Generalized Anxiety Disorder

Overview

Feeling anxious occasionally is perfectly normal, especially if you are going through a stressful period of time. Generalized anxiety disorder is when you experience ongoing worry and anxiety. These symptoms may be hard to control and can interfere in day-to-day life.

You may develop generalized anxiety disorder when you’re a child, or as an adult. Generalized anxiety disorder has symptoms similar to obsessive-compulsive disorder different types of anxiety, and panic disorder, but they’re all different conditions. 

Living with anxiety can be a long-term challenge. In many cases it will occur alongside other mood disorders. Most of the time, generalized anxiety disorder improves with medications or therapy. Making lifestyle changes, using relaxation techniques, and learning coping skills can also help. 

Symptoms

The symptoms of generalized anxiety disorder are varied. They can include: 

  • Overthinking the plans and solutions to all worst-case scenarios. 
  • Difficulty with handling uncertainty. 
  • Difficulty concentrating, or feeling that your mind has ‘gone blank’. 
  • Persistent worrying or a feeling of anxiety towards a number of areas that are out of proportion to the impact of the events. 
  • Perceiving non-threatening events and situations as threatening. 
  • Inability to let go of, or set aside a worry
  • Indecisiveness and a fear of making the wrong choice. 
  • Inability to relax, feeling on edge, or feeling restless
  • Difficulty handling uncertainty. 

Physical signs and symptoms may include:

  • Nausea, IBS, or diarrhea
  • Trouble sleeping
  • Irritability
  • Muscle tension and muscle aches
  • Fatigue
  • Nervousness or being easily startled
  • Sweating
  • Trouble sleeping

There might be times when your worries are not completely consuming you, but for no apparent reason you still feel anxious. For example, you could feel an intense worry about the safety of you or your loved ones. You could also have a general sense that something bad is going to happen. 

If you have generalized anxiety disorder you will experience anxiety, worry, or physical symptoms. These will likely cause you distress at work, in social situations, or in other areas of your life. Worries may shift from one concern to another and they could change with time and age. 

Causes

The cause of generalized anxiety disorder is likely due to a complex interaction of environmental and biological factors. These factors may include: 

  • Genetics
  • Development and personality
  • Genetics
  • Difference in brain function and chemistry. 

Diagnosis

In order to help diagnose generalized anxiety disorder, your mental health professional or doctor may: 

  • Order blood tests or urine tests, if a medical condition is suspected. 
  • Use psychological questionnaires to help in determining a diagnosis
  • Do a physical exam in order to look for signs that your anxiety may be linked to medications or other health conditions. 
  • Ask detailed questions about your medical history or symptoms
  • Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) which is published by the America Psychiatric Association

Treatment

The treatment for your generalized anxiety disorder will be based on how much it affects your ability to function in daily life. There are two main treatments for generalized anxiety disorder: medications, and psychotherapy. You could benefit most from a combination of these two options. It might take some trial and error to figure out which treatments will work best for you. 

Psychotherapy

Psychotherapy, also known as psychological counseling or talk therapy, involves working with a therapist to reduce the symptoms of your anxiety. Cognitive behavioral therapy is found to be the most effective form of psychotherapy for generalized anxiety disorder. 

Cognitive behavioural therapy is usually a short term treatment. CBT focuses on teaching specific skills to effectively and directly manage your worries. This will allow you to gradually return to the activities you’ve avoided due to your generalized anxiety disorder. Through this process, your symptoms will improve as you build on your initial success. 

Medications

There are several kinds of medications that are used in the treatment of generalized anxiety disorder including the ones mentioned below. Talk with your doctor about the risks, benefits, and side effects of different kinds of medications. 

  • Antidepressants. Antidepressants, including medications in the serotonin and norepinephrine reuptake inhibitor (SNRI) and selective serotonin reuptake inhibitor (SSRI) classes, are usually the first medication you will try. Common antidepressants that are also used to treat generalized anxiety disorder include: duloxetine (Cymbalta), venlafaxine (Effexor), escitalopram (Lexapro) and paroxetine (Paxil, Pexeva). Your doctor could also recommend other antidepressants. 
  • Buspirone. Buspirone is an anti-anxiety medication that can be used on an ongoing basis. As with antidepressants, it usually takes several weeks for you to feel the full effects. 
  • Benzodiazepines. In rare circumstances, your doctor could prescribe a benzodiazepine to relieve anxiety symptoms. These are sedatives that are usually prescribed to relieve acute anxiety on a short-term basis. This medication is habit forming so this is not a good option if you have had issues with substance abuse in the past.