Anxiety: Normal or not?
“I always thought I was just a worrier... I’d worry about what I was going to fix for a dinner party, or what would be a great present for somebody. I just couldn’t let something go.”
How much worry is too much? People with generalized anxiety disorder (GAD) go through the day filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. If they get a stomachache, they worry that it’s an ulcer. Sometimes just the thought of getting through the day produces anxiety.
GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least six months. People with GAD can’t seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They can’t relax, startle easily, and have difficulty concentrating, even to read a newspaper or a novel. Often they have trouble falling asleep or staying asleep, and wake up feeling wired in the middle of the night. Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.
When their anxiety level is mild, people with GAD can function socially and hold down a job. Although they don’t avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe. GAD can cause people to miss time at work, provoking fears that they will lose their jobs.
GAD affects about 6.8 million American adults, including twice as many women as men. The disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age. There is evidence that genes play a modest role in GAD. GAD sometimes runs in families, but no one knows for sure why some people have it, while others don’t. Symptoms may get better or worse at different times, and often are worse during times of stress.
People with GAD may visit a doctor many times before they find out they have this disorder. They ask their doctors to help them with the signs of GAD, such as headaches or trouble falling asleep, but don’t always get the help they need right away. It may take doctors some time to be sure that a person has GAD instead of something else
The first step is to go to a doctor or health clinic to talk about symptoms. The doctor will do an exam to make sure that another physical problem isn’t causing the symptoms. The doctor may make a referral to a mental health specialist: a licensed social worker, psychologist, or psychiatrist. Cognitive-behavioral therapy can help people with GAD feel less anxious and fearful.
Your psychiatrist or medical doctor may prescribe a medication to help relieve GAD. It’s important to know that some of these medicines may take a few weeks to start working. The kinds of medicines used to treat GAD are antidepressants, anti-anxiety medicines, and beta blockers.
There is no cure for GAD yet, but treatments can give relief to people who have it and help them live a more normal life.
GAD is one in a family of Anxiety Disorders including Panic Disorder, Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder and specific phobias such as fear of flying. Together they affect about 40 million American adults age 18 years and older (about 18%) in a given year, causing them to be filled with fearfulness and uncertainty. Unlike the relatively mild, brief anxiety caused by a stressful event (such as speaking in public or a first date), anxiety disorders last at least six months and can get worse if they are not treated. Anxiety disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse. In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder.
Panic Disorder: Panic disorder is characterized by sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. People may flush or feel chilled; have tingling or numb hands; and experience nausea, chest pain, or smothering sensations causing them to believe they are having heart attacks, losing their minds, or on the verge of death. Panic attacks can become disabling and people should seek treatment before they begin avoiding places or situations where panic attacks have occurred. When the condition progresses this far, it is called agoraphobia, or fear of open spaces.
Obsessive-Compulsive Disorder: People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. People with OCD may have difficulty throwing things out and sometimes hoard unneeded items. People with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing.
Post-Traumatic Stress Disorder: Post-traumatic stress disorder (PTSD) develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers. People with PTSD may startle easily, become emotionally numb (especially in relation to people with whom they used to be close), lose interest in things they used to enjoy, have trouble feeling affectionate, be irritable, become more aggressive, or even become violent. Most people with PTSD repeatedly relive the trauma in flashbacks that intrude their thoughts during the day and in nightmares when they sleep.
Specific Phobias: A specific phobia is an intense, irrational fear of something that poses little or no actual danger. Some of the more common specific phobias are centered around closed-in places, heights, escalators, tunnels, highway driving, water, flying, dogs, and injuries involving blood. Such phobias aren’t just extreme fear; they are irrational fear of a particular thing. You may be able to ski the world’s tallest mountains with ease but be unable to go above the 5th floor of an office building. While adults with phobias realize that these fears are irrational, they often find that facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.
Copyright National Institute of Mental Health