When to worry about worrying

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There is no shortage of things to worry about --- from personal concerns about job security or health, to fears related to larger issues such as political conflicts or natural disasters. Temporary anxiety can be a healthy response to uncertainty and danger, but constant worry and nervousness may be a sign of generalized anxiety disorder.

Do I have generalized anxiety disorder?

You'll need your doctor's help to know for sure, but while other types of anxiety disorders arise from particular situations, generalized anxiety disorder is characterized by debilitating worry and agitation about nothing in particular, or anything at all.

People with generalized anxiety disorder tend to worry about everyday matters. They can't shake the feeling that something bad will happen and they will not be prepared. They may worry to excess about missing an appointment, losing a job, or having an accident. Some people even worry about worrying too much.

Get your copy of Coping with Anxiety and Stress Disorders

Everyone worries or gets scared sometimes. But if you feel extremely worried or afraid much of the time, or if you repeatedly feel panicky, you may have an anxiety disorder. Anxiety disorders are among the most common mental illnesses, affecting roughly 40 million American adults each year. This report discusses the latest and most effective treatment approaches, including cognitive behavioral therapies, psychotherapy, and medications. A special section delves into alternative treatments for anxiety, such as relaxation techniques, mindfulness meditation, and biofeedback.

Physical symptoms are common too, and can include a racing heart, dry mouth, upset stomach, muscle tension, sweating, trembling, and irritability. These bodily expressions of anxiety can have a negative effect on physical health. For example, people with generalized anxiety disorder are at greater risk for heart attack and other cardiovascular problems.

Taming anxiety

If you have generalized anxiety disorder, therapy — particularly cognitive behavioral therapy (CBT) — can help. CBT helps people recognize when they are misinterpreting events, exaggerating difficulties, or making unnecessarily pessimistic assumptions, and offers new ways to respond to anxiety-provoking situations.

For some people, medications can be an important part of treatment. Commonly prescribed drugs include antidepressants, such as selective serotonin reuptake inhibitors (like Prozac or Zoloft), or dual serotonin and norepinephrine reuptake inhibitors (like Effexor or Cymbalta). These drugs take longer to work than the traditional anti-anxiety drugs, but also may provide greater symptom relief over time.

Symptoms of generalized anxiety disorder Persistent, excessive worry about several different things for at least six months Fatigue, difficulty sleeping, or restlessness Trouble concentrating Irritability Muscle tension Feeling tense or "on edge" Only your doctor can determine whether you meet the criteria for generalized anxiety disorder. If you think you might have this condition, don't hesitate to talk to your primary care doctor. There are many different treatments that can ease the very real discomfort of this condition.

For more on diagnosing and treating anxiety and phobias, buy Coping with Anxiety and Stress Disorders, a Special Health Report from Harvard Medical School.