Mind & Body

Peace of mind

If you always feel anxious and stressed, you may have Generalized Anxiety Disorder. Here's how to reclaim a sense of calm.

Peace of mind
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Two weeks after the World Trade Center was destroyed, Lisa Miller (a pseudonym) began experiencing intense anxiety symptoms. "I went to work, and though I was functional, I was constantly exhausted," the 39-year-old finance manager recalls. "I'd get an anxious thought in my head, and it would get out of control and trigger a panic attack." She eventually left New York for a new job near Durham, N.C., hoping to find calm in a new setting-but the anxiety followed her.

While almost everyone feels anxious from time to time, when you worry excessively for six months or more, you may be suffering from Generalized Anxiety Disorder (GAD). Other symptoms can include difficulty relaxing or sleeping, fatigue, headaches, muscle tension, irritability, sweating, nausea, light-headedness, frequent bathroom trips, feeling out of breath, and even hot flashes. It also can be associated with social phobia, depression, or substance abuse. While experts believe GAD may have a genetic component or stem from childhood fears or restrictive parents, the symptoms can be triggered by trauma-like many New Yorkers at the time, Miller felt profoundly affected by the attacks of 9/11-or a difficult life event such as a divorce or a death in the family.

Anxiety is usually accompanied by a heightened state of arousal-the nervous system is constantly over-activated, even when there's no external reason for it. "In the presence of a threat, your body will naturally click into the fight-or-flight response," notes Jeffrey Brantley, M.D., founder and director of the Mindfulness-Based Stress Reduction Program at Duke University's Center for Integrative Medicine in Durham, which offers an eight-week stress reduction course. "Your body can't tell if the threat is outside or inside your head. So if you have a threatening story going on in your own mind, your body will go into the same fear reaction, and you'll feel anxious."

GAD affects almost 7 million Americans-and around twice as many women as men. (This may be because of interactions between sex hormones and brain chemistry, or because women are more likely to have suffered abuse as children.) And a study published earlier this year at the Indiana University School of Medicine by Kurt Kroenke, M.D., found that 7.6 percent of all patients who see a primary care physician have GAD. If your own anxiety is ongoing and affecting the way you live your life, it's important (and possible) to get relief.