This is the fourth in a series about anxiety.

Q: What is Generalized Anxiety Disorder?

A: Generalized Anxiety Disorder develops quite slowly, often starting during adolescence or young adulthood. Symptoms of GAD are as follows:

• Worrying very much about everyday things.

• Trouble controlling worries or feelings of nervousness.

• Knowing that they worry more than they should.

• Feeling restless and having trouble relaxing.

• Having a hard time concentrating.

• Being easily startled.

• Trouble following asleep or staying asleep.

• Feeling easily tired or tired all the time.

• Having headaches, stomachaches, muscle aches or unexplained pains.

• Having a hard time swallowing.

• Trembling or twitching.

• Being irritable or feeling edgy.

• Sweating a lot, feeling light-headed or out of breath.

• Having to go to the bathroom a lot.

Adults with GAD are very nervous about everyday matters. These include job security or performance, health, finances, health and well-being of their children, being late, completing household chores and other responsibilities. Adults might have physical symptoms that make it difficult to function and interfere with everyday life.

Symptoms vacillate at different times, often worse during periods of stress. Stressful times include times of physical illness, exams at school, or family or other relationship conflicts. Sometimes GAD runs in families, but nobody knows why some family members get it and some don’t. Research has found several parts of the brain, along with biological processes, play key roles in fear and anxiety.

All the above information is from a National Institute of Health publication, updated in 2016.

In an article titled “The Anxiety Epidemic”, by Larry D. Rosen, Ph.D., professor of psychology at California State University, quotes some worrisome statistics from Alex Wilson. He presents some research results that validate the trend that anxiety is now surpassing depression as the leading mental health disorder in college students.

Anxiety disorders are the most common psychiatric disorders in children and adults. Anxiety disorders are highly treatable, but only one-third of people suffering from anxiety disorders receive treatment. From the Mayo Clinic comes the information that Generalized Anxiety Disorders often occur with other disorders such as depression.

Risk factors for developing anxiety disorders include numerous factors. First is trauma. Children and adults who endured or witnessed abuse or trauma can develop anxiety disorders. Having a serious illness can cause significant stress that results in anxiety disorders.

A buildup of stress or one significant major stressor can trigger anxiety that is excessive. Such stressors include death in the family, work stress and continuous worry about finances. Another predisposing factor is certain personality types, such as people who worry a lot, are perfectionistic or have high levels of anxiety on a daily basis.

Another risk factor is having another mental health disorder. For example, people with depression frequently have anxiety disorders. Persons who have blood relatives with anxiety are at risk because anxiety disorders can run in families. Finally, alcohol and other drug abuse or withdrawal can either cause or worsen anxiety. The above risk factors are from an article by the Mayo Clinic.

In an article from the National Library of Medicine, National Institute of Health, the article points out Generalized Anxiety Disorders can develop without any identifiable cause. It also is rare in persons older than 65 years of age. Women are twice as likely as men to develop GAD. It commonly develops between the ages of 30 and 35.

Usually, GAD develops gradually and goes undetected for some time. However, GAD can be hard to get rid of, taking months or years to get over. A person with GAD might experience exaccerbations and remissions.

Generalized Anxiety Disorder resolves in different ways. In one study, people got over their anxiety disorders after two years. Anxiety disorders often improve with age as older people have more experience dealing with stress and anxiety. One reason GAD might take awhile to diagnose is because people first might contact medical help for their physical symptoms. Thus, one symptom or two, such as insomnia or stomachaches, can be treated and not diagnosed as a symptom of Generalized Anxiety Disorder.

An article on anxiety disorders from the University of Maryland states people with anxiety problems are more likely to first see a family doctor because their symptoms are frequently physical. These symptoms can include muscle tension, twitching, trembling, aching, soreness, cold and clammy hands, dry mouth, sweating, nausea, diarrhea or urinary frequency.

Anxiety attacks can initiate or accompany nearly all the acute disorders of the hearts or lungs, including angina and heart attacks. In fact, almost all people with panic disorders are sure their symptoms are physical and possibly life-threatening.

Women actually having a heart attack or acute heart problem are more likely to be misdiagnosed as having an anxiety attack than men with similar symptoms. Mitral valve prolapse might have symptoms nearly identical to symptoms of panic disorder. Actually, the two conditions often occur together.

Mitral valve prolapse is a condition in which the mitral valve does not close correctly when the heart contracts. Incomplete closure allows blood to back flow into the left atrium. Symptoms can include palpitations, chest pain, fatigue, cough, shortness of breath when lying down and difficulty breathing after exertion. Another dysfunction with many of the same symptoms as panic attacks is paroxysmal supraventicular tachycardia.

Asthma attacks and panic attacks have similar symptoms and can coexist. Hyperthyroidism can cause many of the same symptoms as Generalized Anxiety Disorder.

Other medical conditions similar to GAD are hypoglycemia, recurrent pulmonary emboli, adrenal-gland tremors, and women having intense anxiety attacks with hot flashes during menopause.

Medication side effects and withdrawal from medication also can cause anxiety reactions.

• Next week’s article will continue with a discussion of anxiety disorders.

Judy Caprez is professor emeritus at Fort Hays State University.