Are you prone to worry too much? Generalized anxiety disorder causes chronic and exaggerated worry and tension that seem to have no real cause. But symptoms are extremely real! There are several types of anxiety disorders, including phobias, panic disorder, and obsessive-compulsive disorder. People with generalized anxiety disorder (GAD) often worry excessively about health, money, family, or work, and they continually anticipate disaster. Although GAD may be accompanied by depression, substance abuse, or another anxiety disorder, impairment is usually mild. Generally, people with this disorder do not feel too restricted in social settings or on the job. They also don't avoid certain situations as a result of their anxiety. People with GAD usually realize that their anxiety is more intense than the situation warrants, but they can't rid themselves of these irrational concerns. Someone with GAD may have a good job, a happy marriage, and well-adjusted kids, for example, but worries constantly that it's all going to fall apart. Such a person may not let his or her children go on school trips because the person fears they'll get kidnapped. Constant worrying may interfere with GAD sufferers' day-to-day functioning. It may be accompanied by chronic physical symptoms, such as aches and pains, irritability, fatigue, or difficulty sleeping. GAD begins gradually, usually in childhood or adolescence, but it can begin in adulthood, too. It is more commonly seen in women. Each year, 2.8% of people ages 18 and 54 are affected by GAD. What causes it? Brain chemistry, environmental stresses, and other factors contribute to the development of chronic anxiety. Research also suggests that a family history of the condition can make it more likely a person will develop GAD. Some studies show that traumatic and stressful events--such as abuse, the death of a loved one, divorce, or job loss--can bring on GAD in vulnerable people. Alcohol abuse and drug addiction also can bring on or worsen anxiety. GAD is diagnosed when someone spends at least six months worried excessively about a number of everyday problems. The first step in treatment is to determine if the anxiety is caused by a physical condition, an anxiety disorder, or both. If an anxiety disorder is diagnosed, coexisting conditions must be identified and may need to be brought under control before the anxiety disorder can be treated. Sometimes several different treatments or combinations of treatments must be tried to find one that works. It's also important for treatment to be continued for a sufficient time. Treatment can consist of behavioral counseling, psychotherapy, medication, or a combination of these. One major way that GAD is treated is through cognitive behavioral therapy. This therapy helps change both the thinking patterns that support fears and the way the person reacts to anxiety-provoking situations. The therapist also may teach basic stress-management techniques. Medications help control the symptoms of GAD, but they don't cure it. The types of medications used to treat GAD include antidepressants, anti-anxiety drugs, and beta-blockers. These medications may have troublesome side effects, including substance abuse and dependence, so it's important to work closely with your healthcare provider when taking them.