Many people with GAD realize that their anxiety is more intense than the situation warrants, but this knowledge does not reduce the anxiety. They may report being unable to relax; and they often have trouble falling or staying asleep. Their worries are usually 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. The box below contains the official symptoms of the disorder, as reported in the DSM-IV.
Generalized Anxiety Disorder:
- Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
- The person finds it difficult to control the worry.
- The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children.
- restlessness or feeling keyed up or on edge
- being easily fatigued
- difficulty concentrating or mind going blank
- irritability
- muscle tension
- sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
- The focus of the anxiety and worry is not confined to features of an Axis I disorder, e.g., the anxiety or worry is not about having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder.
- The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder. (American Psychiatric Association, 1994)
Should you ask your doctor about Paxil if you suffer from these symptoms? It might be a good discussion to have, but don't expect an immediate change of medications. If your current medications and/or therapy are working, then it may be best to stick with what works. Cognitive/behavioral therapy often works well along with medications. If the medications alone are not doing all that you want, ask for a referral to a therapist who specializes in anxiety disorders. It's important to learn that the symptoms of an anxiety disorder are benign and not life threatening. There are many different relaxation techniques that can help you reduce many of the symptoms as well.
