Generalized Anxiety Disorder

What Is It?

Generalized anxiety disorder is a mental illness that causes a person to have persistent, nagging feelings of worry or anxiety (apprehension or uneasiness triggered by a threatening situation). These feelings are either unusually intense, or out of proportion to the real troubles and dangers of the person's everyday life.

There is no clear dividing line between normal worry and generalized anxiety disorder. People with the disorder typically experience excessive, persistent worry every day or almost every day, for a period of six months or more. In some cases, a person with generalized anxiety disorder finds it hard to remember a time when he or she was not always worrying. This is especially true for adults whose illness started during childhood or adolescence. In other cases, the initial anxiety may be triggered by a crisis or a period of stress, such as a job loss, a family illness or the death of a relative. Although the crisis eventually goes away and the stress passes, an unexplained feeing of anxiety persists, sometimes for years.

In addition to suffering from nagging worries and anxieties, people with generalized anxiety disorder have a variety of physical and psychological symptoms that are related to their anxious feelings. The physical symptoms are so noticeable most people with generalized anxiety disorder first seek treatment with a primary-care doctor, cardiologist, pulmonary specialist or gastroenterologist. Stress also can intensify the anxiety or lead to a situation-specific phobia, such as fear of being near dogs, driving a car or attending a party. People with generalized anxiety disorder may have low self-esteem or may feel insecure, because they interpret people's intentions or events in negative, intimidating or critical ways.

Although the exact cause of generalized anxiety disorder remains a mystery, several studies involving close relatives of people with the illness show that there may be a genetic (inherited) tendency toward developing the problem. Doctors believe the disorder involves a disturbance in levels of certain chemicals that carry signals between brain cells. These chemicals are called neurotransmitters. Generalized anxiety disorder seems to involve the neurotransmitters gamma aminobutyric acid and serotonin. This disturbance in brain chemicals may be especially severe in certain areas of the brain:

• The limbic system, which deals with anxiety and other emotional states
• The basal ganglia, which filter messages involving the performance of body movements
• The frontal cortex, which is involved in judgment and planning

About 3 percent to 8 percent of people in the United States have generalized anxiety disorder. Women have the problem twice as often as men. The average adult patient first seeks medical attention, usually for physical symptoms, between the ages of 20 and 30. However, the illness can occur at any age. Generalized anxiety disorder also has been diagnosed in young children, teen-agers and elderly people. The illness is the most common anxiety disorder affecting people age 65 and older.