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Generalized Anxiety Disorder

Generalized Anxiety Disorder

Do you often find yourself worrying about everyday issues for no obvious reason? Are you always waiting for disaster to strike or excessively worried about health, money, family, work, or school?

If so, you may have a type of anxiety disorder called generalized anxiety disorder (GAD) (GAD). GAD can make daily life feel like a constant state of worry, fear, and dread. The good news is GAD is treatable. Learn more about the symptoms of GAD and how to find help.

What is generalized anxiety disorder?
Occasional anxiety is a normal part of life. Many people may worry about health, money, or family problems. But people with GAD feel extremely worried or nervous more frequently about these and other things—even when there is little or no reason to worry about them. GAD usually involves persistent anxiety or dread that interferes with how you live your life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful events. People living with GAD experience frequent anxiety for months, if not years.
GAD develops slowly. It often starts around age 30, although it can occur in childhood. The disorder is more common in women than in men.

What are the signs and symptoms of generalized anxiety disorder?
People with GAD may:

Worry excessively about everyday things
Have trouble controlling their worries or feelings of nervousness
Know that they worry much more than they should\sFeel restless and have trouble relaxing
Have a hard time concentrating
Startle easily
Have trouble falling asleep or staying asleep
Tire easily or feel tired all the time
Have headaches, muscle aches, stomachaches, or unexplained pains
Have a hard time swallowing
Tremble or twitch
Feel irritable or “on edge.”
Sweat a lot, feel lightheaded or feel out of breath
Have to go to the bathroom frequently
Children and teens with GAD often worry excessively about:
Generalized Anxiety Disorder
Their performance in activities such as school or sports
Catastrophes, such as earthquakes or war
The health of others, such as family members
Adults with GAD are often highly nervous about everyday circumstances, such as:

Job security or performance
The health and well-being of their children or other family members
Being late
Completing household chores and other responsibilities
Both children and adults with GAD may experience physical symptoms such as pain, fatigue, or shortness of breath that make it hard to function and interfere with daily life.

Symptoms may fluctuate over time and are often worse during times of stress—for example, with a physical illness, school exams, or a family or relationship conflict.

What causes generalized anxiety disorder?
Risk for GAD can run in families. Several parts of the brain and biological processes play a key role in fear and anxiety. By learning more about how the brain and body function in people with anxiety disorders, researchers may be able to develop better treatments. Researchers have also found that external causes, such as experiencing a traumatic event or stressful environment, may put you at higher risk for developing GAD.

How is generalized anxiety disorder treated?
Talk to a healthcare provider if you’re experiencing symptoms of GAD. After discussing your history, a healthcare provider may conduct a physical exam to ensure that an unrelated physical problem is not causing your symptoms. A healthcare provider may refer you to a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The first step to effective treatment is to get a diagnosis, usually from a mental health professional.

GAD is generally treated with psychotherapy (sometimes called “talk therapy”), medication, or both. Speak with a healthcare provider about the best treatment for you.

Cognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat GAD. CBT teaches you different ways of thinking, behaving, and reacting to situations that help you feel less anxious and worried. CBT has been well studied and is the gold standard for psychotherapy.

Another treatment option for GAD is acceptance and commitment therapy (ACT) (ACT). ACT takes a different approach than CBT to negative thoughts and uses strategies such as mindfulness and goal setting to reduce your discomfort and anxiety. Compared to CBT, ACT is a newer form of psychotherapy treatment, so fewer data are available on its effectiveness. However, different therapies work for different types of people, so it can be helpful to discuss what form of therapy may be right for you with a mental health professional.

For more information on psychotherapy, visit the National Institute of Mental Health (NIMH) psychotherapies webpage.

Healthcare providers may prescribe medication to treat GAD. Different types of medication can be effective, including:

Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) (SNRIs)
Anti-anxiety medications, such as benzodiazepines\sSSRI and SNRI antidepressants, are commonly used to treat depression, but they also can help treat the symptoms of GAD. They may take several weeks to start working. These medications also may cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts low and is increased slowly over time. Talk to your healthcare provider about any side effects that you may experience.

Benzodiazepines, anti-anxiety sedative medications, can also be used to manage severe forms of GAD. These medications can be very effective in rapidly decreasing anxiety, but some people build up a tolerance to them and need higher and higher doses to get the same effect. Some people even become dependent on them. Therefore, a healthcare provider may prescribe them only for brief periods if you need them.

Buspirone is another anti-anxiety medication that can help treat GAD. Unlike benzodiazepines, buspirone is not a sedative and has less potential to be addictive. Buspirone needs to be taken for 3–4 weeks to be fully effective.

Both psychotherapy and medication can take some time to work. Many try more than one medication before finding the best one. A healthcare provider can work with you to find the best medication, dose, and duration of treatment for you.

For basic information about these and other mental health medications, visit NIMH’s Mental Health Medications webpage. Visit the U.S. Food and Drug Administration (FDA) website for the latest warnings, patient medication guides, and information on newly approved medications.

Support Groups\sSome people with anxiety disorders might benefit from joining a self-help or support group and sharing their problems and achievements with others. Support groups are available both in person and online. However, any advice you receive from a support group member should be used cautiously and does not replace treatment recommendations from a health care provider.

Healthy Habits
Practicing a healthy lifestyle also can help combat anxiety, although this alone cannot replace treatment. Researchers have found that implementing certain healthy choices in daily life—such as reducing caffeine intake and getting enough sleep—can reduce anxiety symptoms when paired with standard care—such as psychotherapy and medication.

Stress management techniques, such as exercise, mindfulness, and meditation, also can reduce anxiety symptoms and enhance the effects of psychotherapy. You can learn more about how these techniques benefit your treatment by talking with a healthcare provider.

To learn more ways to care for your mental health, visit NIMH’s Caring for Your Mental Health webpage.

How can I support myself and others with a generalized anxiety disorder?
Educate Yourself
A good way to help yourself or a loved one struggling with GAD is to seek information. Research the warning signs, learn about treatment options and keep up to date with current research.

If you are experiencing GAD symptoms, have an honest conversation about how you feel with someone you trust. If you suspect a friend or family member is suffering from GAD, talk with them and express your concern while assuring them of your support.

Understand When to Seek Assistance
If your or a loved one’s anxiety begins to cause problems in everyday life, such as at school, work, or with friends and family, it’s time to seek professional help. Discuss your mental health with a healthcare provider.

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