If pushed, most of us admit that if it wasn't for the motivation of a little anxiety, we would never catch a train, pass an exam or meet a deadline. But can it be overdone?

Yes. It certainly can. There are people who constantly worry about money, their job and their health and anything else they can think of. Their anxiety becomes so all-embracing that it takes over their whole lives, eventually leading to an illness known as generalised anxiety disorder (GAD).

What is generalised anxiety disorder?

Psychologists find it hard to define GAD because it is the same as ordinary worry and anxiety, but on a huge and abnormal scale.

Dr Jim White, consultant clinical psychologist at the Clydebank Health Centre, near Glasgow, told NetDoctor: 'People with GAD do worry about whether they have an incurable disease, how they are going to pay the mortgage or if the car will get through its MOT, but what makes them different from the rest of us is that they worry about worrying.

'They wonder why all these thoughts are going through their head but they can't stop it. They have insights into what is happening to them. They know they have got things out of proportion but there is nothing they can do about it.

'People who are well off agonise over money. Healthy young men and women torture themselves with thoughts of fatal illnesses. When they stand back and look at the situation, they can see that it doesn't make sense but that doesn't put their minds to rest. It has become an illness.'

What are the symptoms of GAD?

Apart from chronic anxiety, victims of GAD also experience physical symptoms. They often complain of tightness in the muscles, headaches or a pain in the back of the neck. They have shortness of breath, a racing heart and abnormal tiredness.

Ordinary worrying does not bring on symptoms like these, but for someone with GAD, the anxieties trigger a fresh round of painful soul searching. The physical signs (including numbness, pins and needles and pain running up and down the arm) can almost exactly mimic the symptoms of a heart attack. This can release a vast amount of anxiety. Other symptoms include dizziness, sweating, restlessness, difficulty in concentrating and irritability.

Dr White has found that some of his GAD patients can function perfectly well in their jobs when they are busy and focussed, but when they get home and sit in front of the TV the excessive mental processing starts. And later, lying in bed, it continues.

Who suffers from GAD?

GAD very often strikes in the late teens or early 20s according to Dr White. It can also start in the 30s or 40s but rarely emerges for the first time later in life. It affects women about twice as often as men.

Some surveys suggest that two million people in the UK have GAD, and that as a mental health problem it is second only to depression. The World Health Organization estimates that only half of all cases are diagnosed.

How do I know if I have GAD?

Dr Allan Norris, a psychologist at the Birmingham Nuffield hospital, said: 'In severe cases, it can lead to people being unable to live a normal life. They may fear they are about to crash the car if they drive, or simply find that they get caught up worrying and feeling anxious about life situations.'

If you are as anxious as this, it probably is GAD. Abnormal physical symptoms are also a sign.

Mr John Spector, a consultant psychologist and head of clinical psychology at Watford General Hospital, says 'It is quite normal to worry about something like an exam but if you live under a constant sense of threat and worry about things that others would regard as insignificant - to the extent that you are dysfunctional in most aspects of your life - then it is likely that you are suffering from generalized anxiety disorder.'

How is it diagnosed?

According to Dr White, most people with GAD go to their GP complaining of physical symptoms like headaches, dizziness or stomach problems. The GP may diagnose their real problem from careful questioning.

The doctor may be alerted to the possibility of GAD if the patient has a wide span of symptoms, especially if they are coupled with insomnia or alcoholism. The GP may order some tests to rule out physical illness to help him with the diagnosis.
When GAD is pinpointed the patient will be referred to a psychologist.

What can be done for people with GAD?

Dr White says: 'We usually start by providing a lot of information about GAD. The patient who has often struggled with the condition for years is usually reassured just by being given a diagnosis.

'Drug treatment has not proved very successful and cognitive behaviour therapy is now regarded as the best way forward.

'This involves standing back and analysing your thoughts. The patient is helped to evaluate how he or she thinks of themselves and the world. They are encouraged to face up to their problems and difficulties,' said Dr White.

Cognitive behaviour therapy is a method of changing the way we think. People with GAD need training in problem solving to give them a greater feeling of controlling what is happening to them. They are often lacking these skills.

They also benefit from relaxation methods and breathing control to reduce symptoms of anxiety. Planning relaxing and pleasurable activities are useful ways of distracting themselves from their worries. Physical exercise can also achieve this.

Even with these methods, the research shows that only 50 per cent of GAD victims recover. For many, it becomes a chronic condition that may leave them for a while only to reappear again in the future.

No one knows what causes GAD, but some psychologists believe it is rooted in a lack of stability during childhood.

GAD is not something people should think they could learn to live with because it can lead to other psychiatric problems like depression. It is too complicated a condition for the victims to pull themselves out of it. They need help.

Anyone who feels their little niggly worries are becoming a preoccupation, that they are getting too up tight about small things and experiencing the physical symptoms of anxiety, should talk to their GP. The one thing that everyone agrees on is that the earlier help is given, the better your chances of leaving your cares behind you and once again joining the ranks of the laid back.