What Is It?

In generalized anxiety disorder, a person has persistent, nagging feelings of worry or anxiety. These feelings are either unusually intense, or out of proportion to the real troubles and dangers of the person's everyday life.

The disorder is defined as persistent worry every day or almost every day, for six months or more. In some cases, a person with generalized anxiety disorder feels he or she has always been a worrier, even since childhood or adolescence. In other cases, the 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 may last months or years.

In addition to suffering from nagging worries and anxieties, people with generalized anxiety disorder can have physical and psychological symptoms. The physical symptoms may lead them to seek treatment from a primary care doctor, cardiologist, pulmonary specialist or gastroenterologist. Stress also can intensify the anxiety or lead to a phobia, such as a fear of 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.

The exact cause of generalized anxiety disorder remains a mystery, but some people have a genetic (inherited) tendency to develop the problem. The disorder probably stems from a disturbance in brain circuits that control the fear response. One of these structures is the amygdala, a structure deep in the brain that receives information about environmental threats, appraises their significance, and coordinates an effective response. Another part of the brain called the frontal cortex, which is responsible for judgment and planning, is also part of the anxiety response. The chemical messengers, gamma aminobutyric acid and serotonin, transmit signals along those circuits.