Read about the anxious feelings, causes and treatment for generalized anxiety disorder. Take a GAD self-test.

"I just dread being alone at night. I don't know why, but I do......"

"My thoughts won't shut off. They're constantly running, making me worry, worry, worry......"

"Will I ever be my old self again?"

"I can't remember ever feeling relaxed and calm....What would that be like?"

"I'm always on edge....."

"I hate having to go to work anymore. I haven't always been this way....."

Generalized anxiety disorder is a relatively common anxiety problem, affecting 3-4% of the population, that turns daily life into a state of worry, anxiety, and fear. Excessive thinking and dwelling on the "what ifs" characterizes this anxiety disorder. As a result, the person feels there's no way out of the vicious cycle of anxiety and worry, and then becomes depressed about life and the state of anxiety they find themselves in.

Generalized anxiety usually does not cause people to avoid situations, and there isn't an element of a "panic attack" involved in the prognosis, either. It's the thinking, thinking, thinking, dwelling, dwelling, ruminating, ruminating, and inability to shut the mind off that so incapacitates the person. At other times, thoughts seem almost non-existent because the anxious feelings are so dominant. Feelings of worry, dread, lack of energy, and a loss of interest in life are common. Many times there is no "trigger" or "cause" for these feelings and the person realizes these feelings are irrational. Nevertheless, the feelings are very real. At this point, there is no "energy" or "zest" in life and no desire to want to do much.

Emotional Fear

This emotional fear and worry can be quite strong. If a loved one is ten minutes late, the person with generalized anxiety fears the very worst -- something's dreadfully wrong (after all, they're ten minutes late!), there's been an accident, the paramedics are taking the person to the hospital and his injuries are just too critical to resuscitate him....."Oh, my God!.....WHAT AM I GOING TO DO?" Feelings of fear and anxiety rush in from these thoughts, and the vicious cycle of anxiety and depression runs wild.

Some people with generalized anxiety have fluctuations in mood from hour-to-hour, whereas others have "good days" and "bad days". Others do better in the morning, and others find it easier at the end of the day. These anxiety feelings and moods feed on themselves, leading the person to continue in the pattern of worry and anxiety -- unless something powerful breaks it up.

Causes of GAD

GAD is associated with irregular levels of neurotransmitters in the brain. Neurotransmitters are chemicals that carry signals across nerve endings. Neurotransmitters that seem to involve anxiety include norepinephrine, GABA (gamma-aminobutyric acid), and serotonin.

Norepinephrine is concentrated in the locus ceruleus (nerve cluster that lies near the brain's fourth ventricle). Increased activity in the locus ceruleus is associated with anxiety, and decreased activity in the locus ceruleus diminishes anxiety. Increased levels of GABA and serotonin seem to reduce anxiety. All of these neurotransmitters interact during heightened anxiety.

The psychodynamic theory of psychology sees anxiety as an alerting mechanism that arises when our unconscious motivations clash with the constraints of our conscious mind. This conflict is intensified in people with GAD. Behavioral theory holds that anxiety results from not knowing how to behave in a given situation. The possibility of suffering negative consequences because of inappropriate behavior may result in hesitation and inaction. The anxiety may be generalized to similar situations. For example, anxiety over taking a particular test may be generalized to taking all tests in the future.

Risk Factors for GAD

There are biological and environmental risk factors for GAD, which include the following:

• Environmental stressors (e.g., work, school, relationships)
• Genetics
• Sleep deprivation, sleep inconsistency

Stressful situations in the following areas can intensify symptoms:

• Financial concerns
• Health
• Relationships
• School problems
• Work problems

Research has shown a 20% risk for GAD in blood relatives of people with the disorder and a 10% risk among relatives of people with depression. There also seems to be a correlation between GAD and other psychiatric disorders, including depression, phobia disorder, and panic disorder. Anxiety is a risk factor for sleep disorders such as insomnia.