Anxiety Depression

A Case Study (Part 5): Treating Comorbid Post-traumatic stress disorder, Generalized anxiety disorder and Depression, an Integrative Approach

Integrative Treatment Approach

We continue the exploration of  our integrative approach. As it is with any anxiety disorder, the main emotion that drives GAD is fear (Bourne, 2005; Leahy & Holland, 2000). However, while individuals suffering from other anxiety disorders will for the most part have conditioned a fear response to a specific stimulus, those suffering from GAD will have generalized their fear response to a variety of innocuous situations (Bourne, 2005; Leahy & Holland, 2000). Again, as it is with any anxiety disorder, the primary self-defence mechanism is avoidance, which will be displayed both behaviourally and cognitively (Bourne, 2005; Leahy & Holland, 2000). Cognitively, such individuals will develop self-talk that will create anxiety surrounding their feared stimuli so as to avoid them, and the avoidance behaviour will further reinforce such self-talk (Bourne, 2005; Leahy & Holland, 2000).

Anxiety bubble

The self-talk will gradually reinforce certain fear based core beliefs (the world is dangerous, I won’t be able to cope) and maladaptive assumptions (I must always be on alert), that are common to GAD and anxiety disorders in general, as well as phobic patterns of avoiding those stimuli which they are fearful of (Bourne, 2005; Leahy & Holland, 2000). An example of self-talk typical of GAD is “the worrier” (for patterns of self-talk See Appendix A) (Bourne, 2005). As a consequence of their perpetual state of fearful anticipation, such individuals experience over activation of their sympathetic system leading to physiological symptoms such as, motor tension (shakiness, restlessness, and headaches), arousal (Shortness of breath, excessive sweating, heart palpitations, fatigue and gastrointestinal symptoms), and cognitive vigilance (irritability and startle response), common to Gad and anxiety disorders in general (Bourne, 2005; Sadock & Sadock, 2007).

untill next week … Stay tuned!

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