Feeling anxious is normal. However, a continuing problem with anxiety is called generalized anxiety disorder (GAD). People with GAD feel tense and worried much of the time, and some always feel this way.
GAD is fairly common, often occurring before age 18. It affects more women than men and seems more common in some families.
Certain medical conditions, such as colitis, asthma, hypertension, heart disease, ulcers, and headaches, are highly related to anxiety.
People stressed at work or at home can have anxiety. GAD is also more likely in people who expect things to be perfect, are tired or overwhelmed, had stressful or harmful experiences, have a medical illness, are withdrawing from alcohol or drugs, or were abused as children.
Some people have panic attacks (extreme anxiety in certain situations) or phobias (anxiety caused by fears, such as of heights, or social situations, such as public speaking).
People with GAD feel tense and worried. Other symptoms include restlessness, tiredness, difficulty concentrating, irritability, muscle tension, trouble sleeping, shakiness, headaches, pounding heart, shortness of breath, excessive sweating, and depression. These interfere with daily life.
The health care provider makes the diagnosis after doing an examination and checking symptoms. The health care provider may order blood tests or other tests to make sure another illness such as overactive thyroid isn’t causing symptoms. People diagnosed with GAD have had tension and worry most days for at least 6 months, and they cannot control worrying even when reassured by others.
Forms of anxiety in addition to GAD, panic attacks, and phobias include obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, anxiety caused by legal drugs (e.g., caffeine) or drugs of abuse (e.g., amphetamines, cocaine), and anxiety caused by medical conditions and medicines.
The health care provider tries to find out, by taking a medical history, whether a medical condition or substance abuse is the cause. Drugs producing anxiety include corticosteroids (e.g., prednisone), antidepressants (e.g., fluoxetine), inhalers, thyroid medicine, diet pills, and over-the-counter medicines (e.g., antihistamines, cough and cold medicines). Too much caffeine can worsen anxiety.
Medicine to help symptoms include benzodiazepines, such as alprazolam, lorazepam, and clonazepam, and other anti-anxiety medications, such as buspirone. They do have side effects and can be habit forming. Some antidepressants such as paroxetine, sertraline, and venlafaxine are also effective and frequently used for anxiety disorders.
Talk therapy (psychotherapy) and other methods to reduce stress and muscle tension (biofeedback, relaxation) may help symptoms. Regular exercise, such as walking and swimming, can reduce stress and tension.
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