What is a generalized 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. Generalized anxiety disorder is when you feel worried or anxious most of the time. It is one of the most common types of anxiety disorders. The anxiety associated with this condition can affect many aspects of everyday life and make it hard to carry out everyday activities.

About 12% of people are affected by an anxiety disorder in a given year and between 5-30% are affected at some point in their life. They occur about twice as often in females as males, and generally begin before the age of 25. The most common are specific phobia, which affects nearly 12% and social anxiety disorder, which affects 10% at some point in their life. They affect those between the ages of 15 and 35 the most and become less common after the age of 55. Rates appear to be higher in the United States and Europe.

Causes and risk factors

It is not known what exactly causes a generalized 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 generalized 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.

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 generalized 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 generalized anxiety disorder can make you feel constantly worried, distracted and restless. 

Methods for diagnosis

To work out if you have a generalized anxiety disorder, your doctor may start by asking questions about your symptoms and medical history. You may be diagnosed with a generalized 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.

Types of treatment

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

Psychotherapy

If you have generalized 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 behavioral therapy

Cognitive behavior therapy is a type of psychotherapy that can be used to help manage generalized anxiety disorder. People with generalized anxiety disorder tend to have negative feelings about aspects of their lives. Cognitive behavior therapy can teach people how to recognize 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 generalized anxiety disorder. 

Medication

Antidepressants

A generalized 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 generalized 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 generalized 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 recognizing 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.

Potential complications

A generalized 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.

Prognosis

The outlook for people with generalized 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.

Prevention

Because the cause of generalized 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. Recognizing the signs of generalized anxiety disorder and seeking treatment early may help prevent the condition getting worse.

Support services

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

National Suicide Prevention Lifeline Lifeline Call: 1-800-273-8255

We can all help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.