2. Triple Whammy—HIV, Mental Disorders, African Americans
Affecting > 25 million Americans, anxiety disorders represent the most common type of emotional disorder. Anxiety disorders differ from normal feelings of nervousness, and several distinct anxiety diagnoses are addressed by the DMS-IV. Some common symptoms among anxiety disorders include:
Patients experiencing untreated anxiety disorders may avoid situations that trigger or worsen their symptoms and are also likely to experience depression. In addition, these individuals may abuse alcohol or other substance to try to relieve symptoms, potentially resulting in reduced job or school performance and negative effects on personal relationships. The following paragraphs will present brief overviews of the types of anxiety disorders most commonly experienced by African Americans.
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is diagnosed when a person worries excessively about a variety of everyday problems—eg, health issues, money, family problems, chores or appointments, or difficulties at work—for ≥ 6 months. [Kendler 1992] Although they usually realize that their anxiety is more intense than the situation warrants, GAD patients cannot escape from their concerns, worry constantly, startle easily, and experience difficulty concentrating. Patients often report difficulty falling asleep or staying asleep and physical symptoms that may include fatigue, headaches, muscle tension and aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, breathlessness, and hot flashes. [NIMH Anxiety Disorders]
GAD affects about 6.8 million American adults, [Kessler 2005] including twice as many women as men. [Robins 1991] The disorder develops gradually and can begin at any age, although the highest risk comes between childhood and middle age. [Robins 1991] Some evidence indicates that genes play a modest role in the development of GAD. [Kendler 1992]
GAD seldom occurs alone and is often accompanied by other anxiety disorders, depression, or substance abuse. [Robins 1991, Regier 1998] The most common treatments for GAD are pharmacotherapy and/or cognitive-behavioral therapy (CBT). However, practitioners should also be prepared to prescribe appropriate treatment for any concurrent conditions.