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Generalised anxiety disorder


Expert reviewer, Dr Rahul Bhattacharya, Consultant Psychiatrist
Next review due September 2020

Generalised anxiety disorder is a long-term condition where you regularly feel very worried about a range of everyday things.

When you have generalised anxiety disorder, there may not always be an obvious reason why you feel anxious. This makes it different from other types of anxiety, such as phobias, where your feelings are about a particular situation.

Man looking out window

Symptoms of generalised anxiety disorder

The main symptoms of generalised anxiety disorder are:

  • regularly feeling very worried about a number of everyday things
  • finding it hard to control the worry

These problems aren’t just temporary, but continue for a while. This could be six month or more, although your doctor will consider what symptoms you’ve been having and how serious they are when making a diagnosis.

Generalised anxiety disorder also means having at least three of the following symptoms:

  • feeling restless or nervous
  • becoming tired easily
  • finding it hard to concentrate
  • feeling irritable
  • feeling tension in your muscles
  • having trouble sleeping well

Other symptoms you may experience include:

  • sweating
  • dizziness
  • shortness of breath
  • chest pain
  • feeling sick
  • diarrhoea or stomach problems

Diagnosis of generalised anxiety disorder

Your GP will ask you about your symptoms. They will also want to know whether you, or any of your family members, have had mental health problems in the past. People who have generalised anxiety disorder often have another mental health problem at the same time, such as depression, or another type of anxiety.

Your GP may also ask whether you are taking any medicines or illegal drugs, to rule out other reasons why you may be feeling anxious. They may do some physical checks, for example to test your heart rate. If they think the anxiety might be linked to another health condition, your GP may arrange further tests to look into this.

How to help yourself

Your GP may suggest that you try some self-help techniques to help manage generalised anxiety disorder. These could include:

  • relaxation techniques, such as meditation or mindfulness
  • exercise
  • reading self-help books
  • changing your routine to make it more likely you’ll sleep well – for example, not drinking alcohol or having caffeine in the evening
  • joining a local support group

Talking to your friends and family about how you feel can also be an important source of support when you have anxiety.

Treatment of generalised anxiety disorder

Medicines

Antidepressants are the main drugs used to treat generalised anxiety disorder. These are drugs that improve your mood by changing the balance of chemicals in your brain. The type of antidepressants used to treat generalised anxiety disorder are serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs).

Before taking SSRIs or SNRIs, let your GP know if you suffer from gastritis. You should also let them know if you’re taking aspirin or other painkillers. Although these medications generally help people feel better, some people (particularly younger people) may have suicidal thoughts after taking them. Let your GP know as soon as possible if this happens.

Other drug options will depend on your situation. Your GP may prescribe a medication called pregabalin or, as a short-term solution in a crisis, they may also offer benzodiazepines. However, there can be risks with taking pregabalin or benzodiazepines, including addiction and the medicines not working in the future. So these medications would usually only be offered in exceptional circumstances and for a short while.

For any medicines that your GP prescribes, they should explain how it works, how to take it and the potential side-effects. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice.

Talking therapies

Your GP may be able to refer you to your local mental health team. The mental health team may offer you a choice of two types of counselling.

  • Cognitive behavioural therapy (CBT) – this is a therapy that can help you to challenge negative thoughts, feelings or behaviours.
  • Applied relaxation therapy – this therapy teaches you ways of relaxing your muscles and controlling your breathing.

For either of these types of therapy, you will see a trained therapist or counsellor. You will normally have an hour-long session each week, for around three months (or for less time if you recover sooner). Alternatively, it may be possible for you to have CBT sessions online.

Causes of generalised anxiety disorder

There is no single cause of generalised anxiety disorder. But you may be more likely to experience it if:

  • your life has become more stressful
  • you’ve been through a traumatic experience in the past
  • a family member also had generalised anxiety disorder

Certain chemicals in our body help to regulate our mood, including a chemical called serotonin. Studies have suggested that generalised anxiety disorder can happen when the balance of these chemicals isn't quite right. It may also happen when the parts of your brain that deal with stress become overactive.

Generalised anxiety disorder often happens alongside other mental health problems, particularly depression. The same symptoms that occur with generalised anxiety disorder can also sometimes be linked to alcohol or drug problems, or the physical effects of another health condition.


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Related information

    • BMJ Best Practice. Generalised anxiety disorder. bestpractice.bmj.com, last updated March 2017
    • Anxiety disorders. National Institute for Health and Care Excellence (NICE) guidance. www.nice.org.uk, February 2014
    • Mental health. Oxford Handbook of General Practice (online). Oxford Medicine Online. oxfordmedicine.com, published April 2014
    • Generalised anxiety disorder. PatientPlus. patient.info/patientplus, last checked May 2016
    • Generalised anxiety disorder and panic disorder in adults: management. National Institute for Health and Care Excellence (NICE) guideline. www.nice.org.uk, January 2011  
    • Anxiety, Panic and Phobias. Royal College of Psychiatrists. www.rcpsych.ac.uk, last updated September 2015
    • Antidepressants. Royal College of Psychiatrists. www.rcpsych.ac.uk, last updated February 2015
    • Cognitive and behavioural therapies. PatientPlus. patient.info/patientplus, last checked April 2014
    • Hayes-Skelton SA, Roemer LA contemporary view of applied relaxation for generalized anxiety disorder. Cogn Behav Ther 2013; 42(4). doi: 10.1080/16506073.2013.777106
    • Anxiety and stress-related disorders. Oxford Handbook of Psychiatry (online). Oxford Medicine Online. oxfordmedicine.com, published March 2013
  • Reviewed by Graham Pembrey, Lead Editor, Bupa Health Content Team, September 2017
    Expert reviewer, Dr Rahul Bhattacharya, Consultant Psychiatrist
    Next review due September 2020



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