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Mental Health

Anxiety Disorder

Q. How can someone tell if they have an anxiety disorder?

A. Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It's chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting through the day provokes anxiety. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Or they might feel as though they have a lump in the throat.

Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too. Usually the impairment associated with GAD is mild and people with the disorder don't feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don't characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.

For this and additional information, see the National Institute of Mental Health, NIH.

Q.Who does Generalized Anxiety Disorder affect and how is it diagnosed?

A. GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It's more common in women than in men and often occurs in relatives of affected persons. It's diagnosed when someone spends at least 6 months worried excessively about a number of everyday problems. In general, the symptoms of GAD seem to diminish with age.

For this and additional information, see the National Institute of Mental Health, NIH.

Panic Disorder

Q. What is Panic Disorder?

A. People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can't predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. In between times there is a persistent, lingering worry that another attack could come any minute.

When a panic attack strikes, most likely your heart pounds and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control. You may genuinely believe you're having a heart attack or stroke, losing your mind, or on the verge of death. Attacks can occur any time, even during nondream sleep. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.

For this and additional information, see the National Institute of Mental Health, NIH.

Q. Who does panic disorder affect?

A. Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age--in children or in the elderly--but most often it begins in young adults. Not everyone who experiences panic attacks will develop panic disorder-- for example, many people have one attack but never have another. For those who do have panic disorder, though, it's important to seek treatment. Untreated, the disorder can become very disabling.

For this and additional information, see the National Institute of Mental Health, NIH.

Q. Is panic disorder treatable?

A. Studies have shown that proper treatment--a type of psychotherapy called cognitive-behavioral therapy, medications, or possibly a combination of the two--helps 70 to 90 percent of people with panic disorder. Significant improvement is usually seen within 6 to 8 weeks.

Cognitive-behavioral approaches teach patients how to view the panic situations differently and demonstrate ways to reduce anxiety, using breathing exercises or techniques to refocus attention, for example. Another technique used in cognitive-behavioral therapy, called exposure therapy, can often help alleviate the phobias that may result from panic disorder. In exposure therapy, people are very slowly exposed to the fearful situation until they become desensitized to it.

Some people find the greatest relief from panic disorder symptoms when they take certain prescription medications. Such medications, like cognitive-behavioral therapy, can help to prevent panic attacks or reduce their frequency and severity. Two types of medications that have been shown to be safe and effective in the treatment of panic disorder are antidepressants and benzodiazepines.

For this and additional information, see the National Institute of Mental Health, NIH.


Q. What are the signs of depression?

A. Signs of depression can include: persistent sad or "empty" mood; loss of interest or pleasure in ordinary activities, including sex; decreased energy, fatigue, being "slowed down"; sleep disturbances (insomnia, early-morning waking, or oversleeping); eating disturbances (loss of appetite and weight, or weight gain); difficulty concentrating, remembering, making decisions; feelings of guilt, worthlessness,; thoughts of death or suicide; suicide attempts; irritability ; excessive crying; and chronic aches and pains that don't respond to treatment.

For this and additional information, see the National Institute of Mental Health .

Q. Can depression be prevented?

A. In some cases, major depressive illness can be avoided. Typically, depression is linked to life events, such as widowhood and retirement. However, fostering and maintaining relationships with people, developing interests and hobbies, and staying involved with activities that keep the mind and body active can help keep depression away.

For this and additional information, see the National Institute of Mental Health .

Q. How is depression treated?

A. There are effective medications and psychological treatments that often are used in combination. In severe depression, medication is usually required. A number of short-term talk therapies to treat clinical depression have been developed in recent years. Several types of medications are available, none of them habit-forming. People with severe depression respond more rapidly and more consistently to medication. Those with recurring depression, including bipolar disorder, may need to stay on medication to prevent or lessen further episodes. Many patients need psychotherapy (talk therapy) to deal with the psychological or interpersonal problems often associated with their illness. Other biological treatments can be helpful. For example, electroconvulsive treatment (ECT) may be a very effective treatment for the most severe depressions. Research is also being done on the use of light for the treatment of depression. Early intervention may lessen severity of symptoms and shorten the episode.