Generalized Anxiety Disorder

Topic Overview

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, panic disorder, post-traumatic stress disorder, or social anxiety disorder), alcohol use problems, or personality disorder.

What causes generalized anxiety disorder?

The cause of generalized anxiety disorder is not known. Some studies show that it might be passed through the family (genetic).

Some problems such as hyperthyroidism can cause generalized anxiety symptoms.

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 sports.

You might also have physical symptoms, such as:

• Feeling tired or irritable, or having a hard time concentrating.
• Having headaches or muscle aches.
• Feeling 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 well.
• 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.

Treatment 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.