What is generalized anxiety disorder?
Generalized anxiety disorder occurs when you feel worried and stressed
about many everyday events and activities. Often the things you are worried
about are small or not important. This type of worry disrupts your life most
days. Everyone gets worried or anxious sometimes. But people with generalized
anxiety disorder experience more than normal everyday worries.
Many people who have generalized anxiety disorder have physical symptoms,
such as headaches or being tired all the time.
Anyone can get
generalized anxiety disorder at any age. But it usually starts when you are a
child or teenager. Most people with generalized anxiety disorder have felt
nervous or anxious as long as they can remember. Women are
twice as likely as men to have the problem.
Many people with
generalized anxiety disorder also have other problems such as
depression, other anxiety illnesses (obsessive-compulsive disorder,
post-traumatic stress disorder, or
social anxiety disorder),
alcohol abuse, or personality disorder.
What causes generalized anxiety disorder?
cause of generalized anxiety disorder is not known. Some studies show that it
might be passed through the family (genetic).
Some problems such
hyperthyroidism can cause generalized anxiety
Some medicines can cause worry and stress or make your
stress worse, such as medicines with amphetamines (Ritalin) or too much
caffeine. Illegal drugs such as cocaine can also cause these symptoms. Be sure
to talk with your doctor about any medicines you are taking.
What are the symptoms?
People who have
generalized anxiety disorder get worried and stressed about many things almost
every day. They have a hard time controlling their worry. Adults with this
problem often worry about money, family, health, or work. Children with this
problem often worry about how well they can do an activity, such as school or
You might also have physical symptoms, such as:
- Feeling tired or irritable, or having a hard time
- Having headaches or muscle aches.
a hard time swallowing.
- Feeling shaky, sweating, or having hot
- Feeling lightheaded, sick to your stomach, or out of
- Having to go to the bathroom often.
like you can't relax, or being startled easily.
- Having problems
falling or staying asleep.
How is generalized anxiety disorder diagnosed?
To find out if you have this problem, your
doctor will ask questions about your symptoms and how long you have had them.
Your doctor will also do a
physical exam, ask questions about your medical
history, and ask questions about medicines you are taking. This information
helps your doctor find out whether you have any other condition.
To be diagnosed with generalized anxiety disorder, you must have more
worry and stress than normal. You must feel worried and stressed about many
things almost every day. And these feelings must last for at least 6 months.
You will also have some physical symptoms. The worry, stress, and physical
symptoms might make it hard for you to do normal activities such as going to
work every day or doing grocery shopping.
If you think you may have an anxiety disorder, fill out a form (What is a PDF document?) to check your symptoms.
How is it treated?
Generalized anxiety disorder is treated with
medicines and/or therapy.
The two kinds of therapy that are
used to treat generalized anxiety disorder are called applied relaxation
therapy and cognitive-behavioral therapy. In applied
relaxation therapy, your therapist might ask you to imagine a calming situation
to help you relax. In cognitive-behavioral therapy, your therapist will help
you learn how to recognize and replace thoughts that make you feel
stressed and worried.
Some of the medicines that are used to treat
generalized anxiety disorder are:
- Selective serotonin reuptake inhibitors (SSRIs), such as
fluoxetine and sertraline, and serotonin and norepinephrine reuptake inhibitors (SNRIs),
such as duloxetine and venlafaxine. These are the most common medicine types to treat generalized anxiety disorder. These medicines usually take several weeks to a few months to work
- Benzodiazepines, such as alprazolam or diazepam.
- Tricyclic antidepressants (TCAs), such as imipramine.
- Buspirone, which is often used with other medicines
to treat generalized anxiety disorder.
- Trifluoperazine, an antipsychotic medicine.
Some medicines work better for some people than
for others. Be sure to talk with your doctor about how the medicine is working for
you. Sometimes you might need to try more than one type of medicine before you
find one that works best for you.
Taking medicines for anxiety during pregnancy may
increase the risk of birth defects. If you are pregnant, or thinking of
becoming pregnant, talk to your doctor. You may need to keep taking the medicine if
your anxiety is severe. But your doctor can help you weigh the risks of treatment
against the risk of harm to your pregnancy.
for generalized anxiety disorder helps reduce the symptoms. Some people might
feel less worried and stressed after a couple months of treatment. And some
people might not feel better until after a year or more.
Unfortunately, many people don't seek treatment for anxiety disorders.
You may not seek treatment because you think the symptoms are not bad enough or
that you can work things out on your own. But getting treatment is important.
If you need help deciding whether to see your doctor, see
some reasons why people don't get help and read about how to overcome them.
Organization Anxiety and Depression Association of America (ADAA) www.adaa.org
- Alcohol Abuse and Dependence
- Drug Abuse and Dependence
- Post-Traumatic Stress Disorder
- Stress Relief and Relaxation
Other Works Consulted
Pine DS (2009). Anxiety disorders: Introduction and overview. In BJ Sadock et al., eds., Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th ed., vol. 1, pp. 1839–1926. Philadelphia: Lippincott Williams and Wilkins.
American Psychiatric Association (2000). Anxiety disorders. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 472–476. Washington, DC: American Psychiatric Association.
Gale CK, Millichamp J (2011). Generalised anxiety disorder, search date May 2011. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
Iacoviello BM, Mathew SJ (2010). Anxiety disorder. In EG Nabel, ed., ACP Medicine, section 13, chap. 1. Hamilton, ON: BC Decker.
Keeton CP, Walkup JT (2009). Separation anxiety, generalized anxiety, and social phobia. In BJ Sadock et al., eds., Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3684–3693. Philadelphia: Lippincott Williams and Wilkins.