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Generalized anxiety disorder

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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:

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:

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:

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.

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.

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.

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.

References

  1. Tiller J.W.G. (2012) Depression and anxiety. Medical Journal of Australia 1:4 28-31.
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10 Most frequently asked questions (FAQs)

What is generalized anxiety disorder?
Almost everyone will worry or feel anxious at some time. You might worry about an exam that is coming up, or feel anxious about speaking in front of an audience. People with generalized anxiety disorder feel worried or anxious most of the time, even about small things.
What are the symptoms of generalized anxiety disorder?
The main symptom of generalized anxiety disorder is feeling worried or anxious most of the time. People with generalized anxiety disorder may get tired very easily, feel restless or irritable, find it hard to concentrate, have tense or sore muscles and have trouble carrying out everyday activities.
What are the causes of generalized anxiety disorder?
It is not known exactly what causes generalized anxiety disorder. Many factors are thought to contribute to the development of the condition. This might include experiencing a major stressful event, such as the death of a loved one or loss of a job, or having a traumatic childhood.
How is generalized anxiety disorder diagnosed?
To diagnose generalized anxiety disorder, your doctor may start by asking questions about your symptoms and medical history. To be diagnosed with generalized anxiety disorder, a person generally feels anxiety or worry most of the time for six months or more and experiences three of the following criteria: feeling irritable, feeling restless, getting tired easily, having sore or tense muscles, finding it hard to concentrate, and having difficulty sleeping.
How is generalized anxiety disorder treated?
Treatment for generalized anxiety disorder may involve a combination of psychotherapy and medication. Psychotherapy involves meeting with a therapist to discuss your thoughts and feelings and any problems that you may be having. In particular, a type of psychotherapy called cognitive behavior therapy can teach people how to tell when worrying is not productive and how to let go of things that are needlessly causing anxiety. Medications, such as antidepressants, can also help to relieve the symptoms of generalized anxiety disorder. Reducing stress by taking time to relax, exercising regularly and avoiding stimulants such as alcohol and caffeine may also help to manage the condition.
How does cognitive behavior therapy help with generalized anxiety disorder?
Cognitive behavior therapy is a type of psychotherapy that aims to teach people how to change their thinking habits. It can teach people with generalized anxiety disorder how to tell when worrying is not productive and how to let go of things that are needlessly causing anxiety.
What is anxiety?
Anxiety is a feeling of worry or nervousness about something. Anxiety may cause your heart to beat faster than normal, cause hot and cold flushes and tightening of the chest. It is normal to feel anxious in certain situations, such as before giving a presentation, struggling to meet a deadline, or taking an exam.
Who gets generalized anxiety disorder?
Anyone can get generalized anxiety disorder. People are more likely to develop the condition if they 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, or had a traumatic childhood.
Is there a way to prevent getting generalized anxiety disorder?
Because the causes of generalized anxiety disorder are not fully understood, there is no known way to prevent the condition. There are some steps that can be taken to help 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 from getting worse.
How common is generalized anxiety disorder?
Generalized anxiety disorder is one of the most common types of anxiety disorders. In Australia, it is thought that around one in seven adults are affected by the condition every year.

Related topics

Depression

Depression is a condition that causes a person to feel sad or miserable most of the time. It is a common condition that affects physical and mental health and can interfere with a person's ability to carry out daily activities. There is a range of treatments and support services available to help people recover.

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is an anxiety disorder that can cause significant disruption in a person’s life. It is a reaction to an intense event or period during which a person’s life or safety (or that of a loved one) was in danger.

Premenstrual dysphoric disorder

Premenstrual dysphoric disorder occurs when a woman experiences severe psychological and physical symptoms before menstruation. The symptoms experienced are more severe than those of premenstrual syndrome.

Seasonal affective disorder

Seasonal affective disorder (SAD) is a mental health disorder in which a person repeatedly experiences depression or low mood during the onset of winter (most commonly) or summer.

About this article

Title: Generalized anxiety disorder

Author: Dr Joanne Van der Velden PhD, BSc (Hons)

First Published: 17 Nov 2014

Last reviewed: 17 Jan 2022

Category: Information on Generalized anxiety disorder

Average rating: 5.0 out of 5 (1556 votes)

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