Generalized Anxiety
When Worry Controls a Life

We think of it as a relatively modern disorder. In the 1950s, the "Age of Anxiety" was - somehow - tied to the threat of the Cold War, the Bomb and the Red Scare. As the 50s ended and the turbulent 60s began, anxiety became as common as the common cold. And in a rush to be part of an earlier time, a more peaceful and tranquil time, Americans were asking for - and receiving - record numbers of prescriptions for tranquilizers.

But anxiety is not new to our age, though it seems more people suffer from it than ever before. Our distant relatives might well have been consumed by wild beasts were it not for their anxiety, a healthy fear of what laid in wait outside their abode. In truth, anxiety is as old as heart disease. And for some people, it can be just as debilitating.

"It's not just a disease that starts," says Dr. Melinda Stanley, associate professor of psychiatry and behavioral sciences at The University of Texas-Houston Medical School. "There's probably been a history of anxiety, a history of lifelong worry. The person with anxiety has probably mentioned it to his or her physician and has had physical symptoms including not sleeping well. But there are several questions that come to mind with anxiety," says Dr. Stanley.

Everyone worries, but at what point does it become excessive? When does normal anxiety become clinical? Does clinical anxiety typically present itself later in life?

Dr. Stanley differentiates generalized anxiety from several other types of anxiety. Specific phobias are fairly common: fear of spiders, snakes and large cockroaches; heights; tunnels and bridges; flying in a plane. There are social phobias that can severely limit a person's activities: public speaking, meeting new people, attending social events, starting a new job or school. Obsessive-compulsive disorder is a kind of anxiety where the person has little or no control about unwanted thoughts and little control over ritualistic practices.

We all have some anxiety from time to time. And there are situations that commonly cause anxiety: having to stand in front of a large group and deliver a talk, flying in an airplane, riding an elevator, taking a test. Imagine having that kind of anxiety - feeling shaky, your heart pounding and stomach churning - for no apparent reason.

For many people, anxiety actually interferes in their lives. Their worry begins to control their life, rather than them controlling the worry.

"Unlike panic disorder, which is sudden and discreet, generalized anxiety is with a person almost all of the time," says Dr. Stanley. "The worry simply makes their life unpleasurable." Dr. Stanley discusses a number of scenarios: the elderly person who worries incessantly about her grown children's health and may call them several times a day; the person who worries constantly about his own state of health but never visits a physician; the person who constantly worries about finances and paying bills.

"In many people, you'll also see a good deal of procrastination. It's related to the worry," says Dr. Stanley.

Next issue: UT-Houston program helps elderly deal with generalized anxiety.

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©2006 Texas Medical Center

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