Nowadays, many young people, especially high school and college

students, suffer from stress due to the huge amount of work and
exercise. Many of them are ambitious, always try to fulfill their tasks as
perfect as possible, so that they spend hours to complete their work.
Then they have no time life for leisure, families and friends,
consequently, they gradually lose their social ties and become isolate.
That scenario of life can lead to Anxiety Disorder, a group of disorder
with many subunits (states of disorder) such as Phobias, Panic disorder
and Genaralized Anxiety Disorder (GAD). Occasional anxiety is a normal
part of life, not considered as illness. Many people worry about things
such as health, money, or family problems. But anxiety disorders involve
not only more temporary worry or fear (won’t get away, get worse over
time,...), but also interfering with daily activities such as job performance
and relationships.

Generalized Anxiety Disorder (GAD) is the main type

that this text is going to discuss about, characterized as:
a/ Constant, numerous worry and tension (such as own health,
families ‘s health, girlfriend ‘s problem, …)
b/ Negative premonition, for example: someone said: “Are you sure
that you won't repeat your mistake one more single time ? What if you
do that again ? “

complicated train of thoughts of one suffer from anxiety disorder

1/ Symptoms:

● Feeling restless, wound-up, or on-edge.

● Being easily fatigued.
● Having difficulty concentrating.
● Being irritable.
● Having headaches, muscle aches, stomachaches, or unexplained
pains.
● Difficulty controlling feelings of worry, for example, it ‘s hard to get
back to normal state after having quarrel.
● Having sleep problems, such as difficulty falling or staying asleep.
● Having almost no fear of anything (because dysregulation of
amygdala).

Sometimes you can not even realize your anxiety, here are some
more “hidden" symptoms that you need to know:
● Being impatient.
● Having hard time adjusting to changes in plans => Over
preparing because you need everything to go as planned .
● Getting agitated by minor things.
● Always pacing and not being able to stand still.

2/ Risk factor:

● Chemical (neurotransmitters) imbalance: Severe or long-lasting

stress can change the chemical balance that controls your mood
(Serotonin,...). Besides that, unhealthy lifestyle such as not eating
on proper time, staying up late,.. can affect your circadian rhythm.
Experiencing a lot of stress and maintaining unhealthy life over a
long period can both lead to an anxiety disorder.
● Environmental factors: Experiencing a trauma might trigger an
anxiety disorder such as divorced can lead to GAD for a long
period of time.
● Heredity: Anxiety disorders tend to run in families. You may
inherit them from one or both parents.
● Developmental factors: Living with many concerns such as
debts, family ‘s discord since the early stage of life (childhood) can
leave you with anxiety disorder in further life ‘s stage.
Furthermore, highly specialized work may require determinations,
consistently hard - working, such as doctor and engineer, by years
can leave you with stress, lack of leisure, so that you may suffer
from GAD.
● Discrimination: Because of color's skin, someone can get isolated,
mistreatment and being gradually isolated from the society. For
example, an old (but rich) man is not able to get into a nice
restaurant because of his skin (which is black).
● Stigmatization: devaluing people due to characteristics or
behavior that are negatively judged by society. For example, when
someone with a mental illness is called 'dangerous', 'crazy' or
'incompetent' rather than unwell.
● Abuse of caffein: In order to stay focus, awake for a long day, you
need caffein from sources such as coffee, chocolate,... and that
lifestyle may lead you to not only cardiovascular diseases but also
mental issues such as anxiety disorder.

Stress can lead to anxiety disorder

3/ Protective factor:

● Limit caffeine: Stop or limit how much caffeine you consume,

including coffee, tea, cola and chocolate.
● Live a healthy lifestyle: Exercise regularly and eat a healthy,
balanced diet.
● Stress Management Techniques: such as gym, mindfulness,
meditation, and even help from your friends, colleagues with such
small chats can also reduce anxiety symptoms and enhance the
effects of psychotherapy.
● Self-efficacy: Trust yourself, you can perfectly perform even under
adverse circumstances.
● Dispositional optimism: Have a great belief that things will turn
out well, no matter which pathway it flows, what on your mind will
become truth if you stick with that train of thoughts.
● Social integration: By joining clubs at structural level. That club
doesn’t have to be at high level, just an ordinary club with
members who share the same life perspective is too good to be
true. Generating the cohesion, helping each other even with daily
tasks can prevent you from anxiety disorder.
● Internal locus of control: Everything comes to you is because of
your previous actions, not from anybody else ‘s. Do not blame
anyone and get mad at them, especially your beloved one. You
can still fix the problem if it has not gone on a right way.
 Small group chats, is sometimes enough

4/ Primordial prevention:

Primordial prevention is defined as prevention of the emergence

of General Anxiety Disorder (GAD) ‘s risk factors which they have not
even appeared yet in a group of population (country …), by:

● Changing lifestyles from childhood: Some health disease,

including GAD in adolescence, middle ages have already
developed since the early childhood. By spending more time with
children, taking the kids to the playground instead of extra class is
the most effective means of primordial prevention. By doing this,
when the kids grow up, they will find the most utilizing way to
reduce tension of work, and tighten the relationship between
parents - children.
● Annuling prejudice: Some typical Asian parents still have the
prejudice that their kids must be a doctor or an engineer for
better life condition. You can not force the fish to climb a tree, and
judge their ability to climb a tree as bad and assume that fish is
not talented. So that in order to primordially prevent GAD, we
have to daily update our knowledge about society and abolish all
the prejudice.
 Paying attention to Prevention !

5/ Primary prevention:

Primary prevention is defined as actions from the onset of GAD,

not from the emergence as primordial prevention, annuls its possibility
that GAD will occur, by:

● Changing lifestyles: Even if you have so many works to

complete, you should aware of the amount of caffein, sugar
and alcohol consumption. Just try your best without those
stuffs, reminds that we all have time to complete our tasks
and it's okay to be not perfect. Furthermore, take time for
your ownself everyday, your private time to do everything
you want, that you find it relaxing and still socially
 acceptable. let your brain, your body relax to boost your work
effectively.
● Nutritional intervention: Treat yourself ! Even if you want to
save money for your own purposes, sometimes you have to
eat something different from your own cooking. Go straight
away to a nice restaurant and fill your stomach. With
happiness from that meal, you can reduce anxiety from the
fact that you can finish your task smoothly. You can even
find your true love because the shortest way to conquer a
girl ‘s heart is the way to her stomach.

Healthy lifestyle can prevent you from GAD, from uncontrolled

consequence!

6/ Secondary prevention:
 This type of prevention help find GAD at early stage, when it is
easier for treatment, so that secondary prevention target the one who
are at risk of getting GAD, by:

● Screening exam: A test, including many questions, that checks

for GAD before the symptoms.

7/ Tertiary prevention:

This type of prevention target group of people who is already

diagnosed GAD, in order to prevent the GAD getting worse by days,
help them rehabilitation by:

● Anti-depressant drugs: SSRI (Example: escitalopram) or SSNRI

(Example: Venlafaxine), these drugs have a mood-enhancing
effect and help the one who got GAD to have better feelings. In
some cases, for example, the GAD patients need drugs that help
them to concentrate while studying, so that they can perfectly
complete their task. Therefore they can totally relax and do not
feel anxious anymore.
● Supportive treatment measures: A psychotherapy with
supportive talks from relatives, friends, … or relaxation techniques
such as playing sports with friends, clubs, meditation,… in order to
reduce anxiety .
● Cognitive behavioral therapy (CBT): By education about anxiety
disorder (symptoms, treatment, consequences, …), you can raise
people ‘s awareness of GAD, for example they can realize they got
GAD by informations of specific symptoms. So that they know it’s
time to treat GAD, avoid unnecessary consequences (lose
relationships,…)
7/ References:

● Amboss de, “angststörungen”,

https://next.amboss.com/de/article/kP0mUT?q=angstst%
C3%B6rungen#Z625025e9f4a3eade947f06ec4cef4698
● MEDLINE/PubMed (National Library of
Medicine),https://www.nimh.nih.gov/health/topics/anxiety-
disorders
● American Psychiatric Association. What Are Anxiety Disorders?
(https://www.psychiatry.org/patients-families/anxiety-disorders/w
hat-are-anxiety-disorders) Accessed 12/1/2020.
● Anxiety and Depression Association of America. Understand the
Facts. (https://adaa.org/understanding-anxiety) Accessed
12/1/2020.
● National Institute of Mental Health. Anxiety Disorders.
(https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.s
html) Accessed 12/1/2020.
● AMBOSS de, „Prävention und Gesundsheitsförderung“,
https://next.amboss.com/de/courses/iS0Jz2/zcarUj/article/HK0K3S

● Starcevic, V. Anxiety Disorders in Adults: A Clinical Guide, Edition 1,

Oxford University Press, 2005.
● American Psychiatric Association: Diagnostic and Statistical
Manual of Mental Disorders4th Edition, 2000.
● Journal of Clinical Psychiatry, New Perspectives for Treating GAD,
2004.

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