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Managing worry in generalized anxiety disorder

February 17, 2016


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March 3, 2016

Sir iam suffering from anxiety. And worried for simple reasons. I dont get sleep properly .and my body gets heated .and acidity gastric. Acid reflexses .chest infection .chest pain like heart attack. When consalted cordialogist they done angogram and told me there is a mid myocordial bridge in left arteries. Again and I visited doctor. He suggested to consult psychiatric .my psychiatric doctor has given tables. 1, Duvanta 40mg 1-0-1,2 Etilam 0.5mg 1-0-1,3 Felicita-OD 0-1-0, 4 Petril 0.5mg .do I should take medicine for lifelong .is there is any side effect by taking this medicine.

Srini Pillay
March 3, 2016

I am sorry to hear of the medical challenges you are experiencing, but encouraged to hear that you have sought medical help.

I am afraid that I cannot provide formal medical advice here as I do not have access to your full history and the site is meant to be informational.

That said, I am also not familiar with the specific formulations of medication you mention as they are not marketed by those names in the US.

Some general thoughts for our next discussion with your doctor:
1. Always get clarification from your doctor. Get clarification on why each medication was prescribed for you and how they might interact with one another. Also discuss alternatives.
2. Have him/her explain the side effects of each medication, especially those that could affect heart health or symptoms.
3. It would also help to get clarification on any other things you can do to help your heart health/symptoms
4. Ideally see if your cardiologist and psychiatrist could talk to each other to help optimize your care

Hope this is helpful in your starting a helpful conversation with your doctor. Thanks for being a part of the “Harvard Health Publishing” community.

carol beene
February 24, 2016

I am guessing that a narcissistic person would never have an anxiety attack because they have no emotions and don’t care! That would explain why my husband lacks empathy and shows no concern when I have an attack! Am I correct?

Rhonda Walker
February 23, 2016

Thank you for presenting the research in a way wherein we can understand and apply beneficial techniques immediately!

Dr Premilla Devi Naidoo FCP(SA)
February 22, 2016

Dear Srini
Thanks for a very insightful article. I used to be a worry-wort but have since learned to live in the present.
A quote from a religious magazine
” Yesterday is history
Tomorrow is a mystery
Today is a gift- therefore it is called the present”

Once again Thank you
Dr Prem Naidoo

Srini Pillay
February 18, 2016

Joanne—Thanks so much for your comment. Just to clarify, I don’t think that worrying is good for you. This study that I reported on found that beneath the clearly disruptive and very difficult symptom of worry in GAD, is the unconscious psychology of worrying, making people feel worse, and therefore “protected” against huge negative swings when something goes wrong. In essence, this is not protective, but there is an unconscious fear of large negative swings that is even greater than the problems related to worry. Of course, more studies would need to be done to replicate this. I definitely don’t underestimate GAD because I have seen how many people suffer terribly from it. That said, CBT is controversial because several studies have found it to be ineffective. I would suggest speaking to your/a therapist to see if other forms of therapy e.g ACT (Acceptance and Commitment Therapy)—there are a few others—might be helpful. So just to reiterate, I do not feel that worry makes you stronger or is better. I was simply reporting on a study that shows why it is so problematic and difficult to control. Hope that clears things up. Thanks again for expressing what I know many will resonate with. We are increasingly finding out what helps worry, so I am optimistic that certain therapies be helpful.

Joanne Brown
February 18, 2016

Thank you so much for taking the trouble to reply. What you have said is truly appreciated. I like your suggestions – I will try anything.

Joanne Brown
February 18, 2016

The physical and mental pain experienced with this disorder can be extreme. It is for me. I don’t want this. Worrying may be “good” for a person but not to the extent where simply giving up on life is periodically considered as an option as (for myself) it becomes exhausting continually applying CBT (which I do) and managing the physical symptons (head feels like it is in a vice, muscle pain and extreme sensitivity). Please don’t underestimate it. I am 52 years old and have battled to manage this most of my life. The phrase “what doesn’t kill makes you stronger” doesn’t apply. Over time one is worn down. I spent 2 years in therapy (bi-weekly), learning to manage this. I have ADHD which exaccerbates it and in today’s world of information overload it is very difficult. I have been very successful in my life as I am an “overachiever” and have great mental strength and thus I have always persevered. Underlying guilt and fear is unfortunately the major driving force. I don’t want this. Thus the therapy. But sometimes I feel that it is gradually killing me as. If you told a person who gets migraines that they can be good for them they would probably punch you in the nose! That’s how I feel. I believe GAD eventually can lead to chronic fatigue and ultimately a breakdown in functioning. your article simply doesn’t come close to communicating the pain that this condition causes.

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