What Is Generalised Anxiety Disorder?

We all experience feelings of anxiety at some point in our lives, whether that be due to exams, interviews, or other life events. But if you feel anxious and worry constantly then this may be a sign of generalised anxiety disorder, especially if you feel that the anxiety you experience is affecting your day-to-day life.

This article will help to explore more closely what generalised anxiety disorder is, the different causes, the signs and symptoms, as well as the management and treatment of this mental health condition.

Overview

Generalised anxiety disorder (also known as anxiety neurosis) is different from occasional worry. It is usually described as a feeling of anxiety, intense fear, or constant worry which is persistent and interferes with day-to-day life.¹ You may worry about lots of different things, even though sometimes there may not be a clear reason to worry. People with this condition tend to struggle to relax or remember the last time they felt relaxed. It can be very hard to cope with this condition. You can become more tired because you are constantly worrying, which takes up a lot of energy. You may not be able to perform day-to-day tasks as well and as efficiently because your mind keeps wandering off to your thoughts.

Generalised anxiety disorder (GAD) is a long-term mental health condition. This condition is more commonly seen in people aged 35 to 55 years of age and is more common in women than men. According to Mind, 6 out of every 100 people in England have experienced GAD. 

Anxiety is also a common symptom of other mental health disorders such as social anxiety disorder/social phobia, panic disorder, separation anxiety disorder, obsessive compulsive disorder, selective mutism, and personality disorders.

Causes of generalised anxiety disorder

Generalised anxiety disorder can occur due to different environmental and genetic factors.¹ Although the exact cause of the condition is not known, there is a range of risk factors that could increase the likelihood of developing generalised anxiety disorder.

• Genetics can play a role and generalised anxiety disorders may run in families. You may be more likely to get generalised anxiety disorder if one of your parents has the condition
• Traumatic life events can play a significant role and these can include things such as bullying, childhood abuse, or physical abuse
• Having a long-term health condition or a disability can also increase the risk of generalised anxiety disorder because it can reduce your quality of life
• A history of drug or substance abuse, as well as alcohol misuse, can play a part in this mental disorder
• Other factors include being female, having a low income, and being widowed/divorced/separated.² It is also possible for some people to develop generalised anxiety disorder without a clear reason.

Signs and symptoms of generalised anxiety disorder

Generalised anxiety disorder not only affects you mentally but also physically. People can experience a wide range of symptoms and it presents differently for everyone. You may only have a few symptoms whereas others may have more.

The psychological symptoms of generalised anxiety disorder are:^3,4

• Persistently feeling anxious or worrying
• Finding it difficult to concentrate
• Insomnia (finding it hard to fall and stay asleep)
• Restlessness
• Becoming irritable
• Not being able to let go of your worries
• Overthinking situations
• Finding it hard to tackle uncertainty
• Being worried about making the wrong decision

Generalised anxiety disorder also has many different physical symptoms such as:^3,4

• Shortness of breath
• Palpitations (fast heartbeat)
• Fatigue
• Dizziness
• Tiredness
• Headache
• Sweating
• Muscle aches
• Shortness of breath
• Stomach aches
• Trembling
• Feeling nauseous

We all experience some feeling of anxiety or worry in our lives, but if the symptoms of generalised anxiety disorder are affecting your day-to-day life then it is important to speak to a doctor or your healthcare provider. The doctor will ask you about your psychological and physical symptoms and also check your medical records to help with diagnosis. They may also do some additional blood tests to rule out other health conditions. Likewise, it is important to see a doctor if you have concerns over alcohol or drug misuse as a way of coping with the symptoms of generalised anxiety disorder. If you experience any suicidal thoughts or behaviours then it is best to immediately seek emergency treatment.

Management and treatment for generalised anxiety disorder

Generalised anxiety disorder can be treated with psychological therapies and medication. Psychological treatments may be trialled before medication to see if they help with the symptoms and control your anxiety. Examples of psychological treatments you may be offered are:

• Self-help course: Usually involves working through a workbook or a computer program on your own. Some programs involve working through the self-help course with the addition of seeing a mental health professional every week or fortnightly
• Group courses: Consist of attending a weekly meeting with other people that have similar problems under the supervision of a therapist. In these groups, you will learn how to handle and tackle your excessive anxiety effectively
• Cognitive behavioural therapy: A talking therapy to help you cope more appropriately with the different thoughts, feelings, and emotions that you experience in different situations to help with your anxiety⁴
• Applied relaxation: Involves learning how to relax your muscles in stressful situations to help with general anxiety symptoms. A trained therapist can teach you the various techniques⁵

Medication may be offered if none of the psychological treatments have helped. Your doctor will talk to you about the different options available, how long you need to take the medication, and any side effects or interactions with other medications. You will also need to have regular check-ups with the doctor for the first 3 months to make sure that you are not experiencing too many side effects and whether the dose of the medication needs to be changed

The common medications that are offered are:

• Selective serotonin reuptake inhibitors (SSRIs) – Often offered as first-line treatment, these medications are a class of antidepressants. Examples are sertraline, fluoxetine, and escitalopram.⁴ It usually takes a few weeks for the medication to start working and it is taken long-term. Some common side effects include nausea, diarrhoea, headaches, agitation, constipation, weight loss, decreased appetite, dry mouth, and low sex drive. Side effects usually improve over time. If you experience these unpleasant symptoms, it is important to talk to your doctor because if these symptoms become too overbearing then your doctor can switch your medication.
• Serotonin-noradrenaline reuptake inhibitors (SNRIs) – These may be given if you have had problematic side effects from selective serotonin reuptake inhibitors or if selective serotonin reuptake inhibitors haven’t worked for you. These are also antidepressants which are taken long term and they take a couple of weeks to properly start working.⁴ Examples are duloxetine and venlafaxine. Common side effects are nausea, loss of appetite, dry mouth, headache, constipation, dizziness, insomnia, increased blood pressure, and low sex drive. If you experience concerning side effects, then remember to speak to your doctor. In some situations, if an antidepressant isn’t suitable, then a treatment called pregabalin can be offered.
• Benzodiazepines aren’t routinely offered but can be given short-term to help with a severe period of anxiety or excessive worry. Usually, diazepam is prescribed and it helps to quickly ease the symptoms associated with generalised anxiety disorder. This treatment can become addictive so it can only be taken short term.⁴

There are also lifestyle changes that you can implement to help with the management of generalised anxiety disorder. Things such as remembering to exercise regularly can help to improve your mood and make you feel less anxious. This can include things such as going for a run, swimming, or cycling. Other lifestyle changes include eating a healthy and balanced diet, trying to get enough sleep, avoiding caffeine, and consuming alcohol in moderation.  

FAQs

Can generalised anxiety disorder be prevented?

There is no specific cause of generalised anxiety disorder so it is difficult to prevent it. Looking after your physical and mental health can help prevent you from developing a mental health disorder.

Who are at risk of generalised anxiety disorder?

Many different risk factors could increase your likelihood of developing generalised anxiety disorder including family history, traumatic life events such as bullying, and suffering from other chronic health conditions.

How common is generalised anxiety disorder?

According to Mind, every 6 in 100 people experience generalised anxiety disorder in the UK. The mental disorder is more commonly seen in women than men. 

When should I see a doctor?

If the symptoms of generalised anxiety disorder affect your day-to-day life then it is important to speak to a doctor. Additionally, if you have any concerns over alcohol or drug misuse as a way of coping with the symptoms of generalised anxiety disorder then contact a doctor. If you experience any suicidal thoughts or behaviours then you should immediately seek emergency treatment.

Summary

Generalised anxiety disorder is a mental health condition where constant worry, fear or anxiety interferes with daily life and activities. Both environmental and genetic factors can play a role in developing generalised anxiety disorder, but there is no clear cause as to why it occurs. People can experience a range of psychological symptoms such as persistently feeling anxious, finding it hard to concentrate, and insomnia. Physical symptoms such as fatigue, headaches, and shortness of breath can also be present. Initially, psychological treatments may be offered such as cognitive behavioural therapy; however, medication such as antidepressants may be needed. If you think you may be experiencing generalised anxiety disorder then you should visit your GP.