UNIT I.B: SITUATION OF A COMMUNITY OF ARMY WIVES I. A.

Generalized Anxiety Disorder Symptoms Generalized anxiety disorder (or GAD) is characterized by excessive, exaggerated anxiety and worry about everyday life events with no obvious reasons for worry. People with symptoms of generalized anxiety disorder tend to always expect disaster and can't stop worrying about health, money, family, work, or school. In people with GAD, the worry often is unrealistic or out of proportion for the situation. Daily life becomes a constant state of worry, fear, and dread. Eventually, the anxiety so dominates the person's thinking that it interferes with daily functioning, including work, school, social activities, and relationships. GAD is diagnosed if symptoms are present for more days than not during a period of at least six months. The symptoms also must interfere with daily living, such as causing you to miss work or school. GAD affects the way a person thinks, but the anxiety can lead to physical symptoms, as well. Symptoms of GAD can include:

chemistry and environmental stresses -appear to contribute to its development.

Genetics Brain chemistry: GAD has been associated with abnormal levels of certain neurotransmitters in the brain. Environmental factors: Trauma and stressful events, such as abuse, the death of a loved one, divorce, changing jobs or schools, may lead to GAD. GAD also may become worse during periods of stress. The use of and withdrawal from addictive substances, including alcohol, caffeine, and nicotine, can also worsen anxiety.

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Treatment and Management Medication - The medications most often used to treat GAD in the short-term are benzodiazepines. They work by decreasing the physical symptoms of GAD, such as muscle tension and restlessness. Common benzodiazepines include Xanax, Librium, Valium and Ativan. Antidepressants, such as Paxil, Effexor, Prozac, Lexapro, and Zoloft, are also being used to treat GAD. These antidepressants may take a few weeks to start working but they're more appropriate for longterm treatment of GAD. Cognitive-behavioral therapy - People suffering from anxiety disorders often participate in this type of therapy, in which you learn to recognize and change thought patterns and behaviors that lead to anxious feelings. This type of therapy helps limit distorted thinking by looking at worries more realistically. In addition, relaxation techniques, such as deep breathing and biofeedback, may help to control the muscle tension that often accompanies GAD. FROM MISS LANGUIDO:

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Excessive, ongoing worry and tension An unrealistic view of problems Restlessness or a feeling of being "edgy" Irritability Muscle tension Headaches Sweating Difficulty concentrating Nausea The need to go to the bathroom frequently Tiredness Trouble falling or stayingasleep Trembling Being easily startled

Causes The exact cause of GAD is not fully known, but a number of factors -- including genetics, brain

Escitalopram - SSRI; used for depression, GAD, panic disorder and OCD Paroxetine SSRI; used for depression, GAD, PTSD, premenstrual dysmorphic disorder and social anxiety disorder Propranolol beta blocker; ease some of the physical symptoms such as trembling, but do not affect the mental symptoms such as worry. Clonidine (Catapres) central alpha agonist; for GAD

II. A.

Army Wives Phases of Deployment PRE-DEPLOYMENT is the phase from the time of notification of deployment to the actual departure of the service member. It is often a time of psychological denial of the event, intense preparation, and anticipation of the departure. DEPLOYMENT is the phase from the time of departure through the first month of deployment. It can be a time of significant emotional turmoil as the family tries to regain its equilibrium after the departure of a parent. Feelings can include numbness, sadness, and feelings of isolation or abandonment. Many of the day-to-day responsibilities of the absent parent need to be absorbed by the remaining members of the family and a new balance is established. Communication from the deployed service member upon arrival can be tremendously reassuring. Any unrealistic worries that preoccupied family members in the pre-deployment phase are reduced as they develop a more realistic appreciation of the deployment. SUSTAINMENT is the phase that spans from one month post deployment to one month prior to return. In most adaptive families it is marked by settling into the new routine and going on about regular business, utilizing whatever resources either within or outside of the family are available. Should a family not be able to return to business-asusual, this could impact negatively on the development of children within the family. Conflict between the service member and the remaining spouse can result in emotional turmoil, particularly because communication may not allow full resolution of all disagreements. RE-DEPLOYMENT is the phase that spans from one-month prior to return to the actual physical return of the service member to the family. This is a period of intense anticipation, with conflicting emotions and possibly some anxiety along with excitement.

POST-DEPLOYMENT is the phase that begins with the return of the service member and ends with the reestablishment of family equilibrium. Generally, this period may take from one to several months. The homecoming can be a time of great excitement and jubilation. But, it also can result in frustration and feeling let down due to unmet unrealistic fantasies about the reunion. Service members may become frustrated in finding that the family has moved on in their absence and that changes have been made in family functioning that they were not involved in. The parent who remained behind during the deployment may experience a loss of independence with the return of the spouse who begins to re-exercise autonomy. Marital couples may require time to reestablish physical and emotional intimacy, which can lead to a sense of disappointment or disillusionment. Ultimately, it is important that the deployed service member reasserts his or her role within the family and again reestablishes a healthy equilibrium. Most families and children manage successfully during deployments, despite inherent challenges.

Studies have shown that knowledge and use of Military support assets, keeping oneself informed, and getting regular information from the spouse who is serving can help the Military spouse cope more effectively with the deployment. Attendance in a faith community has also been shown to help spouses and families cope. Friendships and strong marriages, especially during and after the deployment, have been shown to be extremely important to the mental health of the spouse.

Sample Activity Calendar for Army Wives