What is a generalised anxiety disorder?

Almost everyone will worry or feel anxious at certain times. You might worry about an exam that is coming up, or feel anxious about speaking in front of an audience. Generalised anxiety disorder is when you feel worried or anxious most of the time. It is one of the most common types of anxiety disorders. In Australia, it is thought that around 14% of adults are affected by the condition every year. [1]  The anxiety associated with this condition can affect many aspects of everyday life and make it hard to carry out everyday activities.

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.

Causes and risk factors

It is not known what exactly causes a generalised anxiety disorder. Many factors are thought to contribute to the development of the condition, including changes in the levels of certain chemicals in your brain, and genetic and environmental factors. You may have an increased chance of developing generalised anxiety disorder if you:

  • Have a close family member with the condition;
  • Have experienced a major stressful event, such as the death of a loved one or loss of a job, and/or;
  • Had a traumatic childhood.

Genetic

Related to genes, the body's units of inheritance or origin.

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.

Signs and symptoms

Anxiety may cause your heart to beat faster than normal, cause hot and cold flushes and tightening of the chest. Feeling anxious in certain situations is normal, but if you feel worried or anxious most of the time, you may have generalised anxiety disorder. If you have the condition you may also:

  • Find it hard to stop worrying;
  • Find it hard to carry out everyday activities;
  • Get tired very easily;
  • Feel restless or irritable;
  • Find it hard to concentrate;
  • Have tense or sore muscles, especially in the jaw or back, and;
  • Have difficulty getting to sleep or staying asleep.

Teen boy sweating and biting his fingernails from anxiety.A generalised anxiety disorder can make you feel constantly worried, distracted and restless. 

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.

Methods for diagnosis

To work out if you have a generalised anxiety disorder, your doctor may start by asking questions about your symptoms and medical history. You may be diagnosed with a generalised anxiety disorder if you have felt anxious or worried most of the time for six months or more and have also experienced three or more of the following:

  • Feeling irritable;
  • Feeling restless;
  • Getting tired easily;
  • Having sore or tense muscles;
  • Difficulty concentrating, and;
  • Difficulty getting to sleep or staying asleep.

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.

Types of treatment

Treatment for generalised anxiety disorder may involve a combination of medication, psychotherapy and self-care treatments.

Psychotherapy

If you have generalised anxiety disorder, meeting regularly with a therapist to discuss your thoughts and feelings, and any problems that you may be having may help you manage your condition. This is known as psychotherapy or 'talking therapy'.

Cognitive behavioural therapy

Cognitive behaviour therapy is a type of psychotherapy that can be used to help manage generalised anxiety disorder. People with generalised anxiety disorder tend to have negative feelings about aspects of their lives. Cognitive behaviour therapy can teach people how to recognise when worrying is not productive and how to let go of things that are needlessly causing anxiety. Therapy can also involve teaching patients relaxation techniques and strategies to use when they start to feel anxious.

A young woman in a session with a therapist.Psychotherapy may help with treatment of a generalised anxiety disorder. 

Medication

Antidepressants

A generalised anxiety disorder may sometimes be treated with medications called antidepressants. These work by restoring the balance of chemicals in the brain that control mood. Some of the common antidepressants prescribed to treat generalised anxiety disorder include selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, and serotonin and noradrenalin reuptake inhibitors, such as venlafaxine.

Antidepressants generally need to be taken for at least two weeks before you will notice any improvement in symptoms. Medication may also need to be continued for a time even after the symptoms have gone, to prevent them from coming back. When stopping antidepressant medication, the dose usually needs to be reduced gradually over time to prevent any withdrawal responses.

As with many medications, some people may experience some side effects when taking antidepressants. Some common side effects include nausea, dizziness, tiredness and sexual dysfunction. Some antidepressants can have more serious side effects if they are taken with certain other medications or herbal remedies, or when combined with alcohol. Your doctor will work with you to find the medication that is best for you.

Very rarely, some antidepressants may increase suicidal thoughts and the risk of suicide. The risk is highest in the first week after starting antidepressant treatment, or when the dose of antidepressants is changed. If you experience any suicidal thoughts, it is important to speak with a doctor immediately.

Benzodiazepines

In some cases, doctors may prescribe benzodiazepines, such as diazepam, to treat severe anxiety. They should only be used in the short-term, and only for severe symptoms. Benzodiazepines can cause sedation, become addictive and be less effective if taken for a long time.

Self care

Self-care treatments are simple strategies that can be done from home that may help to manage generalised anxiety disorder and help prevent it from becoming worse. Self-care treatments may include allocating time to relax, exercising regularly and avoiding stimulants, such as alcohol and caffeine. Self care may also involve recognising triggers that cause you anxiety and learning to deal with these situations.

As with many mental health issues, support from family members and close friends can play an important role in recovery.

Sexual dysfunction

Any abnormal difficulty that interferes with the sexual response or sexual activity of an individual or a couple.

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.

Potential complications

A generalised anxiety disorder often appears together with depression. It is also associated with several other medical and mental health issues including trouble sleeping, digestive problems, and drug and alcohol abuse.

Digestive problems

Conditions that affect the digestive system and interfere with the process of digestion.

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.

Prognosis

The outlook for people with generalised anxiety disorder depends on how bad their condition is. In some cases, the symptoms may come and go, or are easily managed, while in other cases the condition is a long-term problem that needs continual management.

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.

Prevention

Because the cause of generalised anxiety disorder is not fully understood, there is no known way to prevent getting the condition. However, there are some steps that may be useful in helping to reduce anxiety. Finding time to relax, exercising regularly and maintaining a healthy diet can all help to reduce stress and anxiety levels. Recognising the signs of generalised anxiety disorder and seeking treatment early may help prevent the condition getting worse.

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.

Support services

If you or someone you know needs help, please call or visit:

Lifeline. Website: http://www.lifeline.org.au/ Tel: 13 11 14.
Kids Helpline. Website: http://www.kidshelp.com.au/ Tel: 1800 55 1800.
Beyond Blue. Website: http://www.beyondblue.org.au/ Tel: 1300 22 4636.

1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.