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Headache 2008: Anxiety
Dr. Larry Robbins
Posted: December 2007  
Headache 2008

Everybody feels somewhat anxious or worried at times, often increased by stressful events. Feeling very anxious or constantly worried without stress, and on a chronic basis, may be "generalized anxiety disorder" (GAD). With GAD, there is usually unrealistic worrying and anxiety. Symptoms of GAD include some of the following: irritability, trouble concentrating, restlessness, constantly feeling keyed-up, loss of patience, muscle tension, a feeling of shortness of breath, increased sweating, difficulty with sleeping, trouble swallowing (or feeling as if there is a lump in the throat), and heartburn, reflux, or diarrhea. GAD is often accompanied by irritable bowel syndrome, and by headaches.

GAD may cycle in people’s lives, and certainly is worse with stress. There is almost always a family history of anxiety, and anxiety usually starts in childhood. Other anxiety disorders that may occur in childhood or adolescence include: obsessive-compulsive disorder, separation anxiety, and panic disorder.

As with depression, there are a number of differences in the brain, and nervous system, in people with anxiety. There are changes in certain neurochemicals or transmitters, and genetics has a major role to play. It is as much a physical disorder as asthma, headaches, or diabetes.

Certainly stressful events may trigger anxiety, but most people with GAD have an inherited physical and chemical difference in their brain.

Anxiety is eminently treatable with exercise, yoga, psychotherapy, biofeedback, and medication. The medications primarily involve use of the antidepressants and/or the "pure" antianxiety medicines, in particular the benzodiazepines. Examples of antidepressants include the SSRI’s such as Prozac, Zoloft, etc., and the benzodiazepines include Xanax, Ativan, etc. While it is inconvenient, and somewhat expensive, to go to a psychotherapist on an ongoing basis, it is very helpful in the long run.