What is Generalized Anxiety Disorder?

Occasional anxiety can be a normal part of life. But people with generalized anxiety disorder experience persistent and extreme worry out of proportion to the actual likelihood or impact of an anticipated event. This chronic anxiety results in physical symptoms which interfere with managing tasks of everyday living to the point of being debilitating.

Signs & Symptoms

For a diagnosis of generalized anxiety disorder, a person must have experienced excessive anxiety and worry more days than not for at least six months; finds it difficult to control the worry; and the anxiety or worry causes at least three of the following physical symptoms of anxiety:

• Restlessness or feeling keyed up or on edge
• Being easily fatigued 
• Difficulty concentrating or mind going blank
• Irritability 
• Muscle tension that results in trembling, twitching, feeling shaky, and muscle aches or soreness
• Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)
• Other physical anxiety symptoms including sweating, nausea, diarrhea, exaggerated startle reflex, headaches and irritable bowel syndrome

In addition, a diagnosis of generalized anxiety disorder is considered when the anxiety is not related to another mental health condition such as panic attacks, PTSD or social phobia; substance abuse; or a medical condition.

Causes

General anxiety disorder sometimes runs in families, but the exact cause is unknown.

Risk Factors

Risk factors that could contribute to generalized anxiety disorder include:

Gender: Females are twice as likely to experience a generalized anxiety disorder.

European descent: Those of European descent are more likely to experience the disorder than those of other descents.

Environment: People from developed countries report more experiences with a generalized anxiety disorder than people from underdeveloped countries.

Temperament: Generalized anxiety disorder has been associated with temperaments of inhibition, neuroticism and harm avoidance.

Environmental factors: Childhood adversities and parental overprotection have been associated with the condition.

Diagnosis

Diagnosing generalized anxiety disorder (GAD) requires a thorough physical and psychological evaluation. Your behavioral health provider will use the criteria for generalized anxiety disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to determine if your symptoms indicate the condition.

Diagnostic tests for GAD include:

Physical examination: Your physician will perform a physical exam and ask questions about your health to determine if your symptoms could be linked to an underlying physical health problem.

Psychiatric evaluation: Your behavioral health provider will ask about your symptoms, thoughts, feelings and behavior patterns. You will be asked about your personal and family history of mental illness, anxiety disorders and other mood disorders. Your behavioral health provider may also ask questions to test your reasoning, memory and ability to express yourself.

Prognosis

Proper diagnosis and treatment help people with generalized anxiety disorder lead healthy and productive lives.

Treatment

Most people with generalized anxiety disorder benefit from a combination of medication and psychotherapy delivered by a psychiatrist, psychologist or other behavioral health professionals.

Psychotherapy for GAD

Working with a therapist can reduce the symptoms of anxiety and help you identify and monitor anxiety, teach physical and mental control strategies and provide skills to cope with worry.

Medications to Treat Generalized Anxiety Disorder

Medication can help treat the symptoms of generalized anxiety disorder and is typically prescribed along with therapy. You may need to try a few different medications or combinations before finding the one that’s right for you. Some medications take a few weeks before their full effect is obvious. Some cause side effects for certain patients. If you experience any side effects, it’s important to talk to your provider immediately but not abruptly stop taking the medication, which could cause worsening symptoms.

Common medications prescribed for generalized anxiety disorder include:

• Antidepressants: These medications may be prescribed to help manage depression caused by anxiety.
• Antianxiety medications: An antianxiety medication called buspirone may be prescribed to treat symptoms including fear, irritability, pounding heart and other symptoms caused by anxiety.
• Sedatives: These medications may be recommended for a short term to help with severe episodes of anxiety or until antidepressants take effect.

Complications

Early and ongoing treatment is key for managing generalized anxiety disorder. Left untreated, the disorder can be very disruptive to a person’s life, leading to:

• Inability to perform daily tasks quickly and efficiently, compromising effectiveness at school or work
• Trouble sleeping
• Substance abuse
• Depression

Prevention

Seeking treatment at the earliest sign can help prevent generalized anxiety disorder from getting worse or interfering with your life. Certain lifestyle changes can assist in minimizing the effects of generalized anxiety disorder:

Physical activity: Regular exercise helps reduce stress and improve mood.

Avoid alcohol, caffeine and nicotine: Alcohol, caffeine and tobacco products can worsen anxiety. 

Get enough sleep: Healthy sleep patterns can help defend against anxiety.