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February 8, 2014

When to worry about worrying

There is no shortage of things to worry about — from personal concerns about job security or health to fears related to larger issues such as political conflicts or natural disasters. Anxiety can be a healthy response to uncertainty and danger, but constant worry and nervousness may be a sign of generalized anxiety disorder.

Do I have generalized anxiety disorder?

You’ll need your doctor’s help to know for sure, but while other types of anxiety disorders — such as specific phobias or social anxiety disorder — arise from particular situations, generalized anxiety disorder is characterized chiefly by debilitating worry and agitation about nothing in particular, or anything at all.

People with generalized anxiety disorder tend to worry about everyday matters. They can’t shake the feeling that something bad will happen and they will not be prepared. They may worry to excess about missing an appointment, losing a job, or having an accident. Some people even worry about worrying too much.

Physical symptoms are common too, and can include a racing heart, dry mouth, upset stomach, muscle tension, sweating, trembling, and irritability. These bodily expressions of anxiety can have a negative effect on physical health. For example, people with generalized anxiety disorder are at greater risk for heart attack and other cardiovascular problems.

Taming anxiety

If you have generalized anxiety disorder, therapy — particularly cognitive behavioral therapy (CBT) — can help. CBT helps people recognize when they are misinterpreting events, exaggerating difficulties, and making unnecessarily pessimistic assumptions. This form of therapy helps generalized anxiety disorder sufferers learn new ways to respond to anxiety-provoking situations.

For some individuals, medications can be an important part of treatment. Commonly prescribed drugs include antidepressants, such as selective serotonin reuptake inhibitors (like Prozac or Zoloft), or dual serotonin and norepinephrine reuptake inhibitors (like Effexor or Cymbalta). These drugs take longer to work than the traditional anti-anxiety drugs but also may provide greater symptom relief over time.

Symptoms of generalized anxiety disorder

Generalized anxiety disorder is characterized by excessive anxiety and worry that is difficult to control and causes serious distress or interferes with daily activities. For at least six months, these symptoms occur on more days each week than they don't occur, along with at least three of the following:

  • restlessness or feeling on edge
  • tiring easily
  • difficulty concentrating
  • irritability
  • muscle tension
  • sleep problems.

Only your doctor can determine whether you meet the criteria for generalized anxiety disorder. If you think you might have this condition, don’t hesitate to talk to your primary care doctor. There are a range of treatments that can ease the very real discomfort of this condition.

Adapted from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).

For more on diagnosing and treating anxiety and phobia disorders, buy Coping with Anxiety and Phobias, a Special Health Report from Harvard Medical School.

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