Generalized Anxiety Disorder

WHAT IS GENERALIZED ANXIETY DISORDER?

Generalized anxiety disorder, sometimes referred to as GAD, is characterized by chronic, excessive worry. Even when people with GAD recognize that their worry is extreme or unwarranted, they are nonetheless unable to control it.

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. About 5% of people have generalized anxiety disorder at some time. 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 abuse, or personality disorder.

WHAT ARE THE SYMPTOMS OF GENERALIZED ANXIETY DISORDER?

People suffering from GAD often experience symptoms such as restlessness, insomnia, poor concentration, fatigue and irritability. These are also common symptoms of depressive illnesses, and not surprisingly, GAD occurs most frequently in combination with depression and/or with other anxiety disorders.

COULD YOU BE SUFFERING FROM GENERALIZED ANXIETY DISORDER?

A trained healthcare professional can best determine whether or not GAD is a problem for you. He or she will likely ask you a number of questions to look for the symptoms of GAD, for example:

  • Are you a particularly nervous or anxious person?
  • Do you or people who know you well think of you as a worrier?
  • You might refer to your answers to these questions when discussing your concerns with your healthcare provider.

HOW IS GENERALIZED ANXIETY DISORDER TREATED?

Doctors commonly rely on antidepressant medications, specifically a class of medications called SSRIs, to help manage the symptoms of GAD. Benzodiazepines and other antidepressants are also effective in changing the brain’s underlying chemical messengers.

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 think positive thoughts instead of 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 (Prozac) and sertraline (Zoloft). Studies have shown sertraline to be a good medicine for children or adolescents with generalized anxiety disorder. These medicines usually take several weeks to a few months to work well.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor). Studies have shown venlafaxine to be a good medicine for people who have another problem along with generalized anxiety disorder, such as panic disorder or depression. These medicines take several weeks to work well.
  • Benzodiazepines, such as diazepam (Valium) or alprazolam (Xanax), which traditionally have been used to treat generalized anxiety disorder. In some people who take benzodiazepines, their body becomes too used to the medicine and their doctor might need to prescribe more of the medicine for it to work. If you stop taking benzodiazepines all of a sudden, you might feel more jittery or worried than usual (withdrawal symptoms). Some people might have seizures from stopping the medicine too quickly. Be sure to talk with your doctor before you stop taking your medicine. People can become addicted to it. Be sure not to let anyone else take this medicine.
  • Tricyclic antidepressants (TCAs), such as amitriptyline (Elavil) or nortriptyline (Pamelor) have also traditionally been used to treat generalized anxiety disorder.
  • Buspirone is often used with other medications to treat generalized anxiety disorder. It may be used alone if the anxiety is mild. It can take 2 to 3 weeks to start working. People who take buspirone will not become addicted to the medicine.

Tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin and norepinephrine reuptake inhibitors (SNRIs) can sometimes have side effects such as being restless and not being able to sleep. These symptoms can be similar to generalized anxiety disorder, but they usually go away after you take the medicine for a while.

Some medicines work better for different people than 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.

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.

To learn more about these options, visit Know your treatment options.