On Sunday nights, Michelle Roe's body went through a ritual: She got pain in her stomach, her fingertips went numb, her face and neck felt flushed and prickly, and she would run into the bathroom to dry heave. "I thought I was going to die if I went to work," says the 32-year-old resident of Adrian, Mich. "I was an accountant, so it was not like my job was dangerous."
Stress and hormones are common triggers for anxiety disorders. There is also a strong genetic predisposition, says Winston, that is independent of behavior that can be learned from an anxious family member, such as obsessive hand washing. People with a disorder often experience their first episodes of disabling anxiety during adolescence, after the loss of a job, or after the birth of a child.
Research suggests that a combination of cognitive-behavioral therapy and medication can help control symptoms and lead to complete remission in some people.