People with generalized anxiety disorder (GAD) worry uncontrollably about common occurrences and situations. It’s also sometimes known as chronic anxiety neurosis.

GAD is different from normal feelings of anxiousness. Most people feel anxious at times about aspects of life, such as their finances, but people with GAD feel overwhelmed by their problems and their anxiety.

If you have GAD, you may worry constantly about a range of everyday things, such as your family, health, or finances. You may do this, even when you’re aware there isn’t a reason to worry.

GAD often appears around the age of 30, but it can also affect children.

This excessive, unrealistic worry can be frightening and can interfere with relationships and daily activities. However, a range of treatment options are available.

Physical and mental symptoms of GAD include:

  • perceiving situations as more threatening than they are
  • difficulty in letting go of worries
  • difficulty concentrating
  • difficulty sleeping
  • difficulty with uncertain situations
  • irritability, nervousness, overthinking, and difficulty relaxing
  • fatigue and exhaustion
  • muscle tension
  • twitching or trembling
  • sweating (including sweaty palms)
  • repeated stomachaches, diarrhea, or other gastrointestinal issues
  • feeling shaky or weak
  • rapid heartbeat
  • dry mouth
  • being easily startled
  • neurological symptoms, such as numbness or tingling in different parts of the body

Childhood and teenage anxiety may occur in about 1 in 4 children at some point during their teen years. Symptoms in young people and teenagers can also include:

  • anxiety about fitting in with their peers
  • issues with confidence and self-esteem
  • worrying excessively about or avoiding social situations and schoolwork
  • worrying about approval from teachers and other authority figures
  • having issues with physical symptoms such as stomachaches

Distinguishing GAD from other mental health issues

Anxiety is a common symptom of many mental health conditions, like depression and various phobias. GAD is different from these conditions in several ways.

People with depression may occasionally feel anxious, and people who have a phobia may worry about one particular thing. People with GAD worry about a number of different topics over a long period of time (6 months or more), or they may not be able to identify the source of their worry.

Causes of and risk factors for GAD may include both environmental and genetic factors, such as:

  • a family history of anxiety
  • recent or prolonged exposure to stressful situations, including personal or family illnesses
  • excessive use of caffeine or tobacco, which can make existing anxiety worse
  • childhood abuse or bullying
  • certain health conditions such as thyroid problems or heart arrhythmias

Some 2015 evidence suggests that those living with GAD may experience certain activation in areas of the brain associated with mental activity and introspective thinking when they encounter situations that could cause worry.

Studies show that the prevalence of GAD is likely about 7.7% in women and 4.6% in men over their lifetime.

GAD is diagnosed with a mental health screening that your doctor can perform. They will ask you questions about your symptoms and how long you’ve had them. They can also refer you to a mental health specialist, such as a psychologist or psychiatrist.

Your doctor may also do medical tests to determine whether there’s an underlying illness or substance abuse problem causing your symptoms. Anxiety has been linked to:

If your primary care professional suspects that a medical condition or substance abuse problem is causing anxiety, they may perform more tests. These may include:

  • blood tests, to check hormone levels that may indicate a thyroid disorder
  • urine tests, to check for substance abuse
  • gastric reflux tests, such as an X-ray of your digestive system or an endoscopy procedure to look at your esophagus to check for GERD
  • X-rays and stress tests, to check for heart conditions

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) involves meeting regularly to talk with a mental health professional.

The goal of CBT for general anxiety is to change your thinking and behaviors. This approach has been associated with lower anxiety symptoms within 12 months after treatment.

It may be even more effective for GAD than for other types of conditions, such as post-traumatic stress disorder (PTSD) or social anxiety disorder (SAD).

In therapy sessions, you’ll learn how to recognize and manage your anxious thoughts. Your therapist will also teach you how to calm yourself when upsetting thoughts arise.

Doctors often prescribe medication along with therapy to treat GAD.

Medication

If your doctor recommends medication, they will most likely create a short-term medication plan and a long-term medication plan.

Short-term medications relax some of the physical symptoms of anxiety, such as muscle tension and stomach cramping. These are called anti-anxiety medications. Some common anti-anxiety medications are:

Anti-anxiety drugs are not meant to be taken for long periods of time, as they have a high risk of dependence and abuse.

Medications called antidepressants can work well for long-term treatment. Some common antidepressants are:

These medications can take a few weeks to start working. They can also have side effects, such as dry mouth, nausea, and diarrhea. These symptoms can bother some people so much that they stop taking these medications.

There’s also a very low risk of increased suicidal thoughts in young adults at the beginning of treatment with antidepressants. Stay in close contact with your prescriber if you’re taking antidepressants. Make sure you report any mood or thought changes that worry you.

Your doctor may prescribe both an anti-anxiety medication and an antidepressant. If so, you’ll probably only take the anti-anxiety medication for a few weeks until your antidepressant starts working, or on an as-needed basis.

Many people can find relief by adopting certain lifestyle or behavioral changes. These may include:

  • getting regular exercise if possible
  • eating a balanced and nutrient-dense diet
  • getting enough sleep
  • practicing yoga and meditation
  • avoiding stimulants, such as coffee, diet pills, and caffeine pills
  • talking with a trusted friend, spouse, or family member about fears and worries

Alcohol and anxiety

Drinking alcohol can make you feel less anxious almost immediately. This is why people who live with anxiety may turn to drinking alcohol to feel better.

However, it’s important to remember that alcohol can have a negative effect on your mood. Within a few hours after drinking, or the day after, you may feel more irritability or depression.

Alcohol can also interfere with the medications used to treat anxiety. Some medication and alcohol combinations can be fatal.

If you find that your drinking is interfering with your daily activities, talk with your doctor. You can also find free support to stop drinking through Alcoholics Anonymous (AA).

GAD can lead to or aggravate other mental and physical health issues, such as:

  • depression, which often occurs with an anxiety disorder
  • sleep problems
  • misuse of drugs or alcohol
  • digestive problems
  • social isolation
  • challenges with work or studies
  • reduced quality of life
  • thinking of or attempting suicide

Seeking advice promptly for GAD may help prevent these issues.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

People who have feelings of anxiety or depression can benefit from seeking help early.

Tips that can help include:

  • learning about anxiety
  • understanding how medications work
  • following the doctor’s advice on treatment, following up, and so on
  • working with counselors
  • stopping the use of caffeine and other stimulants
  • seeking help and support for any physical conditions that may be contributing to anxiety
  • managing stress through regular sleep and exercise
  • establishing and maintaining social interactions

People who find it hard to establish social interaction may benefit from joining a walking group, group counseling, or volunteering with a charity.

Most people can manage GAD with a combination of therapy, medication, and lifestyle changes.

Talk with your doctor if you’re concerned about how much you worry. They can refer you to a mental health specialist.

What are the symptoms of generalized anxiety disorder?

People with GAD may feel restless, tense, or on edge. They may find it hard to focus and have recurring thoughts about a source of worry, such as finances. Physical signs include gastrointestinal disturbances, muscle tension, twitching, trembling, and sweating. They may also have problems sleeping. GAD can also interfere with daily activities, including work or studies.

What is the main cause of GAD?

Doctors do not know why GAD happens, but it may be linked to levels of serotonin and norepinephrine in the brain. Often, people feel better when they use drugs known as selective serotonin reuptake inhibitors (SSRIs) or selective norepinephrine reuptake inhibitors (SNRIs), which help maintain circulating levels of these hormones.

What does GAD feel like?

If you have GAD, you may feel as if your problems or your anxiety are out of control. Daily life may feel like one long round of worry, fear, and dread. You may also notice physical symptoms, such as clenched muscles, sweating, trembling, or twitching. The anxiety may last for months or years. Sometimes it’s present from childhood, but it commonly begins around the age of 30.

People with GAD worry more intensely and frequently than other people. They may worry about one thing for a long time, and sometimes they cannot identify the source of the anxiety. Stress, physical illness, and life changes can worsen symptoms.

Treatment is available in the form of medication, counseling, and lifestyle remedies. Anyone who believes they may have GAD should seek medical advice. Treating GAD early may help prevent complications, such as depression and social isolation.