What is Generalised Anxiety Disorder?

Experiencing some anxiety from time to time is a common part of everyday life. If you’re faced with a stressful or threatening situation, anxiety can help you to respond to that situation. Anxiety is a natural response and can even be helpful when it matches or is in proportion to the situation causing it and fades once the source of anxiety is no longer present.

However, your anxiety may be negatively impacting your life when:

• You have trouble identifying the cause of your anxiety
• Your anxiety is out of proportion to (i.e., does not match the level of seriousness or danger of) what’s causing it
• Your anxiety continues to linger after the stressful situation has ended

Generalised Anxiety Disorder (GAD) is a mental health condition that causes excessive worry and anxiety. People with GAD often feel worried and sometimes have difficulty pinpointing where their worry comes from. ​​They may also experience anxiety that doesn’t seem to match the actual level of threat or the nature of the situation.

What causes Generalised Anxiety Disorder?

People of all different backgrounds can develop GAD. It is not always clear why someone develops it, and the specific causes vary for different people. Usually, GAD doesn’t have a single cause. Multiple factors are often involved.

Below are some of the factors that can increase a person’s risk of developing GAD, although the list is not exhaustive:

• Traumatic experiences, like losing a loved one or experiencing abuse
• Misuse of alcohol and/or other drugs
• Having a close family member with GAD or another anxiety disorder, or someone who has had these conditions in the past

If you already experience GAD, experiencing stressful situations can lead to a worsening of your symptoms.

Signs and symptoms of Generalised Anxiety Disorder

Excessive worry is the primary symptom of GAD. People with GAD often struggle to ignore their feelings of worry, even when the source of the worry has been resolved or when they know their concerns aren’t realistic or likely to happen.

Below is a list of some of the common symptoms of GAD. Keep in mind that symptoms can vary from person to person. If you suspect you have GAD, you might identify with some of these symptoms. However, confirming whether or not you have the condition requires a diagnosis from a qualified mental health professional.

Emotional and behavioural symptoms

• Intense feeling of worry on a daily basis
• Overthinking future situations and planning for the worst-case scenario
• Avoiding tasks that may cause excessive worry
• Constantly on edge waiting for something to go wrong
• Panic attacks
• Difficulty concentrating
• Mind “goes blank”
• Difficulty handling uncertainty
• Difficulty making decisions
• Lack of confidence
• Need to be reassured that you are performing well
• Intense longing to be perfect
• Intense longing to “fit in” or belong

Physical symptoms

Excessive worry caused by GAD puts extra stress on your body, which can cause you to experience physical symptoms too. These can include:

• Dizziness
• Stomach issues, including nausea and diarrhoea
• Excessive sweating
• Trouble falling asleep or staying asleep
• Fatigue
• Easily startled
• Irritability
•  Muscle tension or aches

Treatment for Generalised Anxiety Disorder

If you suspect you have GAD or have been diagnosed with GAD, it’s likely you’ve developed your own ways of coping. Personal coping mechanisms can come in different forms, but many people with GAD avoid situations or environments that tend to worsen their anxiety. Others use drugs and alcohol to numb their feelings of anxiety.

Although these strategies might offer short-term relief, they can actually increase your anxiety in the long run. They can limit your ability to engage in work, school, or social relationships, and they don’t address the underlying issues. Other evidence-based interventions, like talk therapies, may offer more lasting benefits. Through counselling or psychotherapy, you can learn healthier, more effective coping methods, as well as confronting the root cause of your persistent worry.

If you suspect you have GAD, going to your GP and explaining your symptoms is a good first step. Your local GP can point you in the right direction for treatment. Taking notes before your appointment—such as the duration, frequency, and intensity of your symptoms—can help you describe your experience clearly and accurately to your GP.

The types of treatment you receive may vary depending on the level of anxiety you experience. However, all treatments share the common goal of decreasing feelings of worry and increasing your capacity for self-regulation. Self-regulation is the ability to handle your emotional reactions to stress in a flexible way. This means learning to calm yourself or hold back emotions when needed and to communicate your feelings clearly and appropriately in different social situations.

Talk therapy

Talk therapy is often a part of treatment for GAD. It is a form of psychological therapy which involves speaking with a therapist in either an individual or group setting. This type of therapy allows you to identify healthy long-term coping strategies that work for you and explore what is causing your anxiety.

Cognitive behavioural therapy (CBT) is a widely recommended psychological treatment for GAD that can work well for people of all ages. CBT helps individuals understand how unrealistic or negative thoughts can influence their behaviours, and how these behaviours can, in turn, strengthen those negative thoughts. By challenging these thoughts, people with GAD can learn to change their behaviours and significantly reduce their anxiety. CBT can also help you to develop greater self-awareness, identify what triggers your anxiety, and establish new coping strategies that don’t reinforce familiar, unhelpful thoughts.

CBT is not the only treatment option available for GAD. In addition to CBT, your therapist might use graded exposure techniques to slowly introduce you to situations or environments you’ve been avoiding. Applied relaxation is another treatment often used for GAD, where you learn to relax your muscles in a specific way during stressful situations.

Medication

There are many medications available to help people manage GAD. The three main types are antidepressants, anti-anxiety medications, and beta-blockers. These medications are prescribed for a variety of conditions and will have different side effects for different people. If you are open to taking medication, work with a GP or psychiatrist to find the one that works for you.

Antidepressants are usually the first medication prescribed for anxiety. Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, escitalopram, and sertraline are effective at treating anxiety as well as depression. Other antidepressants include serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine and duloxetine. Antidepressants can take a few weeks or months to become fully effective, and your doctor may work up to your full dose gradually to avoid the risk of adverse side effects.

Another option is anti-anxiety medications, such as duloxetine. These work quickly to reduce anxiety symptoms, but they can be habit-forming so they are usually only prescribed as a short-term solution.

Finally, beta-blockers are sometimes prescribed for people with GAD. Beta-blockers help block the physical symptoms of anxiety caused by adrenaline. They are usually prescribed for specific anxiety-inducing occasions, like a public speaking event, rather than as a long-term solution.

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