Fear and stress reactions are essential for human survival. They enable people to pursue important goals and to respond appropriately to danger. In a healthy individual, the stress response (fight or flight) is provoked by a genuine threat or challenge and is used as a spur for appropriate action.
An anxiety disorder, however, involves an excessive or inappropriate state of arousal characterized by feelings of apprehension, uncertainty, or fear. The word is derived from the Latin, angere, which means to choke or strangle. The anxiety response is often not triggered by a real threat. Nevertheless it can still paralyze the individual into inaction or withdrawal. An anxiety disorder persists, while an appropriate response to a threat resolves, once the threat is removed.
Anxiety disorders are classified according to the severity and duration of their symptoms and specific behavioral characteristics. Types of anxiety disorders include:
- Generalized anxiety disorder (GAD)
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Separation anxiety disorder (which is almost always seen in children)
GAD and panic disorder are the most common. Anxiety disorders are usually caused by a combination of psychological, physical, and genetic factors, and treatment is, in general, very effective.
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is the most common anxiety disorder. It affects about 5% of Americans over the course of their lifetimes. It is characterized by:
- A more-or-less constant state of worry and anxiety, which is out of proportion to the level of actual stress or threat in one's life.
- This state occurs on most days for more than 6 months despite the lack of an obvious or specific stressor. (It worsens with stress, however.)
- It is very difficult to control worry. For a clear diagnosis of GAD, the specific worries should be differentiated from those that would define other anxiety disorders, such as fear of panic attacks or appearing in public. Moreover, they are not obsessive such as those that occur with obsessive-compulsive disorder.
- Patients with GAD may experience physical symptoms (such as gastrointestinal complaints) in addition to, or even in place of, mental worries.
- People with GAD tend to be unsure of themselves, overly perfectionist, and conforming.
Given these conditions, a diagnosis of GAD is confirmed if three or more of the following symptoms are present (only one for children) on most days for 6 months:
Review Date: 01/27/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.