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Features

• Months of excessive anxiety and worry
• The worry is out of proportion to the event, pervasive and excessive, difficult to control
• Accompanied by muscle tension, hyperarousal and symptoms of the "flight or fight" response

• Education about nature of disorder
• Progressive muscle relaxation
• Structured problem solving
• Graded exposure to difficult situations
• Specialist referral to a cognitive behavioural program for non-responders

A 25-year-old woman presented with worries about her health, her career and her relationships. She said that she had always worried easily, but over the past several months she had felt more tense and agitated. The current increase in anxiety began following a dispute at work with a colleague who she believed had taken advantage of her, but since then she had been unable to assert herself with this colleague. She frequently worried about the quality of her work and worried that making a mistake would ultimately cause her to lose her job. Over this time she had developed a pattern of waking frequently during the night and being unable to get back to sleep for two to three hours while thinking about all her worries. She had also come to see her general practitioner for various somatic complaints over the years, which she worried were signs of a serious physical illness.

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