Dear Dr. Garner,
I really hope you can help me. I am writing this letter at about 4 a.m. — another night without sleep and constant worrying.
My problem is that I worry about everything. My husband is a police officer and I have two young children in school. I worry about their safety and health and imagine all the horrible things that can happen to them.
I feel terrible most of the time and I know this can’t be good for my health. People used to joke about my worrying, but at this point it is becoming a very serious matter interfering with my life.
Is there anything I can do, any medications or doctors who specialize in this that you can recommend. I am at the end of my rope.
Worrier in Willamsburg
Dear Worrier,
I am glad that you wrote this letter because it demonstrates that you realize you have a problem and need help.
Worrying, or anxiety, is an important part of life, and often helps to guide us through difficult situations, alerting us to danger.
When the worrying interferes with everyday life it can cause us to have problems in our relationships, jobs, school, enjoyment of life, and even health problems.
Common anxiety or excessive worrying symptoms include:
• Feeling weak or tired
• Feeling nervous in general
• Feeling powerless
• Having a sense of impending danger, panic or doom
• Trembling or breathing rapidly
The condition you describe fits the pattern of generalized anxiety disorder. It is characterized by at least six months of persistent and excessive anxiety and worry about small or large issues. It frequently is accompanied by depression.
The following are indications to see your doctor:
1. You recognize that you worry too much and it interferes with your life.
2. You feel depressed, and perhaps have trouble with alcohol or drug use.
3. You think your anxiety may be due to a physical problem.
4. You have suicidal thoughts or behaviors.
There is a good chance your worries will not go away on their own.
The cause of your condition is not completely understood, but is thought to be due to a chemical imbalance in the brain. Life experiences such as tragic or traumatic events appear to trigger anxiety disorder in people who are prone to develop it.
Occasionally, medical issues may be linked to an anxiety disorder. Heart disease, diabetes, thyroid problems, drug abuse and alcohol withdrawal, have all been implicated.
Several Risk Factors
There are several risk factors associated with generalized anxiety disorder. They include:
— Being female.
— Childhood trauma, particularly those who were abused or witnessed tragic events.
— Stress due to an illness such as cancer, or other chronic disease.
— Stress buildup due to one or more stressors, such as financial worries or a death in the family.
— Personality. Some personalities are more prone to anxiety disorders.
Quite often, the anxiety disorder can cause medical problems, such as abnormal bowel habits or digestive problems, headaches and teeth grinding. Trouble sleeping is a frequent finding.
The best way to start addressing your problem is to make an appointment with your doctor. Prior to your visit, write a summary of your problem and symtoms.
You should list any major life changes or stressful events that might have triggered the situation. List any traumatic events from your past, particularly as a child.
You should note any medical problems you have as well as a list of every medication that you are taking, including over-the-counter supplements or vitamins.
Treatment Options
Doctors can help you and improve your situation using some of the following treatments:
1. Medications
There are several to ask your doctor about, including antidepressants and an anxiety-reducing medication known as Buspar.
2. Psychotherapy
Counseling and talk therapy can be very effective in the treatment of anxiety. It can help you reduce your stress by changing the way you respond to anxiety-producing events.
3. Lifestyle changes
Exercise, eat right, avoid drugs, alcohol and cigarettes. Make sleep a priority.
4. Alternative medications, such as kava, valerian root and B vitamins may be helpful.
The bottom line is that you have a serious medical condition that needs to be treated. If you do not have a primary care physician, contact me. I would be happy to recommend someone to deal with your situaiation.
Do not despair. Your anxiety can be reduced and you can regain control of your life.
