To be human is to worry -- about finances, your
children's health, work, even whether you remembered
to unplug the iron when you go on vacation.
But if you find that worry seems to consume your
life, that you barely finish ruminating about one
thing before something else begins to trouble you,
even to the point of feeling physically ill, you
may suffer from the often-undiagnosed but treatable
illness called General Anxiety Disorder (GAD).
"It's normal to worry about things,"
said Dr. Boadie Dunlop, an assistant professor of
psychiatry at Emory University's School of Medicine
in Atlanta, who works with patients suffering from
GAD.
"People with GAD, however, are chronically
concerned about future events. They feel powerless
in the face of the worry," he said. And, their
distress is often accompanied by physical symptoms,
like muscle tension, a racing heart, sweating and
trembling, he added.
Unfortunately, because everyone worries to some
degree, people with GAD sometimes don't recognize
they're struggling with a treatable illness, said
Dr. Eric Hollander, director of the Compulsive,
Impulsive and Anxiety Disorders Program at Mount
Sinai School of Medicine in New York City.
The result, he said, "is that their problems
often can go undetected for many years."
GAD affects approximately 5 percent of the U.S.
population, with more women than men diagnosed with
the ailment -- perhaps because they're more likely
to seek help, Hollander said.
A common obstacle to timely GAD diagnosis, said
Dunlop, is that a sufferer is reluctant to talk
to a doctor about it.
"People with GAD are known to go to the doctor
more frequently, but they report medical problems,"
he said, often ailments such as stomach pains or
heart palpitations. So the doctor will look for
physical causes for the patient's discomfort, rather
than ask about anxiety.
However, most primary care physicians know about
GAD, so patients can get the help they need, Dunlop
said. "If a patient is able to express his
concerns, the doctor will pay attention," he
said.
Teasing out a diagnosis of GAD can be tricky, both
doctors said, because you always have to evaluate
a patient for physical problems first, including
potential difficulty with the heart, blood sugar
and thyroid. Also, anxiety can be part of other
ailments as well.
"Frequently anxiety disorders can accompany
other things, like depression," said Hollander,
who is also the author of Coping with Social
Anxiety: A Guide to Effective Treatment Options.
Social anxiety disorder is another potentially crippling
ailment that inhibits people from normal social
interaction.
But with the proper diagnosis, he said, doctors
can help patients significantly reduce their GAD
symptoms by either drug therapy, psychotherapy or
both.
"Many people with mild-to-moderate illness
are treated with drugs and do well," Dunlop
said.
Selective serotonin re-uptake inhibitor antidepressants
(SSRIs) like Zoloft and Paxil are commonly prescribed,
although relapse rates are high for GAD if people
stop taking them, he said.
Cognitive behavior therapy, often in conjunction
with SSRIs, is another treatment option, enabling
patients to learn to control their anxiety, Hollander
said.
The best news for GAD sufferers, and those who
have other anxiety disorders, is the increased understanding
that anxiety is rooted in a physiological, rather
than a psychological, condition. The brain, like
the other organs of the body, sometimes malfunctions,
and excessive anxiety can result, Dunlop said.
"The biggest single thing [for GAD sufferers]
is the reduction of stigma in society about anxiety,"
he said. "People don't feel stigmatized by
others and that enables them to seek help."