It is normal to feel worried or anxious before taking a big test, after losing your job, and during other stressful times in your life. But when intense feelings of anxiety, tension, or dread emerge in the face of ordinary problems or routine situations--and those feelings continue for six months or longer--you may be suffering from generalized anxiety disorder, or GAD. To the estimated 10 million Americans with GAD, the proverbial glass is almost always half-empty. They anticipate the worst even when there is every reason to expect the best.

Symptoms

In GAD, excessive worry is accompanied by at least three of the following physical symptoms in adults and at least one in children:

• Restlessness or feeling keyed up or edgy
• Becoming fatigued easily
• Having difficulty concentrating
• Irritability
• Muscle tension
• Sleep disturbance

Some GAD sufferers also report trembling, lightheadedness, breathlessness, headaches, having a constant lump in their throat, nausea, and frequent diarrhea. The severity of GAD symptoms can range from mild to severe. People with mild GAD can function fairly normally and don't tend to avoid certain situations people with panic disorder often do. People with moderate to severe GAD feel intensely keyed up all or most of the time. They startle easily and are unable to relax and enjoy themselves. It is not unusual for individuals with severe GAD to become clinically depressed.

The onset of GAD is insidious. It develops gradually, usually beginning in childhood or adolescence. GAD symptoms seem to subside naturally as a person ages.

Treatment

Many GAD patients have been treated successfully with the anti-anxiety medication buspirone. Researchers are investigating the effectiveness of other medications, such as benzodiazepines and antidepressants, as treatments for GAD. Cognitive-behavioral psychotherapy, relaxation techniques, and biofeedback to control muscle tension may also lessen or relieve GAD symptoms.