Generalised Anxiety Disorder (GAD): Symptoms, Causes, Treatment

Everyone worries sometimes. But if worry feels constant, hard to control and starts to affect your daily life, it may be more than ordinary stress. This article explains generalised anxiety disorder (GAD) using information from the UK's National Health Service (NHS) and the World Health Organization (WHO).

What is GAD?

The NHS describes GAD as a common mental health condition in which people feel very anxious about many different things. The main symptom is stress or worry that affects daily life and is difficult to control. The NHS says most people feel anxious sometimes, and GAD is more likely if anxiety is present most of the time and affects everyday life.

Common symptoms

Besides worry, the NHS lists:

• trouble sleeping
• restlessness, irritability or difficulty concentrating
• tiredness and tension
• stomach problems
• palpitations, which means a noticeable or unusual heartbeat
• lightheadedness or dizziness
• low mood

GAD often occurs alongside other anxiety conditions, such as panic disorder or phobias. Because many of these symptoms can have other causes, a doctor can help work out what is going on.

Causes and risk factors

The NHS says GAD usually has no single obvious cause. Factors that can raise the risk include:

• having another anxiety disorder
• close relatives with anxiety, depression or other mental health conditions
• stressful or traumatic experiences, such as domestic violence, child abuse or bullying
• a painful long-term health condition
• a history of drug or alcohol misuse

The NHS adds that GAD is more common in women than in men. The WHO says anxiety disorders result from social, psychological and biological factors, and that people who have faced abuse, severe losses or other adversity are more likely to develop one.

How is GAD diagnosed?

A doctor will ask about your worries and physical symptoms, and being honest helps them reach an accurate diagnosis. According to the NHS, GAD may be diagnosed if you worry about a wide range of things, your anxiety affects daily life, your feelings are hard to control and you have felt anxious much of the time for at least six months.

Treatment options

The NHS says treatment can help manage symptoms, although it may take time. Main options are:

• Talking therapies, usually cognitive behavioural therapy (CBT), one-to-one or in a group
• Medicine, usually a type of antidepressant called an SSRI, prescribed by a doctor
• Referral to a community mental health team that can create a treatment plan

Doctors usually recommend talking therapy before medicine or specialist referral. The WHO says CBT-based treatments have the most evidence across a range of anxiety disorders, and that a class of sedative medicines called benzodiazepines is generally not recommended because of high dependence potential and limited long-term benefit. A doctor decides what is right for each person.

Self-help ideas from the NHS

• Talk to someone you trust.
• Try self-help books, online tools or courses.
• Practise calming breathing exercises, or gentle activities such as yoga.
• Get enough sleep and exercise regularly.
• Eat regular, balanced meals and limit caffeine.
• Gradually spend time in situations you have been avoiding, rather than avoiding them completely.
• Do not use alcohol, cigarettes, gambling or drugs to cope, because they can make mental health worse.

When to see a doctor

See a doctor if you think you may have GAD, or if you have been diagnosed and treatment is not helping. The NHS notes that adults in England can refer themselves to NHS talking therapies. If you feel unable to cope or have thoughts of harming yourself, seek urgent help right away. Crisis help lines exist in India and the United States, and a doctor or local health service can tell you which are available.

Do not stop or change prescribed treatment without talking to your doctor.

In an emergency, call your local emergency number (112 in India, 911 in the United States).