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If you have anxiety disorder, the main symptom is that you worry all the time. This worry stops you from doing what you want and can make your life miserable. Doctors call this illness generalized anxiety disorder. We'll call it anxiety disorder for short.

There are differences between normal, everyday worrying and the sort of worrying that happens with anxiety disorder. In anxiety disorder:^{1 2 3}

• You worry too much
• Your worries have bothered you most days for the last six months
• You worry about lots of things at once even when there is no particular reason to worry
• You can't stop or even control your worrying, however hard you try.

Worrying too much in this way can stop you from getting on with your life and daily activities. Perhaps you're too anxious to drive, or you worry about getting lost if you do. Maybe you don't apply for a job because you don't think you're good enough to get it. Or you won't go out because you're afraid something might happen to your home.

If you have anxiety disorder, you also have at least three of these other symptoms:¹

• You're restless and can't relax. You often feel keyed up or on edge.
• You get tired easily. You get worn out by a short trip to the store. Or you feel like sleeping all the time, even when you have just gotten up.
• You can't concentrate. Your mind keeps going blank. You have trouble staying focused on what you are doing.
• You're irritable. Everyone gets grouchy sometimes, but some people with anxiety disorder feel cranky most of the time.
• Your muscles are tense. This can make you shaky. Your hands may tremble so much you spill your coffee or can't write clearly. You may also get aches and pains in your muscles.
• You sleep badly. You have trouble falling asleep or staying asleep. Or, if you do sleep, you are restless and don't feel refreshed when you wake up.

Anxiety disorder can cause physical symptoms. These symptoms can be very frightening, and people with anxiety disorder often think they have a physical illness. You may see several doctors and have many tests to try to find out what's wrong.

About half the people with anxiety disorder have been to see a doctor who specializes in heart problems.⁴

Here are some of the physical symptoms people get:¹

• Cold, clammy hands
• Dry mouth
• Sweating
• Nausea
• Diarrhea
• Palpitations (when you can feel your heart beating too fast)
• Feeling short of breath.

These symptoms all happen because of the way your autonomic nervous system is working. This network of nerves controls automatic activities in your body, such as your heart rate and breathing. For example, it makes your skin produce sweat in hot weather, your heart beat faster when you run, and your mouth release saliva when you chew food.

If you are very anxious, your autonomic nervous system works "overtime." This can lead to symptoms such as sweating too much, palpitations or a dry mouth.

Anxiety can also cause other physical symptoms that don't seem to be related to the autonomic nervous system. For example, you may have:

• Headaches
• Pain in your chest
• Pain in your joints.

These aches and pains are real, but doctors can't find physical causes for them. Doctors call these psychosomatic symptoms. It means your body is translating your feelings into physical pain. We don't know why some people with anxiety disorder have these symptoms while others don't.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.