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. About 5% of people have
generalized anxiety disorder at some time.1 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 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.
- Having
a hard time swallowing.
- Feeling shaky, sweating, or having hot
flashes.
- Feeling lightheaded, sick to your stomach, or out of
breath.
- Having to go to the bathroom often.
- 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 (Prozac) and sertraline (Zoloft). Studies show 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 show 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, the
body becomes too used to the medicine and the 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 or
nortriptyline (Pamelor), which have also traditionally been used to treat generalized
anxiety disorder.
- Buspirone, which is often used with other medicines
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.
- Trifluoperazine (Stelazine), an antipsychotic medicine that has been approved by the FDA to treat generalized anxiety disorder. Other antipsychotic medicines are also being studied. These medicines are not commonly used for generalized anxiety disorder because of their side effects, including mild to severe problems with body movements.
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 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 how to overcome them.