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Generalised anxiety disorder


Expert reviewers Dr Liz Russell, Consultant Psychiatrist and Dr Angana Nankani, Bupa Clinics GP
Next review due May 2023

Generalised anxiety disorder is a long-term condition where you regularly feel very worried about a range of everyday things. There may not always be an obvious reason why you feel anxious. This makes generalised anxiety disorder different from other types of anxiety, such as phobias, where your feelings are about a particular situation.

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If you need help now

This page is designed to provide health information about anxiety. If you need help now, the following helpline is free for you to call and talk to someone.

  • Samaritans
    116 123 (UK and ROI)

Alternatively, follow this link to Mind’s website and click on the yellow ‘I need urgent help’ button at the top left of the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.

If you need immediate help or are worried about someone, call the emergency services.

Causes of generalised anxiety disorder

There’s no single cause of generalised anxiety disorder. But you may be more likely to get 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. Research has 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.

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, usually for at least six months. If you have generalised anxiety disorder, you’ll also have at least three of the following symptoms.

  • Feel restless or nervous.
  • Get tired easily.
  • Find it hard to concentrate.
  • Feel irritable.
  • Feel tension in your muscles.
  • Have trouble sleeping.

Other symptoms you may get 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.

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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
  • self-help books
  • changing your routine to make it more likely you’ll sleep well – for example, not having caffeine past 3pm or drinking alcohol in the evening
  • joining a local support group

It may help to talk to your friends and family about how you feel as they can also be an important source of support when you have anxiety.

For more tips and advice, see the article: How to stop worrying: six helpful ideas.

Treatment of generalised anxiety disorder

Talking therapies

Your GP may refer you to your local mental health team or you may be able to refer yourself through the Improving Access to Psychological Therapies programme. Contact your local trust to find out how, or your GP surgery if you need any help with this. 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 your thoughts, feelings or behaviours. You’ll normally have either group sessions or a one-on-one hour-long session each week for around three to four months (or for less time if you recover sooner). Alternatively, it may be possible for you to have CBT sessions online.
  • Applied relaxation therapy – this therapy teaches you ways of relaxing your muscles and controlling your breathing.

For either of these types of therapy, you’ll see a trained therapist or counsellor.

Medicines

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

Although these medicines 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, or seek urgent medical help. Other treatment options will depend on your situation. If you have physical symptoms of anxiety, your GP may prescribe you beta-blockers for example, such as propranolol.

For any medicines that your GP prescribes, they’ll 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.

Frequently Asked Questions

  • Yes, children can get generalised anxiety disorder.

    It’s usual for children to feel anxiety while they’re growing up – everything from separation anxiety from parents to being scared of the dark. But these usually pass with time as they get older and they don’t interfere with life. They might then be faced with different anxieties, such as their first day at school, or teenagers might feel worried about their looks and social pressures.

    While these are a natural part of life, if these worries are too strong, they might affect how children do at school, or behave, and even make them physically unwell. If you’re concerned about your child, ask your GP for advice. They’ll ask your child about how they’re feeling and assess if they have anxiety. Treatment options include CBT (including online therapy) and if this doesn’t work, your doctor might consider antidepressants but will usually refer your child for this care.



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Related information

    • Generalised anxiety disorder. BMJ Best Practice. newbp.bmj.com, last reviewed October 2019
    • Mental health. Oxford handbook of general practice. Oxford Medicine Online. oxfordmedicine.com, published online April 2014
    • Anxiety disorders. Medscape. emedicine.medscape.com, updated 27 March 2019
    • Generalised anxiety disorder and panic disorder in adults: management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, last updated July 2019
    • Better mental health for all: a public health approach to mental health improvement. Faculty of Public Health and Mental Health Foundation. www.fph.org.uk, published 2016
    • Generalized anxiety disorder. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2017
    • Anxiety, panic and phobias. Royal College of Psychiatrists. www.rcpsych.ac.uk, published February 2015
    • Cognitive behavioural therapy (CBT). Royal College of Psychiatrists. www.rcpsych.ac.uk, published March 2015
    • Antidepressants. Mind. www.mind.org.uk, published 2016
    • Antidepressant drugs. NICE British National Formulary. bnf.nice.org.uk, last updated 6 November 2019
    • Propranolol hydrochloride. NICE British National Formulary. bnf.nice.org.uk, last updated 30 April 2020
    • Andrews G, Bell C, Boyce P, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Aust N Z J Psychiatry 2018; 52(12):1109–72. www.ranzcp.org
  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, May 2020
    Expert reviewers Dr Liz Russell, Consultant Psychiatrist and Dr Angana Nankani, Bupa Clinics GP
    Next review due May 2023

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