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Updated 30 June 2014

Just how anxious are you?

Generalised Anxiety Disorder is a serious illness. Here's what you need to know.

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Everybody knows what it's like to feel anxious – the butterflies in your stomach before a first date, the tension you feel when someone important to you is angry with you, the way your heart pounds if you're in danger.

Anxiety rouses you to action. It gears you up to face a threatening situation. It makes you study harder for an exam, and keeps you on your toes when you're making a speech. In general, it helps you cope.

But if you have an anxiety disorder, this normally helpful emotion can do just the opposite – it can keep you from coping and disrupt your daily life. Anxiety disorders aren't just a case of "nerves." They are illnesses, often related to the biological makeup and life experiences of the individual, and they frequently run in families.
 
There are several types of anxiety disorder, each with its own distinct features. An anxiety disorder may make you feel anxious most of the time, without any apparent reason. Or the anxious feelings may be so uncomfortable that to avoid them you may stop everyday activities. Or you may have occasional bouts of anxiety so intense they terrify and immobilise you.

Generalised Anxiety Disorder (GAD)
Many people have a single anxiety disorder. But it isn't unusual for an anxiety disorder to be accompanied by another illness, such as depression, an eating disorder, alcoholism, drug abuse, or another anxiety disorder. In such cases, these problems will need to be treated as well.

GAD is much more than normal day-to-day anxiety. It's chronic, exaggerated worry and tension. Having this disorder means always anticipating disaster and often worrying excessively about health, money, family or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting through the day may provoke anxiety.

People with GAD can't seem to shake their concerns, even though they usually realise their anxiety is more intense than the situation warrants. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, hot flushes, and feeling light-headed or breathless. They may feel nauseated or have to visit the bathroom frequently. Or they might feel as though they have a lump in the throat.

Symptoms of Generalised Anxiety Disorder
Generalised anxiety disorder (GAD) is characterised by excessive anxiety and worry. The person finds it difficult to control the worry and may feel tired, restless, irritable, have difficulties with sleep and/or concentration. As in the case of other anxiety disorders, GAD can be very debilitating, making it difficult to carry out ordinary daily activities.

Prevalence of GAD
GAD is more common in women than men and often occurs in relatives of affected persons.

Treatment of GAD
Successful treatment may include medication and psychotherapy. Certain antidepressants have been successful in helping people with this disorder. In some cases, other agents (e.g. benzodiazepines) are used. Also useful is cognitive-behavioural therapy.

Prevention
Early treatment can perhaps prevent the level of disability/dysfunction reached. Early treatment may help prevent the development of co-existing conditions such as depression and alcoholism.
Early treatment of panic disorder can often stop the progression to agoraphobia.

(Original article reviewed by Dr Soraya Seedat, MRC Unit on Anxiety and Stress Disorders)
 
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