFollow General Measures, as applicable.Maintain an optimistic outlook.When on sedating drugs, avoid driving vehicles or operating machinery.
  
Follow UpRegular visits. Watch out for associated depression that is often missed. Monitor for possible drug dependendce.
  
Inadequate ResponseRule out associated depression. Could be a more time consuming subtype like obsessive compulsive neurosis. Get psychiatric reassessment.
  
PreventionManagement of stress.Relaxation techniques.
  
Reference Fromwww.lef.org/protocols/ptrcl-011.shtml
   

 

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