• What Is Generalized Anxiety Disorder?

    Anxiety can be a natural, beneficial reaction to stress or danger. Under normal circumstances, anxiety diminishes when the stressful situation ends. But for some people, anxiety persists and serves no constructive purpose. In generalized anxiety disorder (GAD), a person experiences excessive, prolonged worry over everyday concerns, such as job responsibilities, health or family well-being, or even minor matters, such as household chores or personal appearance.

    Along with worry itself, GAD may produce such physical symptoms as heart palpitations, sweating, headaches, and nausea. In addition, perpetual anxiety may impair concentration, memory, decision-making ability, and social functioning, such as maintaining intimate relationships or working. GAD is the most common anxiety disorder, affecting 3% of the population. Most people with GAD first have symptoms during young adulthood, though it may start at any age, and the disorder is slightly more prevalent among women.


    Who Gets Generalized Anxiety Disorder?

    GAD affects more than 6 million people in the United States. The chance that any given person in the United States will develop it over a lifetime is estimated at about 8%. General anxiety disorder affects more women (60%) than men (40%).



    • Excessive anxiety or worry that is not in ­proportion to the event.
    • Impaired concentration.
    • Decreased attention span.
    • Heart palpitations.
    • Profuse sweating.
    • Headaches.
    • Nausea.


    Causes/Risk Factors

    • The cause of GAD is unknown, but alterations in neurotransmitters such as gamma-aminobutyric acid (GABA), serotonin, and dopmaine may play a role.
    • Anxiety disorders also run in families, so genetic factors may play a role. Environmental triggers may also be involved.
    • Various drugs or chemical substances can trigger anxiety; these include caffeine, nonprescription decongestants and cold remedies, thyroid hormones and inhaled asthma drugs. Anxiety also accompanies withdrawal from alcohol, tobacco, sedatives, narcotics, and other addictive drugs.



    • A thorough psychological evaluation is used to identify the type of anxiety.
    • A physical examination, including certain blood tests, may help rule out underlying causes of anxiety or other disorders, such as an asthma attack, a heart attack, overactive thyroid, or certain vitamin deficiencies, that mimic its symptoms.



    • GAD can respond well to medication. Antidepressant medications are used for long-term treatment. These include selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), and paroxetine (Paxil); serotonin and norepinephrine reuptake inhibitors such as venlafaxine (Effexor); and tricyclics such as nortriptyline (Aventyl) and imipramine (Tofranil). The antianxiety drug buspirone (BuSpar) is also used for long-term management.
    • Short-term treatment involves the use of benzodiazepines such as alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin).
    • Psychotherapy, especially cognitive behavioral therapy, may be recommended, either alone or in combination with medication. During cognitive behavioral therapy, a person learns how to identify anxious thoughts, see how they are distorted, and develops skills to challenge and counteract them.
    • Relaxation techniques, such as deep breathing exercises or meditation, may help relieve anxiety.
    • Getting adequate sleep and regular exercise (which aids sleep and can improve self-esteem) can help.
    • Substances that trigger anxiety, such as caffeine, should be limited or discontinued.



    • Treatment of GAD may help prevent future episodes.


    When To Call Your Doctor

    • Consult a doctor if symptoms of anxiety interfere with daily functioning, or if you’ve experienced symptoms of GAD for longer than 3 months.


    Reviewed by Christos Ballas, M.D., Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA.  Review provided by VeriMed Healthcare Network.