Generalized anxiety disorder currently is more common for Inland Northwest women than panic attacks, social phobias, and other anxiety-related health issues, experts here say. More frequently, they say, women are waiting until anxiety-related health issues reach a crisis level before they seek help.

Dr. Juan Bala, a family practitioner at Inland Family Medicine, in the Deaconess Medical Building, at 801. W. Fifth, says between 5 percent and 10 percent of all of his patients have sought treatment for generalized anxiety disorder. Bala says the majority of his anxiety-affected female patients waited between three and six months, or longer, before they sought medical attention.

Connie Chapman, a clinical social worker and therapist here with Inland Psychiatry & Psychology, says some people seek assistance only after having to be hospitalized due to a breakdown, or having to quit a job. Other times, anxiety has adversely affected relationships.

"The unfortunate part of it is that it feeds on itself," Chapman says. "You develop feelings of anxiety about when you'll have feelings of it again."

Nationally, generalized anxiety disorder affects about 6.8 million adults in the U.S., or 3.1 percent of the population, in any given year, according the Anxiety Disorders Association of America (ADAA). The organization says women are twice as likely to develop the disorder as men.

Symptoms of the disorder are defined as persistent and uncontrollable feelings of dread or worry to the point that they interfere with daily activities. Those feelings must be present more days than not for six months, clinical guidelines say.

Anxiety disorders can affect women of any age, but women usually develop cases between puberty and middle age, the ADAA says. Bala says most of his female anxiety-disorder patients experienced the onset of the condition in their 20s and 30s, which he believes might be because that is the stage at which many women become established in their careers or start a family.

Women are diagnosed with anxiety more frequently than men due to a number of factors. In general, women simply are more likely to seek treatment for anxiety than men, Bala and Chapman say. In addition, societal pressures on women are strong, and differences in brain chemistry make women more prone to anxiety disorders.

Specifically, the neurotransmitter serotonin, which is known to contribute to feelings of happiness and well-being, may play a role in females' responses to stress and anxiety, the ADAA says. Recent evidence suggests that the female brain might not process serotonin as quickly as the male brain.

In addition, researchers are finding that women are more sensitive to low levels of a hormone, called corticotropin-releasing factor, that organizes stress responses in mammals, causing women to be twice as vulnerable as men to experience stress-related disorders, the association says.

It's also believed that the hormones estrogen and progesterone might cause a fight-or-flight response to be more readily activated and longer maintained in women than in men, the ADAA says.

Societal pressures on women also contribute, Chapman contends.

"There is such a significant amount of expectation of women," she says. "Not only are they expected to perform well in the workplace, but also maintain the home, raise kids, be organized, maintain the family's finances, and be involved in their own activities."

Chapman says some women develop anxiety disorders because they don't have enough down time to relax and focus on their own needs. She treats anxiety patients through a variety of behavior-changing approaches, such as altering lifestyle habits and identifying major stressors that could trigger such intense feelings of anxiety.

For his patients that have been diagnosed with general anxiety disorder, Bala says he usually recommends they start with a combination treatment of behavioral counseling, or therapy, with a prescribed medication, because some classes of medicines commonly used to treat and control anxiety disorders can take several weeks to take effect.

Antidepressant medications, such as sertraline (Zoloft) or citalopram (Celexa), often are prescribed to control anxiety in patients with long-term symptoms, he says.

Bala says he typically prescribes a class of medicines called benzodiazepines to treat specific phobias and panic attacks, because they are short-acting and can help decrease feelings of intense or uncontrollable anxiety by altering the effects of some brain chemicals.

Another way patients with anxiety disorders can help reduce constant feelings of anxiety, Bala says, is to exercise regularly, which releases feel-good hormones into the bloodstream that help soothe feelings of worry.

To help ease feelings of heightened anxiety and worry in her female patients, Chapman says she encourages them to give themselves permission to create "me time" to relax and unwind.

"I often have women make lists of things they can't achieve (because they're too busy), such as making time for coffee dates with their friends, taking a 30-minute yoga class, or reading their favorite book," she says.