Noel Christopher B.

Marquez
Jonathan M. Magnata
Generalized Anxiety Disorder
People with generalized anxiety disorder (GAD) experience extreme worry that can interfere
with sleep and is usually accompanied by body symptoms ranging from tiredness to headaches to
nausea. Treatment with antidepressants or other medications and psychotherapy, alone or
combined, may alleviate the condition.
Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience
day to day. It is chronic and sufferers experience severe worry and tension, often without
provocation. This disorder involves anticipating disaster, often worrying excessively about health,
money, family, or work. Sometimes, though, just the thought of getting through the day brings on
anxiety.
People with GAD can't shake their concerns, even though they usually realize that much of
their anxiety is unwarranted. People with GAD also seem unable to relax and often have trouble
falling or staying asleep. Their worries are accompanied by physical symptoms such as trembling,
twitching, muscle tension, headaches, irritability, sweating, hot flashes, and feeling lightheaded or
out of breath.
Many individuals with GAD startle more easily than other people. They tend to feel tired, have
trouble concentrating and may suffer from depression. GAD may involve nausea, frequent trips to
the bathroom or feeling like there is a lump in the throat.
When their anxiety level is mild, people with GAD can function socially and hold down a job.
Although they don't avoid certain situations as a result of their disorder, people with GAD can
have difficulty carrying out the simplest of daily activities if their anxiety is severe.
GAD affects about 6.8 million American adults, including twice as many women as men. The
disorder develops gradually and can begin at any point in the life cycle but usually develops
between childhood and middle age. The prevalence of the diagnosis peaks in middle age and
decreases across the later years of life.There is evidence that genes play a modest role in GAD.
Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely
occurs alone. GAD is commonly treated with medication or cognitive-behavioral therapy, but co-
occurring conditions must also be treated using the appropriate therapies

Symptoms
Generalized anxiety disorder (GAD) is characterized by six months or more of chronic,
exaggerated worry and tension that is unfounded or much more severe than the normal anxiety
most people experience. In children and adolescents with generalized anxiety disorder, their
anxieties and worries are often associated with the quality of performance or competence at school
or sporting events. Additionally, worries may include punctuality, conformity, perfectionism, and
they may be so unsure of themselves that they will redo tasks to reach a level of perceived
perfection.

I. Profile

1. Basic Information
Name: Mr. KL
Nickname: Tabaching
Address: Goodluck Hills Subdivision, Domoit, Lucena City.
Age: 19 years old
Height: 5’3 ft.

2. Identifying Information
Mr. KL; a 19-year-old student currently studying at Manuel S. Enverga University Foundation.
He is taking up Bachelor of Science in Business Administration major in Accounting Management.
He’s nickname is “tabaching”. He is an only child. He is residing in a suburban house in Goodluck
Hills Subdivision in Domoit, Lucena City. He’s height is 5’3 ft. His weight is 68 kg. His father’s
occupation is a Salesman in Atlanta Industries. While his mother is a corporate secretary in Kings
2000 Security Agency.

3. Purpose of Assessment
To assess what particular area of the subject’s life are being restrained due to the subject’s
anxieties and worries. To know whether the subject’s anxiety cause him to experience personal
distress or impairment in social, occupational or other important areas of functioning.
The objective of this interview is to assess the subject’s behavioral and cognitive functioning.
If the subject’s anxiety are linked to a psychological dysfunction and traced back its origin or the
causal factor.

4. Presenting Problem
The subject’s presenting problem is that he’s really worried about what future lies ahead of
him and what will it look like. His anxieties kick in whenever thoughts of his future come to mind.
The thought of not a living of a comfortable life in the near future worries him. The subject also
feared that he will not be successful in his line of work. That puts him in a mental state of personal
distress.

5. Psychosocial Profile
According to the subject’s Schema and Self Schema, he stated that he perceived the world as
an endless opportunities for us people who are the risk takers. For him, he sees the world as an
endless cycle and people will not be able to survive if they don’t have the guts to push through it.
He’s very cautious in everything and even the steps in life that he would like to make but it doesn’t
stop him to go after the things that he likes. The subject likes to take every chances that he can
even if sometimes he must have to suffer through it. The subject’s Self Schema is he stated that he
perceived himself as the 2 sides of the coin. He said that he can be good as he can be but also can
be very bad if needed. For him his flexible enough for certain kinds of people.
According to how well the subject assimilate and accommodate amidst variations; the subject
stated that he can adapt to changes because for him change is necessary and it’s a must. The subject
also said that people must learn to accept changes because we won’t survive if we don’t.
According to the subject’s predictability and controllability; the subject stated that there are
times that his actions are unpredictable. He said that most of the time a lot of things go around his
head and it’s difficult for him what to entertain first. He have a hard time dealing overthinking
things which are not that necessary which makes him to act in an unpredictable way.
When the subject was asked what is home for him? He stated that home is where love can be
met at all times and without condition. Because for him parents are always there when you feel
like giving up, they will carry, support and uplift you and they will always be there for you even
the hardest of times no matter how hard the situation is.
According to subject’s parental psychopathology, The subject said that his mother changed
when he grew up, his mother now is always been aggressive and gets easily angry even of simplest
of things and because of the sudden changes the subject now is living in an authoritarian kind of
parenting style.
According to the subject’s maladaptive peer relationship, the subject said that he once
experienced bullying before as he grows up. The subject said that during his early childhood days
he was called names and even get pick up by bully because of his weight.

6. Socio-cultural Profile
According to the subject, he perceived their status in life as above average. The subject said
that they’re not that kind of rich but her father can provide enough to sustain the needs of their
family.

7. Personal History/Background Information, Clinical Interview/Life History

 Mr. KL, an only child was born on September 9, 1997 at Lucena City, Quezon Province. His
father is currently working as a Salesman in Atlanta Industries. While his mother is a corporate
secretary in Kings 2000 Security Agency. The subject described his parents as warm and careful
to set clear limits. The subject has a few friends but he make sure that they’re the one he can always
count on. He started his elementary years in International School for Better Beginnings until his
sixth grade. The subject also experience bullying when he was in fourth grade. His classmates
made fun of his weight. Due to this incident he transferred and finish his High School in Maryhill
College in 2014. The subject also experienced a traumatizing incident when his parents had a fight
that lasted from his 1st year in High School up to his last. Because of the never ending quarrel of
the subject’s family his mother almost filed an annulment. When he entered College, he chose AB
Political Science but his mother force him to choose BS Accountancy instead. After several
semester, he started to choose the desires of his heart and take up BS Business Administration
major in Management Accounting. Now, the subject is struggling to maintain decent grades in his
academic life to build a better future ahead of him.

8. Behavioral Observation

Mr. KL is kind of overweight and his height is in average. He wears the typical school uniform
wearing a white shirt underneath his white polo, black pants, white socks and black leather shoes.
He has poor posture and he always tend to bend down while talking. He also have this compulsion
to always check his hair in front of his phone. He always brush his hair with his hand. His ability
to follow command or request is low because he fears that this interview will make him very
vulnerable and transparent. He cannot maintained a good eye contact. He also feels suspicious
about this interview and feared that it will be revealed to others. Oftentimes he’s secretive of the
things he doesn’t want to discuss. He’s also feels lethargic in the way he response. A paucity of
answer to questions. He also feels pressured when talking. And is kind of slow to response. The
volume of his speech is soft and somehow in monotone. The fluency and rhythm of his speech is
hesitant for he fears that his answers will be discussed in class. His mood is not good he feels
drowsy and kind of sleepy during interview. He feel discouraged and low lately because his
significant other doesn’t reply to his messages. He feel angry and irritable lately because of the
fight he had with his mother. His affect is appropriate to the flow in conversation, its range is
restricted, the intensity is flat, and the quality is anxious. The thought process is circumstantial and
evasive to some questions. In his thought content, when he feels sad or angry the only thing he has
in mind is how to get through the night because he can’t sleep easily at night when he’s feeling
blue. The thing on his mind lately is how he can get over the exam and pass all the test he is about
to take and get 90 and above percentage in the result. The thing that is ruminating in his mind
lately is what will be his main source of income in the near future, the thought of not a living of a
comfortable life in the near future worries him. The subject also feared that he will not be
successful in his chosen career. And the only thing he’s really worried about right now is his future
and what lies ahead of him and what the future will look like. He sometimes feel detached from
others around him when things get difficult. There are times when he misinterpret real things such
as muffled noise or shadow especially at night. Before he feels that life isn’t worth living and he
would just as soon be dead. It was during the time when he feels like nothing good is happening
to him and when people make him feel like a nuisance when he is offering help. This feeling of
suicidality oftentimes happen when he is having an argument with his mom. The thing that he has
in mind if he commit on doing it is he will not feel any kind of feeling of anymore and things will
be in pitch black.

II. Causal Factors of the Abnormality

Necessary cause:
Predisposing factors:
 His traumatizing experience of his parents separating ways
 The bullying he experienced during his childhood

Sufficient cause:

Mr. KL perceives himself as having a low self - esteem, fragile, and helpless during
times of emotional outburst. He also thinks our world is cruel because of the uncertainty
it brings. He’s afraid that nobody will probably like him and he’ll end up solo in the
near future. Having a thought like this worries him so much and it gives him greater
anxiety.
Contributory cause:
 His mother that pressured him to do excellently in class
 The society that he is currently living in; due to the fact that his relatives is living an
above average class, and he feel the need to keep up that makes him feel more anxious.

Psychological Intervention
Medication and specific types of psychotherapy are the recommended treatments for this
disorder. The choice of one or the other, or both, depends on the patient's and the doctor's
preference, and also on the particular anxiety disorder.

Antidepressants
A number of medications that were originally approved for treating depression have been
found to be effective for anxiety disorders. These must be taken for several weeks before symptoms
start to fade, so it is important not to get discouraged and stop taking these medications. They
need a chance to work.
Some of the newest antidepressants are called selective serotonin reuptake inhibitors, or
SSRIs. These medications act on a chemical messenger in the brain called serotonin. SSRIs tend
to have fewer side effects than older antidepressants. People do sometimes report feeling slightly
nauseated or jittery when they first start taking SSRIs, but that usually disappears over time. Some
people also experience sexual dysfunction when taking some of these medications. An adjustment
in dosage or a switch to another SSRI will usually correct bothersome problems. It is important to
discuss side effects with your doctor so that he or she will know when there is a need for a change
in medication. Venlafaxine, a drug closely related to the SSRIs, is useful for treating GAD.
Similarly, antidepressant medications called tricyclics are started at low doses and
gradually increased. Tricyclics have been around longer than SSRIs and have been more widely
studied for treating anxiety disorders. For anxiety disorders other than OCD, they are as effective
as the SSRIs, but many physicians and patients prefer the newer drugs because the tricyclics can
sometimes cause dizziness, drowsiness, dry mouth, and weight gain. Tricyclics are useful in
treating people with co-occurring anxiety disorders and depression. Imipramine, prescribed for
panic disorder and GAD, is an example of such a tricyclic.

Psychotherapy
Psychotherapy involves talking with a trained mental health professional, such as a psychiatrist,
psychologist, social worker or counselor to learn how to deal with problems like anxiety disorders.

Cognitive-Behavioral and Behavioral Therapy

Cognitive-behavioral therapy (CBT) is very useful in treating anxiety disorders. The cognitive part
helps people change the thinking patterns that support their fears, and the behavioral part helps
people change the way they react to anxiety-provoking situations.
For example, CBT can help people with panic disorder learn that their panic attacks are not really
heart attacks and help people with social phobia learn how to overcome the belief that others are
always watching and judging them. When people are ready to confront their fears, they are shown
how to use exposure techniques to desensitize themselves to situations that trigger their
anxieties. Another behavioral technique is to teach the patient deep breathing as a relaxation aid.
If you undergo CBT or behavioral therapy, exposure will be carried out only when you are ready;
it will be done gradually and only with your permission, and you will work with the therapist to
determine how much you can handle and at what pace you can proceed. To be effective, the therapy
must be directed at the person's specific anxieties and must be tailored to his or her needs. There
are no side effects other than the discomfort of temporarily increased anxiety.
CBT or behavioral therapy generally lasts about 12 weeks. It may be conducted in a group,
provided the people in the group have sufficiently similar problems. Group therapy is particularly
effective for people with social phobia. Often "homework" is assigned for participants to complete
between sessions. There is some evidence that, after treatment is terminated, the beneficial effects
of CBT last longer than those of medications for people with panic disorder; the same may be true
for OCD, PTSD, and social phobia. If you have recovered from an anxiety disorder, and at a later
date it recurs, don't consider yourself a treatment failure. Recurrences can be treated effectively,
just like an initial episode. The skills you learned in dealing with the initial episode can be helpful
in coping with a setback.
For many people, the best approach to treatment is medication combined with therapy. As stated
earlier, it is important to give any treatment a fair trial. And if one approach doesn't work, the odds
are that another one will.

Self–Help
Self-help methods for the treatment of this disorder are often overlooked by the medical profession
because very few professionals are involved in them. Many support groups exist within
communities throughout the world which are devoted to helping individuals with this disorder
share their commons experiences and feelings of anxiety. Individuals should first be able to tolerate
and effectively handle a social group interaction. Pushing an individual into a group setting,
whether it be self-help or a regular group therapy experience, is counterproductive and may lead
to a worsening of symptoms.