Generalized anxiety disorder

Overview

It's normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities may be a sign of generalized anxiety disorder.

It's possible to develop generalized anxiety disorder as a child or an adult. Generalized anxiety disorder has symptoms that are similar to panic disorder, obsessive-compulsive disorder and other types of anxiety, but they're all different conditions.

Living with generalized anxiety disorder can be a long-term challenge. In many cases, it occurs along with other anxiety or mood disorders. In most cases, generalized anxiety disorder improves with psychotherapy or medications. Making lifestyle changes, learning coping skills and using relaxation techniques also can help.

Symptoms

Generalized anxiety disorder symptoms can vary. They may include:

• Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events
• Overthinking plans and solutions to all possible worst-case outcomes
• Perceiving situations and events as threatening, even when they aren't
• Difficulty handling uncertainty
• Indecisiveness and fear of making the wrong decision
• Inability to set aside or let go of a worry
• Inability to relax, feeling restless, and feeling keyed up or on edge
• Difficulty concentrating, or the feeling that your mind "goes blank"

Physical signs and symptoms may include:

• Fatigue
• Trouble sleeping
• Muscle tension or muscle aches
• Trembling, feeling twitchy
• Nervousness or being easily startled
• Sweating
• Nausea, diarrhea or irritable bowel syndrome
• Irritability

There may be times when your worries don't completely consume you, but you still feel anxious even when there's no apparent reason. For example, you may feel intense worry about your safety or that of your loved ones, or you may have a general sense that something bad is about to happen.

Your anxiety, worry or physical symptoms cause you significant distress in social, work or other areas of your life. Worries can shift from one concern to another and may change with time and age.

Symptoms in children and teenagers

Children and teenagers may have similar worries to adults, but also may have excessive worries about:

• Performance at school or sporting events
• Family members' safety
• Being on time (punctuality)
• Earthquakes, nuclear war or other catastrophic events

A child or teen with excessive worry may:

• Feel overly anxious to fit in
• Be a perfectionist
• Redo tasks because they aren't perfect the first time
• Spend excessive time doing homework
• Lack confidence
• Strive for approval
• Require a lot of reassurance about performance
• Have frequent stomachaches or other physical complaints
• Avoid going to school or avoid social situations

When to see a doctor

Some anxiety is normal, but see your doctor if:

• You feel like you're worrying too much, and it's interfering with your work, relationships or other parts of your life
• You feel depressed or irritable, have trouble with drinking or drugs, or you have other mental health concerns along with anxiety
• You have suicidal thoughts or behaviors — seek emergency treatment immediately

Your worries are unlikely to simply go away on their own, and they may actually get worse over time. Try to seek professional help before your anxiety becomes severe — it may be easier to treat early on.

Causes

As with many mental health conditions, the cause of generalized anxiety disorder likely arises from a complex interaction of biological and environmental factors, which may include:

• Differences in brain chemistry and function
• Genetics
• Differences in the way threats are perceived
• Development and personality

Risk factors

Women are diagnosed with generalized anxiety disorder somewhat more often than men are. The following factors may increase the risk of developing generalized anxiety disorder:

• Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are.
• Genetics. Generalized anxiety disorder may run in families.
• Experiences. People with generalized anxiety disorder may have a history of significant life changes, traumatic or negative experiences during childhood, or a recent traumatic or negative event. Chronic medical illnesses or other mental health disorders may increase risk.

Complications

Having generalized anxiety disorder can be disabling. It can:

• Impair your ability to perform tasks quickly and efficiently because you have trouble concentrating
• Take your time and focus from other activities
• Sap your energy
• Increase your risk of depression

Generalized anxiety disorder can also lead to or worsen other physical health conditions, such as:

• Digestive or bowel problems, such as irritable bowel syndrome or ulcers
• Headaches and migraines
• Chronic pain and illness
• Sleep problems and insomnia
• Heart-health issues

Generalized anxiety disorder often occurs along with other mental health problems, which can make diagnosis and treatment more challenging. Some mental health disorders that commonly occur with generalized anxiety disorder include:

• Phobias
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Depression
• Suicidal thoughts or suicide
• Substance abuse

Prevention

There's no way to predict for certain what will cause someone to develop generalized anxiety disorder, but you can take steps to reduce the impact of symptoms if you experience anxiety:

• Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
• Keep a journal. Keeping track of your personal life can help you and your mental health professional identify what's causing you stress and what seems to help you feel better.
• Prioritize issues in your life. You can reduce anxiety by carefully managing your time and energy.
• Avoid unhealthy substance use. Alcohol and drug use and even nicotine or caffeine use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a treatment program or support group to help you.