GAD101
What are three psychological or physiological symptoms commonly associated with GAD?
Any of the following:
Excessive concern, restlessness, difficulty sleeping, tiredness, irritability, sweating, trembling, tachycardia and palpitations
A patient with GAD says, “I feel really worried and on edge right now.” Which MSE domain does the patient's description primarily relate to?
Mood — the patient's subjective description of their emotional state.
Name a first-line medication class commonly prescribed for GAD.
SSRIs
What's one simple way to make your voice and body language less threatening when approaching a patient in acute anxiety distress?
Any one of: crouch/sit to their level, keep a calm even tone, avoid sudden movements, give them physical space, introduce yourself and explain what you're doing before you do it.
"People with GAD are just worriers who could snap out of it if they tried harder."
Myth
Per DSM-5, how long must symptoms of GAD, such as persistant and excessive worry, be present for a clinical diagnosis?
At least 6 months
Name three potential changes in vital signs for an acute anxiety presentation
Increased RR, increased HR and increased BP
What serious drug interaction should paramedics keep in mind for a patient on an SSRI or SNRI who has also taken another serotonergic substance?
Serotonin syndrome
Name three pieces of information that should be included in your handover for a patient presenting with acute GAD symptoms.
Any three of: history of GAD, current symptoms and vital signs, medications, precipitating factors/triggers, mental state findings, any risk issues, interventions already given.
"Anxiety disorders as a group are the most common category of mental illness."
Fact
What is the key difference between the worry associated with GAD and the fear experienced during a specific phobia?
GAD involves excessive, difficult-to-control worry across multiple areas of life, whereas a specific phobia involves intense fear or anxiety triggered by a particular object or situation.
You attend a 29-year-old patient with GAD who reports feeling extremely anxious. Their observations are: HR 118 bpm, RR 24/min, BP 150/88 mmHg, SpO₂ 99%. During your MSE, they appear restless, speak rapidly and repeatedly state, “Something terrible is going to happen.” They are alert and orientated.
Which findings could be explained by acute anxiety, and why might you consider causes other than GAD before deciding this is an anxiety-related presentation?
Potentially consistent with acute anxiety:
All findings are non specific and could be explained by other conditions, substances or problems
A patient on long-term benzodiazepines has missed several doses. What withdrawal symptoms might paramedics see?
anxiety, tremor, tachycardia, sweating, and in severe cases seizures.
Name two ongoing support or recovery services paramedics might mention or refer a GAD patient toward.
Any two of: GP for review/referral, psychologist or CBT-based therapy, Lifeline or Beyond Blue, local community mental health services.
"Someone with GAD can still be high-functioning, including in demanding jobs."
Fact