Disease: Anxiety disorder, generalized

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

It's normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that 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 medications or talk therapy (psychotherapy). Making lifestyle changes, learning coping skills and using relaxation techniques also can help.

Source: http://www.mayoclinic.com

Generalized anxiety disorder symptoms can vary. They may include:

  • Persistent worrying or obsession about small or large concerns that's out of proportion to the impact of the event
  • Inability to set aside or let go of a worry
  • Inability to relax, restlessness, and feeling keyed up or on edge
  • Difficulty concentrating, or the feeling that your mind "goes blank"
  • Worrying about excessively worrying
  • Distress about making decisions for fear of making the wrong decision
  • Carrying every option in a situation all the way out to its possible negative conclusion
  • Difficulty handling uncertainty or indecisiveness

Physical signs and symptoms may include:

  • Fatigue
  • Irritability
  • Muscle tension or muscle aches
  • Trembling, feeling twitchy
  • Being easily startled
  • Trouble sleeping
  • Sweating
  • Nausea, diarrhea or irritable bowel syndrome
  • Headaches

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.

Symptoms in children and teenagers

In addition to the symptoms above, children and teenagers who have generalized anxiety disorder may have excessive worries about:

  • Performance at school or sporting events
  • Being on time (punctuality)
  • Earthquakes, nuclear war or other catastrophic events

A child or teen with generalized anxiety disorder may also:

  • Feel overly anxious to fit in
  • Be a perfectionist
  • Redo tasks because they aren't perfect the first time
  • Spend excessive time doing homework
  • Lack confidence
  • Strive for approval
  • Require a lot of reassurance about performance

When to see a doctor

Some anxiety is normal, but see your doctor if:

  • You feel like you're worrying too much, and it's interfering with your work, relationships or other parts of your life
  • You feel depressed, have trouble with drinking or drugs, or you have other mental health concerns along with anxiety
  • You have suicidal thoughts or behaviors — seek emergency treatment immediately

Your worries are unlikely to simply go away on their own, and they may actually get worse over time. Try to seek professional help before your anxiety becomes severe — it may be easier to treat early on.

Source: http://www.mayoclinic.com

As with many mental health conditions, the exact cause of generalized anxiety disorder isn't fully understood, but it may include genetics as well as other risk factors.

Source: http://www.mayoclinic.com

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

To help diagnose generalized anxiety disorder, your health provider may:

  • Do a physical exam to look for signs that your anxiety might be linked to 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

Many experts use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose mental conditions. This manual is also used by insurance companies to reimburse for treatment.

DSM-5 criteria for generalized anxiety disorder include:

  • Excessive anxiety and worry about several events or activities most days of the week for at least six months
  • Difficulty controlling your feelings of worry
  • At least three of the following symptoms in adults and one of the following in children: restlessness, fatigue, trouble concentrating, irritability, muscle tension or sleep problems
  • Anxiety or worry that causes you significant distress or interferes with your daily life
  • Anxiety that isn't related to another mental health condition, such as panic attacks or post-traumatic stress disorder (PTSD), substance abuse, or a medical condition

Generalized anxiety disorder often occurs along with other mental health problems, which can make diagnosis and treatment more challenging. Some disorders that commonly occur with generalized anxiety disorder include:

  • Phobias
  • Panic disorder
  • Depression
  • Substance abuse
  • PTSD

Source: http://www.mayoclinic.com

Having generalized anxiety disorder does more than just make you worry. It can:

  • Impair your ability to perform tasks quickly and efficiently because you have trouble concentrating
  • Take your time and focus from other activities
  • Sap your energy
  • Disturb your sleep

Generalized anxiety disorder can also lead to or worsen other mental and physical health conditions, such as:

  • Depression (which often occurs with generalized anxiety disorder)
  • Substance abuse
  • Trouble sleeping (insomnia)
  • Digestive or bowel problems
  • Headaches
  • Heart-health issues

Source: http://www.mayoclinic.com

There's no way to predict for certain what will cause someone to develop generalized anxiety disorder, but you can take steps to reduce the impact of symptoms if you experience anxiety:

  • Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
  • Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
  • Prioritize issues in your life. You can reduce anxiety by carefully managing your time and energy.
  • Avoid unhealthy substance use. Alcohol and drug use and even caffeine or nicotine use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a treatment program or support group to help you.

Source: http://www.mayoclinic.com

Some people are interested in trying alternative medicine (a nonconventional approach instead of conventional medicine) or complementary medicine (a nonconventional approach used along with conventional medicine).

Several herbal remedies have been studied as a treatment for anxiety, such as those listed below, but more research is needed to fully understand the risks and benefits. Here's what researchers know — and don't know:

  • Kava. Kava appeared to be a promising treatment for anxiety, but reports of serious liver damage — even with short-term use — caused several European countries and Canada to pull it off the market. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using kava until more rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.
  • Valerian. In some studies, people who used valerian reported less anxiety and stress, but in other studies, people reported no benefit. Discuss valerian with your doctor before trying it. While it's generally well-tolerated, there are a few case reports of people developing liver problems when taking preparations containing valerian. If you've been using valerian for a long time and want to stop using it, many authorities recommend that its use be tapered down to prevent withdrawal symptoms.
  • Passionflower. A few small clinical trials suggest that passionflower might help with anxiety. In many commercial products, passionflower is combined with other herbs, making it difficult to distinguish the unique qualities of each herb. Passionflower is generally considered safe when taken as directed, but some studies have found it can cause drowsiness, dizziness and confusion.
  • Theanine. This amino acid is found in green tea and may be found in some supplements. Preliminary evidence shows that theanine may make some people feel calmer, but there is limited evidence that it helps treat anxiety.

Before taking herbal remedies or supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

Source: http://www.mayoclinic.com

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:

  • Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
  • Avoid alcohol and other sedatives. These substances can worsen anxiety.
  • Quit smoking and cut back or quit drinking coffee. Both nicotine and caffeine can worsen anxiety.
  • Use relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
  • Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.
  • Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed.

Source: http://www.mayoclinic.com

To cope with generalized anxiety disorder, here's what you can do:

  • Stick to your treatment plan. Take medications as directed. Keep therapy appointments. Consistency can make a big difference, especially when it comes to taking your medication.
  • Join an anxiety support group. Here, you can find compassion, understanding and shared experiences. You may find support groups in your community or on the Internet.
  • Take action. Work with your mental health provider to figure out what's making you anxious and address it.
  • Let it go. Don't dwell on past concerns. Change what you can and let the rest take its course.
  • Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.
  • Socialize. Don't let worries isolate you from loved ones or enjoyable activities. Social interaction and caring relationships can lessen your worries.

Source: http://www.mayoclinic.com

These 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.
  • Being female. Women are diagnosed with generalized anxiety disorder somewhat more often than men are.

Source: http://www.mayoclinic.com

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