Worry and anxiety are common and understandable aspects of life for many people. Our modern world can certainly be stressful and complex. Worry generally describes thoughts about what will happen in the future, while anxiety refers to a subjective emotional experience and bodily tension. Many believe that there may even be a self-protective, evolutionary basis for worry and anxiety. Worry and anxiety work like an alarm system that set off the “fight or flight” response in response to a perceived threat. When set off, this system will kick in the adrenaline boost you need to, for example, prepare for an approaching hurricane, an upcoming exam, or a first date with a potential mate. The person whose alarm system works is more likely to survive the hurricane, ace the exam, and have a second date lined up Saturday night.

However, for some people, worry and anxiety become a problem. It is as if the alarm system just will not turn off. These individuals perceive most situations as a threat, not merely one or two. People begin to perceive that terrible things are going to happen most of the time, even if the likelihood is very low. Of greater concern, they find it hard to control their worry. They also experience several physical manifestations of the “fight or flight” response gone awry, such as physical restlessness, fidgetiness, fatigue, difficulty concentrating, irritability, muscular tension, or problems falling or staying asleep. These symptoms of worry, anxiety, and physical problems typically last for a period of at least six months, and become so excessive and distressing that they begin to interfere with day-to-day functioning. In these cases, a person may be diagnosed with Generalized Anxiety Disorder (GAD).

The worry and anxiety people experience who are diagnosed with GAD is different than the worry and anxiety experienced by people who are diagnosed with other anxiety disorders. For example, individuals with GAD do not solely worry about having a panic attack, or being contaminated, or gaining weight, or being teased in public situations, or having a major medical problem, or having many physical problems. On the other hand, people with GAD are more than merely “stressed” or “worried” by everyday situations in the typical sense. The symptoms of GAD are also not due to a medical condition such as hyperthyroidism, or due to a medication or illegal drug.

Treatment for GAD typically entails medication and/or Cognitive Behavioral Therapy (CBT). CBT focuses on identifying and then altering a variety of perceptual or thinking errors. For example, a patient may be asked to estimate the probability of a feared event (“I have a headache which means I might die from a brain tumor.”) actually happening to help alter the thinking error of jumping to conclusions. Behavioral strategies are also introduced to counteract the physical symptoms of GAD such as relaxation training and behavioral treatments for insomnia. With appropriate treatment and practice at home, there is every reason to hope for relief from symptoms of GAD.

TIP: Identify a specific worry (a thought). Identify what you predict will happen. List the evidence for and the evidence against what you predict will happen. Estimate the probability of what you predict will happen. Then see what really happens. Was it as bad as you though it would be? As the old saying goes, “the anticipation is worse than the reality.”