Generalized Anxiety Disorder

Medically Reviewed by Zilpah Sheikh, MD on October 15, 2023
Written by WebMD Editorial Contributors
9 min read

Generalized anxiety disorder (GAD) is when you worry a lot and have a hard time controlling it. When you have GAD, you tend to expect disaster and can't stop worrying about health, money, family, work, school, or other things.

Everyone feels anxiety now and then—and there can be good reasons why. But with GAD, your worry is often constant. Daily life becomes a never-ending state of worry, fear, and dread. Eventually, anxiety can dominate your thinking so much that you find it hard to do routine things at work or school, socially, and in your relationships. But there are treatments that can help.

Nearly 4 million adult Americans, or about 2% of the population, have GAD during the course of a year. It often begins in childhood or adolescence, but it can begin in adulthood. It's more common in women than in men.

GAD affects the way you think, and it can lead to physical symptoms. Mental health professionals use a standard set of criteria to diagnose GAD. Those symptoms can't be caused by a medical problem or other condition, and they must last at least 6 months.

Mental symptoms include:

  • Ongoing worry and tension
  • Viewing problems more intensely than those who don't have GAD
  • Overthinking plans or solutions
  • Worst-case scenario thinking
  • Viewing events as threatening even if they aren't
  • Restlessness or feeling on edge
  • A hard time dealing with uncertainty
  • A fear of making the wrong choice
  • Trouble concentrating
  • Tiring easily or being fatigued
  • Increased crankiness or irritability
  • Feeling like your mind is blank

Physical symptoms include:

  • Trouble falling sleeping or staying asleep
  • Muscle tension or muscle aches and soreness
  • Fatigue
  • Trembling or feeling twitchy
  • Headaches
  • Hot flashes
  • Lightheadedness
  • Breathing trouble
  • Being easily startled
  • Going to the bathroom a lot
  • Feeling like there's a lump in your throat
  • Feeling unable to relax
  • Nausea, diarrhea, or irritable bowel syndrome
  • Sweating

Those with GAD often also have other anxiety disorders such as panic disorder or phobias, obsessive compulsive disorder, clinical depression, or problems with drug or alcohol misuse.

Symptoms in children

Kids and teenagers can have worries similar to those of adults. Their symptoms might include:

  • Being a perfectionist
  • Feeling overly worried to fit in
  • Spending too much time doing homework
  • Redoing tasks because they're not perfect the first time
  • Looking for approval
  • Not having enough confidence
  • Having a lot of stomach aches or other physical symptoms
  • Needing a lot of reassurance
  • Not going to school or avoiding social events

Children might worry more about:

  • Their family members' safety
  • Their performance in school or sporting events
  • Being on time
  • Earthquakes or other catastrophic events

Experts don't know the exact causes of GAD. Several things—including genetics, brain chemistry, and environmental stresses—appear to contribute to its development.

  • Brain chemistry. This is complex. GAD has been linked to problems with certain nerve cell pathways that connect particular brain regions involved in your thinking and emotion. These nerve cell connections depend on chemicals called neurotransmitters that send information from one nerve cell to the next. If the pathways that connect particular brain regions don't work well, problems related to mood or anxiety may result. Medicines, psychotherapies, or other treatments that are thought to work on these neurotransmitters may improve the signaling between circuits and help to improve symptoms related to anxiety or depression.
  • Environmental factors. Trauma and stressful events such as abuse, the death of a loved one, divorce, and changing jobs or schools may contribute to GAD. The condition can also worsen when your stress feels out of hand. Use of, and withdrawal from, addictive substances (including alcohol, caffeine, and nicotine) can also worsen your anxiety.
  • Medication side effects. If you take certain medicines or have a substance abuse disorder, you may have anxiety as a symptom. Many different medications can do this. Ask your doctor if you're concerned that your medicine is causing you anxiety.
  • Medical conditions. Some conditions can cause anxiety too, like hyperthyroidism, because it raises hormones. Some chronic illnesses and diseases can also cause GAD.

There some risk factors that can increase your risk for GAD:

Being female. Those assigned female at birth are slightly more likely to be diagnosed with GAD than those assigned male at birth.

Genetics. Some research suggests your family history affects your chances of having GAD. But no anxiety genes have been identified, and families may also pass down a GAD tendency through lifestyle or environment.

Experiences. You may have had large life changes or traumatic experiences recently or while growing up. Due to this, your risk of mental illness and mental health disorders may be higher.

Your personality. If you're more negative, timid, or fearful of anything dangerous, you may have a higher risk of GAD.

If you have symptoms of GAD, your doctor will ask questions about your medical and psychiatric history. You may also get a physical exam. Lab tests don't diagnose anxiety disorders, but some can help doctors check for physical illness that might be causing your symptoms.

Your doctor bases their diagnosis of GAD on reports of how intense and long-lasting your symptoms are, including any problems with daily life caused by the symptoms. They determine whether you have GAD.

To be diagnosed with GAD, your symptoms must interfere with daily living and be present for more days than not for at least 6 months.

GAD-7

This is a tool you can use to find out if you have GAD. You can see how severe your anxiety symptoms are and screen for social anxiety, panic, and post-traumatic stress disorder.

This diagnostic test is only seven items long and takes 2-5 minutes to complete.

You're asked to rate how often you've had anxiety symptoms in the last 2 weeks on a scale from 0 to 3 (with zero being not at all and three being nearly every day).

You can take this test by yourself or by interview in-person or over the phone. You can take it at home or in a doctor's waiting room or office. You may write the answers down with a paper and pencil or record your answers with a tablet or another device.

After you take the test, the numbers will be added up to get your score. Your results will be based on these different ranges:

  • 1-4: minimal symptoms
  • 5-9: mild symptoms
  • 10-14: moderate symptoms
  • 15-21: severe symptoms

Your doctor will review your symptoms to figure out if your issues are from another condition before they diagnose you with GAD.

If no other medical condition is found, you may be referred to a psychiatrist or psychologist. These are mental health professionals trained to diagnose and treat mental health conditions including GAD. Treatment of GAD most often includes a combination of medication and cognitive behavioral therapy (CBT). And your daily habits can make a difference.

Therapy

When you're treated for anxiety disorders, you might take part in CBT, in which you learn to recognize and change your thought patterns and behaviors that can lead to anxious feelings. This type of therapy helps limit your distorted thinking by looking at your worries through a more balanced lens. You may want to join a support group.

Medication

These aren't a cure, but they can help ease your symptoms. You can combine therapy with medications if therapy alone isn't enough. Your doctor may recommend drugs called benzodiazepines, often used to treat GAD in the short term. These are prescribed less often than in the past because they may be addictive or sedating and can interfere with your memory and attention.

They work by curbing your physical symptoms of anxiety, such as muscle tension and restlessness. Common benzodiazepines include alprazolam (Xanax), chlordiazepoxide Hcl (Librium), diazepam (Valium), and lorazepam (Ativan). These drugs can exaggerate sedation effects when combined with many other medicines, and they are dangerous if mixed with alcohol.

Certain antidepressants such as duloxetine (Cymbalta), escitalopram oxalate (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and venlafaxine (Effexor) are also used to treat GAD for longer periods. They may take a few weeks to start working, but they're safer and more appropriate for long-term treatment of GAD.

Buspirone is an antianxiety medication that can help on an ongoing basis. It also may take a few weeks to start working.

If you have GAD, you may need medication or therapy to keep your symptoms under control. But you can also try these lifestyle changes:

Exercise. Being active most days out of the week can be beneficial for your anxiety. It can help lower stress, keep you healthy, and boost your mood. Ease into a workout plan and heighten the amount of exercise you do slowly.

Try relaxation methods. Meditation, visualization techniques, yoga, and deep breathing are greats ways to lower anxiety.

A healthy diet. Eating well balanced meals packed with vegetables, fruits, fish, and whole grains might help lower anxiety. But more studies are needed to learn the exact link between anxiety and food.

Getting enough sleep. Make sure you get a good amount of high-quality sleep at night. If you have trouble sleeping, talk to your doctor.

Avoiding caffeine. A lot of caffeine can make your anxiety worse. Cut down or stop drinking it altogether to manage your symptoms.

Avoiding alcohol and other drugs. Nicotine, alcohol, and other drugs can make your anxiety worse as well. Avoid these if they trigger your symptoms.

Biofeedback. This technique uses electrical pads to get information about your body (like your heart rate, muscular responses, and breathing patterns).You can use biofeedback in a doctor's office or at home. But biofeedback machines for home use aren't controlled by the FDA. It's best to ask your doctor which ones are best before starting.

GAD can cause many different complications such as:

  • Low energy
  • A higher risk of depression
  • Distracting your focus and taking time away from other things
  • Harming your ability to complete tasks quickly and properly due to lack of concentration

It can also cause or worsen other health conditions like:

  • Heart-health issues
  • Headaches and migraines
  • Chronic illnesses and pain
  • Sleep issues like insomnia
  • Digestive or bowel conditions like irritable bowel syndrome or ulcers

It's possible to become dependent on sedative-hypnotic medications (benzodiazepines) if they're used on an ongoing basis.

Side effects of antidepressants that treat GAD vary by specific drug and the person taking them. Common side effects include sleepiness, weight gain, nausea, and sexual problems.

There are no negative side effects from therapy or healthy lifestyle measures. Whether those are enough to handle an anxiety disorder or if medications are also needed is a decision to make with your doctor.

Most people with GAD have substantial relief from their symptoms with proper treatment. Symptoms can come and go. So it's important to stick to your treatment plan, which may include therapy, healthy lifestyle habits, and medication. If your anxiety symptoms flare up, reach out to your support team, including your doctor or therapist.

Anxiety disorders like GAD can't always be prevented. But there are some things that you can do to help prevent it or lessen your symptoms:

  • Seek counseling and support after a traumatic or disturbing experience or if you're feeling more anxious than usual.
  • Get 30 minutes or more of exercise 3-5 days a week.
  • Stay connected to others. Don't get isolated.
  • Take breaks when you start to worry. Try to let go of concerns about the past.
  • If you have an anxiety treatment plan, stick with it.
  • Ask your doctor or pharmacist before taking any over-the-counter drugs or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
  • Practice stress management techniques.
  • Consider joining a support group for people dealing with anxiety.
  • Avoid or limit substance use as much as you can.
  • Prioritize things so you don't get overwhelmed.
  • GAD is when you worry a lot and have a hard time controlling it.
  • GAD can be hard to control, but treatments and lifestyle changes can help.
  • Most people with GAD have substantial relief from their symptoms with proper treatment.
  • GAD can lead to other issues, which is why it's important to keep it under control.
  • Can you live a normal life with GAD?

Yes. If you're able to control your symptoms and get proper treatment, you can live a normal life.

  • What is an example of GAD?

With GAD, you may worry a lot about your health, money, job, schooling, family, or other things. These worries are stronger than typical concerns.

  • Is GAD considered a serious mental illness?

GAD is considered a serious mental illness.

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