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Generalized anxiety disorder: A guide

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SymptomsCausesTreatmentsSummary
Generalized anxiety disorder (GAD) can deeply affect your life, causing symptoms like panic, persistent worry, and insomnia. But there are treatments available to help you manage it.
Medically reviewed by Joshana K. Goga PharmD MBA BCPP
Updated on February 2, 2024

Generalized anxiety disorder (GAD) is a very common form of anxiety that affects millions of people worldwide.

Due to its pervasiveness, the medical field has dedicated considerable research into the symptoms and causes of generalized anxiety disorder, as well as forms of treatment. These include cognitive behavioral therapy (CBT), antidepressant medications, and natural remedies.

There are also important lifestyle changes you can make to help distance yourself from your worrisome thoughts and help keep GAD at bay.

Symptoms

Two adolescents living with generalized anxiety disorder, laughing and eating ice cream.
Maskot/Getty Images

It’s important to distinguish GAD from worry that is limited to a specific event or stressful period. GAD is persistent and excessive worry. It’s the most common anxiety disorder among adults, affecting 6.8 million adults or 3.1% of the U.S. population. 

A doctor diagnoses GAD when an individual has difficulty managing their worry on more days than not for a period of more than 6 months and has three or more of the following symptoms:

  • nervousness or irritability
  • a sense of impending doom, panic, or danger
  • increased heart rate
  • hyperventilation and sweating, trembling, or both
  • weakness or fatigue
  • difficulty concentrating
  • sleeplessness
  • stomach problems

Like all forms of anxiety, an inability to deal with uncertainty can overwhelm a person’s daily functioning, the severity of which can fluctuate over time. 

When an individual is able to manage their anxiety symptoms, they can function well both personally and professionally. When anxiety is more severe, the condition may greatly affect a person’s day-to-day activities.

Causes

Genetics, family background, and negative life experiences can all play a role in causing GAD, and women are twice as likely to be diagnosed with GAD than men.

According to medical research, there is a link between GAD and an imbalance in the levels of naturally occurring brain chemicals such as serotonin and norepinephrine. Some people may be genetically predisposed to such an imbalance in the brain.

However, some research has also found that external factors — traumatic life events in childhood or adulthood or severe sources of stress — can put people at higher risk for developing GAD. 

There is a link between certain medical conditions and GAD. For example, some 2020 research finds that chest pain in coronary artery disease can lead to increased anxiety symptoms.

Other research finds an association between your thyroid and anxiety disorders. For example, there’s a link between autoimmune thyroiditis and hypothyroidism and anxiety disorders like GAD.

Treatments

Several options are available to help people manage their GAD symptoms, including pharmaceutical drugs, natural treatments, and therapy.

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Medication

As there is a link between GAD and the availability of certain hormones in the brain, medical professionals consider selective serotonin reuptake inhibitors (SSRIs) or selective norepinephrine reuptake inhibitors (SNRIs) as the first-line treatment for the condition. 

SSRIs can help keep serotonin circulating in the brain. Examples include escitalopram (Lexapro) and paroxetine (Paxil).

SNRIs affect the chemical messengers used to communicate between brain cells. Examples include duloxetine (Cymbalta) and venlafaxine (Effexor).

There are also anti-anxiety drugs, like benzodiazepines, that you can use in the short term to help relieve some of the physical symptoms of GAD, such as muscle tension and stomach issues. Examples include:

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Therapy

The leading therapy for GAD is cognitive behavioral therapy (CBT), which a 2017 study showed to be a key method of helping people distance themselves from their anxious thoughts. 

It involves regularly connecting with a mental health professional who can teach mindfulness practices and exercises. The goal is to change the anxious thinking and behaviors associated with GAD.

Natural remedies

Some home remedies can help ease anxiety, which can work especially well in combination with the treatments above. These include chamomile, which research finds can help GAD by affecting your body’s cortisol levels. Chamomile tea might be a possible home remedy for you.

Mindfulness practices such as yoga and meditation are showing promising results in helping to reduce anxiety levels, according to some 2019 research. The combination of breath work, meditation, and exercise can help slow anxious thoughts and release hormones in the body that reduce stress. 

All forms of exercise can also help release these neurotransmitters, called endorphins. Therefore, the regularity of the exercise is more important than the type.

Eating a healthy, balanced diet, getting enough sleep, and avoiding stimulants such as caffeine can also reduce the negative effects of GAD on health and well-being.

Summary

GAD is a common anxiety disorder that can result in recurrent thoughts of worry and often coincides with physical symptoms like headaches, sweaty palms, and stomach issues.

Treatments for GAD include anti-anxiety or antidepressant medications, cognitive behavioral therapy, and lifestyle changes. Often, the most effective management plan involves multiple treatments. 

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