Categorized | Anxiety, Stress Disorders

Living With Chronic Worry? You May Have a Generalized Anxiety Disorder

We all feel anxiety when we perceive there is a real threat to our safety, security and welfare.  For example, you worry that your child’s drug use may get him in trouble with the law. Or, for example, you worry that you are at risk for future health problems because of your smoking habit. These fears and worries may actually pose a real threat to you, at some future time. Thus, some anxiety is adaptive; it protects and warns you of possible danger and stimulates a fight-or-flight response in you, until you find a way to resolve the threat. Once you do, your anxiety about the problem ends.

But, there are people whose physical makeup predisposes them to chronic anxiety. They worry about everything, no matter how unreal the perceived threat seems to be. They have a Generalized Anxiety Disorder (GAD). But, their anxiety is in no way typical or adaptive. Their anxiety causes them significant distress and impairment throughout their daily life. They continually worry and anticipate bad things happening to them that can range from missing work deadlines to dying in a natural disaster. Their worries and fears make them ever more stuck in a vicious cycle of never-ending worry and anxiety.

People with GAD may seem neurotic, high-strung, and perfectionistic, because of their excessive worry and high need for control. Thus, it is easy to see people with GAD as having personality disorders that often have anxiety as a feature, like obsessive-compulsive disorder.  Also, people with GAD develop maladaptive ways to deal with their anxiety that make them seem neurotic and high strung. Nonetheless, GAD is a distinct syndrome that stems from  dysfunction in the parts of the brain that deal with fear, emotion and memory.

Researchers have known that the amygdala, a pair of almond-sized bundles of nerve fibers in the middle of the brain that help process emotion, memory and fear, are involved in anxiety disorders like GAD. But, until this new study that was conducted by researchers at Stanford University’s School of Medicine, researchers had not been able to peer closely at the nerve pathways that go to and from the subsections of this tiny brain area to other parts of the brain. They found scrambled connections between the parts of the brain that processes fear and emotion and the other brain regions (  Scrambled connections trigger anxiety, even when there’s no threat. Moreover, they found that by stimulating a distinct brain circuit in the amygdala, it counters rather than triggers anxiety and enhanced animals’ willingness to take risks (Amygdala circuitry mediating reversible and bidirectional control of anxiety). This discovery could lead to new treatments for anxiety disorders that deal specifically with the circuits in the amygdala. Until then, however, the mental health field has a range of treatments for anxiety that are very effective.

Treatment of GAD


The quickest way to reduce your anxiety is through medication. Today, the anti-anxiety medications work quickly, but, like most medications, they are not without side-effects. If you are going to seek treatment for your anxiety, you should know what the research says about medication versus psychotherapy for disorders of anxiety and depression. The research shows that medication and psychotherapy together work better than either treatment alone. Medication reduces your symptoms and permits new learning, because it lowers anxiety enough for you to take risks and implement healthier coping strategies.

The Selective Serotonin Reuptake Inhibitors (SSRIs) are usually psychiatrists’ first choice for treatment of anxiety, even though they are typically used as anti-depressants. This is because they are non-addictive and thus safer than traditional anti-anxiety medications (benzodiazepines). For optimal functioning, the mood stabilizing nerve chemical, serotonin, maintains a certain level within our nervous system and brain. Too much or too little causes brain dysfunction. In states of depression and anxiety, serotonin levels are often low. The SSRIs permit serotonin to circulate at higher levels in the nervous system and brain, which alleviates anxiety and depression and stabilizes mood.  The typical SSRIs used to treat anxiety are Lexapro and Paxil.

The Benzodiazepines include the well-known drugs Valium (diazepam), Xanax (alprazolam), Klonopin (clonazepam), and Ativan (lorazepam). They are no longer considered a first-line of treatment because, although they reduce anxiety quickly, they are addictive. Non-psychiatrists often treat anxiety with this class of drugs, but they are not trained to distinguish between the various psychiatric disorders. I would think very carefully, before you begin treatment with this class of medication. It’s the type of medication that requires you to continue taking more of it to alleviate your symptoms. Thus, developing an addiction is a risk with the benzodiazepines.

Buspar is another anti-anxiety medication that is neither an SSRI or benzodiazepine. However, like the SSRIs, it leaves more of the nerve chemical serotonin circulating in the body to alleviate anxious symptoms. But, unlike the SSRIs, buspar has little to no affect on sexual desire.


Anxiety is physiological. But, it can be lessened or worsened by the ways you cope with it. Thus, psychotherapy for anxiety disorders is very helpful, especially the psychotherapies that emphasize symptom management, like cognitive-behavioral therapy, mindfulness, and the stress-management therapies. Importantly, these therapies teach you ways to calm your brain and body, counter the irrational ideas that lead to excessive fear and worry, and learn better coping behaviors. If you’ve lived with anxiety for long, you have most likely reduced your world, to control some of your anxiety. A trained mental health professional can help you to replace the unhealthy ways that you’ve been controlling your fears and worries with behaviors that reduce your anxiety and open you to new experiences and learning.

Self-Care (Diet and Exercise)

Drink and food choice can trigger anxiety symptoms. Eating nutrient-deficient foods, not getting enough carbohydrates, protein or fat in your diet, or not eating enough can fluctuate blood-sugar levels that trigger anxiety. In particular, however, the omega-three fatty acids have been shown to be quite helpful in treating depression. More recently researchers have studied the relationship between the omega-three fatty acids and anxiety symptoms in substance abusers, as anxiety is a major cause of relapse from drug abstinence. They found that when these patients were given a high dose of omega 3 fatty acids (greater than 2 grams per day), there was a statistically significant reduction in anxiety compared to those receiving a placebo supplement. Moreover, the degree of the anxiety reduced was highly correlated to the decrease of the ratio of anti-inflammatory hormones to omega 3 fatty acids in the blood. It seems that the omega three fatty acids lower inflammation that has a positive effect on anxiety. Patients were able to handle stress better and had significant improvements in mood (Anxiety and Omega-Three Fatty Acids).

Exercise, when added to a program of cognitive-behavior therapy for the anxiety disorders, gives additional health benefits, and also extends the positive effects of psychotherapy treatment. Some studies have found that exercise  provides almost the same benefit as treatment with a medication. Researchers recommend exercise in the range of 30-40 minutes, three times per week, for anxiety reduction (; Exercise and Mood). If you have interest, Authors Otto and Smit give you exercise strategies for managing your anxiety (Exercise Strategies,

Do You Have A Generalized Anxiety Disorder?

The questions that follow meet the diagnostic criteria for a Generalized Anxiety Disorder (Diagnostic and Statistical Manual of Mental Disorders 4th Ed.; Washington DC: American Psychiatric Association, 2000). You may want to answer these questions, if you think you have a generalized anxiety disorder.

  1. Do you worry and are you fearful much of the time?
  2. Do you feel anxious, wound up, tense and restless, easily fatigued and worn-out, or have concentration and attention problems, or difficulty staying or falling sleeping ?
  3. If you answered “yes” to either question 1 or 2, have the symptoms been present most days over the past six months?
  4. Do you anticipate impending doom, even when there’s little basis to your fears?
  5. Do you struggle to regain control, or relax, or cope with your symptoms, but to no avail?
  6. Are your symptoms unrelated to another mental disorder?
  7. Do your symptoms cause you significant distress or problems functioning in your relationships, job, and other areas of your life, and these symptoms are not due to a substance or medical issue?
  8. Can you trace your anxiety symptoms back to your childhood?

If you answered yes to most of these questions, it’s best to get a Psychiatrist or Psychologist to help with diagnosing your symptoms. Anxiety is a symptom of many psychiatric and medical disorders. General medical practitioners and physician assistants do diagnose and treat anxiety conditions. But, they have not been trained to rule out the various addiction and personality disorders that have anxiety as a feature of the main problem, rather than the problem itself. So many times people are put on the wrong medications, because they went to a professional who did not accurately diagnose the problem. This adds to their anxiety and discomfort, as now they have to be weaned off the wrong medication, which takes time.

Remember, no two patients are alike. The reasons why one medication benefits one and harms another can vary greatly. When it comes to psychiatric disorders, only a licensed mental health professional has the education and training to diagnose and recommend appropriate treatments. And, when it comes to disorders that may be a result of an addiction or a serious medical condition, making the diagnosis requires sufficient education and training to make more subtle diagnostic distinctions as is necessary to many disorders, like GAD. Only the highest educated and trained of the mental health professionals, like a licensed Psychiatrist or Clinical Psychologist has this background.

I hope the information that I provide here today is helpful to you. I developed Psychology in Everyday Life to show you the many ways that psychology plays out in our daily lives, and also to make you an informed consumer of psychological services and treatments. The more you know about psychological conditions and options in treatments, the greater power you have over your psychological well being and health. After all, it’s your life. You should work in a collaborative fashion with your medical and mental health providers. The only way that you can do this is by becoming an informed consumer to the best of your ability.

If you found this post helpful, please say so by selecting the Like icon that immediately follows. Have a calm, peaceful and fear-free day. Warmly Deborah.


27 Responses to “Living With Chronic Worry? You May Have a Generalized Anxiety Disorder”

  1. avatar Adriana Hubert says:

    The story of my life right now:( Maybe, once I’m done with school my GAD/PTSD will leave?

    • avatar Dr. Deborah Khoshaba says:

      Hi Adriana, thank you for your comment. If your anxiety is a true generalized anxiety disorder then it most likely began before school and will persist beyond it, as GAD is unrelated to a specific stressor. but, it is true that GAD symptoms worsen with stress. so, if you have GAD, it certainly could be made worse by the stressor of going to school. Going to school, especially college and graduate school where the expectations are high, is a high stressor. You are right, it can produce a lot of anxiety for students because of the high expectations, lessened sleep, and tendency to decrease in self-care. So, take care of yourself physically. This will go a long way toward helping to manage your anxiety during this stressful, challenging, but exciting time. Congratulations on your efforts. Warm regards, Deborah.

  2. avatar Persi says:

    Hi Debbie: in addition to diet and exercise, as part of self-care, I think a person who has GAD should avoid those habits that worsen the GAD symptoms. For example, if watching certain TV programs worsens GAD symptoms, they should be avoided. The same goes with smoking and drinking alcoholic beverages.

    • avatar Dr. Deborah Khoshaba says:

      Such a good point Persi. While television programs that are high in aggressive and action can raise anxiety levels–anything that stimulates a person’s fear can arouse the system. The same is true for smoking and drinking alcoholic beverages or caffeinated drinks. Thank you for your great points and for stopping by to read my articles. Warmly, Deborah.

  3. avatar shahsawar khan says:

    hi Debora i was smoked a weedy cigeret then i think i m n GAD the doctor said since from one and a half year.
    i used the related drugs i,e esitalopram peroxit and benzodiazipines i was ok until i was leavd it.
    but now i m always like a drunker a blurred vision like fear of memory loss and so on
    so can u help me

    • avatar Dr. Deborah Khoshaba says:

      Hello, there is a site that will help you to track and monitor your anxiety. It is Have you seen this site? Please take a look at it, if you have not.

      But, let me also say that the combination of marijuana smoking and anti anxiety medications can make you feel demotivated and out of it, like you are drunk. Memory loss on psychiatric medications is only temporary. And, it is not true loss of memory. It is rather than some psychiatric drugs can make it more difficult to retrieve information that is stored in your memory. But, it is still there. It doesn’t go away. So, don’t worry about this. But, I think if you do some behavioral training to relax your body, you will gain more control over your anxiety. This may help you to reduce eventually the amount of psychiatric medication that you have to take. I hope this helps you Shahsawar. Warmly Deborah.

      • avatar shahsawar khan says:

        i m soo thanx to u Dr.Debora that u telling me the ways and i m not seen this site yet and also not doing some behavioral training.
        and i m not taking marijwana smoking now fro one year and not taking anti anxiety medication approxi from 3 mounth.
        now can i meet any doctors please suggest for me any who can do it.and please let me give ur email that i gain more help.
        thanx Dr Deborah for helpsss

    • avatar Mian Sabahatullah says:

      Dear Shahsawar khan continue the treatment recommended by Dr. Deborah but we all must have to care about our religious activities…. Do we offer all those activities properly or NOT??? if not then it is the main reason for GAD because Anxiety has a strong connection with religion especially for those who takes it seriously…. We all have a strong belief that Allah is the imposer of every kind of situation (State) but at the same time if we disobey Allah’s will like (stop offering our prayers, committing illegal sexual activities, late marriages, wrong use of tong, showing no respect to parents brothers and sister or other fellows) then the Panic starts… and this is the initial point where we are subjected to the depression, hopelessness from Allah’s side…. and we start thinking that due to my crimes, Allah will never help me hence we enters in a stat of hopelessness and it leads us to different kind of psychological problems when often lead us to another serious crime and that is Suicide.. May Allah Make us to Detect and feel his Mercy upon us. Ameen

      • avatar Dr. Deborah Khoshaba says:

        Hello Mian, I agree faith is very helpful to our mental and physical well being–giving us faith, courage and guidance to cope with our lives. But also God gives us the ability to help ourselves and to understand how to do this. Thank you Mian. Warm regards Deborah.

      • avatar shah sawar khan says:

        dear Mian SabahatullAH thanks for giving me the priceless principles,,treats,,of life and how to overcome it
        u told me the real real treats of my life i will try to obey,,,,thanks

        • avatar Dr. Deborah Khoshaba says:

          Thank you so much. I am pleased that this article contained very helpful things for you. I’m glad to see you here and that you are following my blog. Look forward to your comments again. Warm regards to you and yours Deborah.

  4. avatar shahsawar khan says:

    i m soo thanx to u Dr.Debora that u telling me the ways and i m not seen this site yet and also not doing some behavioral training.
    and i m not taking marijwana smoking now fro one year and not taking anti anxiety medication approxi from 3 mounth.
    now can i meet any doctors please suggest for me any who can do it.and please let me give ur email that i gain more help.
    thanx Dr Deborah for helpsss

  5. avatar shahsawar khan says:

    hi dear now i m telling u some of my symptems so plz diagnos it and tell me the treatment i,e medication and other ways…….blurred vision,blushing,tension on simple things,feeling angry,electric jolt feeling in the body,desire for death,tiredness of mind,sexual unintrusted,fear of losing memory or mind or losing controle,need to seat near exit,burning scalp,noises in the ear pulsing sound and reduction of hearing.difficulty in speaking in concentration,feeling angry,stomack problems,some time difficulty in sleeping,fear of some undetected illness,nervousness in company,and in stress while i havnt any activity and i m rcently completed my MBA but due to these problems i can,t awail my goals so pleeeeeeaz give me more time than other one tody i hope u will,,,,,,,,ur client shahsawar khan

  6. avatar Arslan Ali says:

    I’m having all these symptoms for four years. What should I do? I’ve thought of suicide dozen of times but the fear of leaving my family alone actually keeps me away from it. What should I do? I can’t afford a psychiatrist and nor they are available in my locality. Where should I go? Any on-line resources that might help me get out of this situation.

    • avatar Dr. Deborah Khoshaba says:

      Hello Arsian, the best advice I can give you is to see a professional for help, especially because you have thought of suicide. Arsian, you can get better. There is a website called Soundmindz ( They have an online app for your phone that allows you to track your worry and anxiety, so you can see what makes it worse and what you do that makes it a little better. The more you understand about what is driving your biology, the more control you will have over it and the happier you will be. So, I definitely recommend you doing this even if you do see a doctor for your symptoms. Also, there are many clinics that offer help for people who do not have money to pay for it. If you check near where you live, I bet someone will know. Even if you call a psychiatrist, he or she will know clinics for people who do not have funds to pay for treatment. Let me know how it all goes for you. Take a look at the site I mention here. They have lots of information on Anxiety. Warmly Deborah.

  7. avatar Mushtaque Sargani says:

    I realy appreciate you for your such type of efforts,which are supporting to over knowledge.Thank u so much.

    • avatar Dr. Deborah Khoshaba says:

      Hello Mushtaque, I love to support people through empowering them with knowledge. You say it well. I appreciate your kind words and for taking time to visit and read this post. Take good care. Warmly Deborah.

  8. avatar Mubashar says:

    Hello. I have been experiencing very wierd condition. I would sleep and after one hour or two get up suffocated as if cant breath and my mind is messed up as if its some worst nightmare but only am awake. Feel like dyng and cAnt control it hav palpitations as well. What is this condition kindly guide its killing me. Thanks

    • avatar Dr. Deborah Khoshaba says:

      Hello Musbashar. I don’t diagnose on the internet but I can say that waking up feeling like you can’t breathe and you feel confused may be waking up with an extreme anxiety that seems like panic. Have you heard of panic attacks? They involve the feelings of dying and feeling out of control. Musbashar–maybe there was a loss in your life recently, a death or some other catastrophe that has shaken you up deeply. This can cause panic attacks. Or there is something else. But, I highly recommend that you see a psychiatrist or psychologist where you live to help you. There is a lot of good treatments for panic attacks. Some may at firs involve medication but this should always include what we call cognitive and behavioral treatment that teaches you how to breathe properly so that can bring yourself down from panic and restore calm but also to change ideas like you are going to surely die or anything else that increases the anxiety and panic you have even more. You take good care. And, believe me, professionals know very much about how to help people who have this disorder. Warm regards to you Deborah.

  9. avatar Shamim khan says:

    A nice helping website for helping ppl
    With anxiety

    • avatar Dr. Deborah Khoshaba says:

      Thank you Shamim, I’m glad you like it. Thank you for saying hello. Warm regards Deborah.

      • avatar Muhammad sibtain says:

        Hello madam I am suffering anxiety since last two years and also having stomach problem like heart burn.I. am taking citaloparam since last 8 months and feel much better. is anxiety cause due to gastric or stomach problem.
        please guide me how I will free from anxiety completely.
        thnks for such useful article

        • avatar Dr. Deborah Khoshaba says:

          Hello Muhammad, with anxiety, it is usually not a situation of getting rid of it forever, but learning how to manage it. Muhammad, we can be genetically predisposed to anxiety, so that if our lifestyle isn’t supporting our biology, we can become anxious. I mean that we have to eat well, get rest, take medication if needed, exercise and cope well to keep our anxiety low. I’m very glad the ideas in this article helped you. I think if you follow the recommendations you will keep your anxiety low. I’m glad the medication has been so helpful. Warm regards to you Deborah.

  10. avatar shah sawar khan says:

    hi Dr. Deborah Khoshaba
    i m your past patient of anxiety bcz of your priceless opinion and website i 80 percent overcome it
    bt now from three days ago im feeling in my right side of head just above the head vein twitching or bubbling like feelings
    i m soo worried about it
    i m jobless so i m deppressed from some time,, is the stress is the cause of this?
    or any thing else


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