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.

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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"

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.

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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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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.

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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

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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.