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. 

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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

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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"

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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

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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

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Diagnosis:

To help diagnose generalized anxiety disorder, your doctor or mental health professional may:

• Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition

• Order blood or urine tests or other tests, if a medical condition is suspected

• Ask detailed questions about your symptoms and medical history

• Use psychological questionnaires to help determine a diagnosis

• Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

 

Treatment:

Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

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Psychotherapy:

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

Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.

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Medications:

Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects.

• Antidepressants. 

  • Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants.

• Buspirone. 

  • An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective.

• Benzodiazepines.

  •  In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you have or had problems with alcohol or drug abuse.

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