Generalized Anxiety Disorder

What Is Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is a medical condition characterized by excessive worrying, a sense of overwhelm, and even fear—sometimes without having a clear reason why.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), what separates generalized anxiety disorder from everyday feelings of anxiety is that GAD is often excessive and can be long-lasting.

GAD also differs from basic anxiety because it often impacts a person’s ability to perform daily activities, particularly those involving social situations (like work).

Additionally, many people with GAD experience panic attacks. Sometimes, these attacks seemingly come out of nowhere or are triggered by what might seem like an innocuous or minor incident.

An estimated 7 million American adults (roughly 3% of the U.S. population) have generalized anxiety disorder.

Causes and Risk Factors

Like most mental health conditions, some people are more likely to develop GAD than others.

Some of the more common risk factors for generalized anxiety disorder include:

• Brain Chemistry: Studies have shown that generalized anxiety disorder has been linked to chemical imbalances in the brain. There are also links between GAD and problems with specific nerve cell pathways that connect to the parts of the brain that control thinking and emotion.
• Genetics: While no anxiety gene has been identified, research suggests that you are more likely to develop generalized anxiety disorder if an immediate family member also has GAD.
• Trauma and environmental factors: Experiencing traumatic or stressful events (especially at an early age) can increase the risk of generalized anxiety disorder. Someone who is either currently dealing with addiction or has recently quit some type of substance abuse might also be more prone to GAD.

Symptoms of Generalized Anxiety Disorder

Experiencing stress and anxiety throughout the day doesn’t necessarily mean you have GAD.

For someone with GAD, the mental and physical symptoms of anxiety might manifest in the same way as regular anxiety but can be more intense, last longer, or have no real source. These symptoms can eventually become distracting and limit someone’s ability to manage their daily lives.

Common physical symptoms of GAD include:

• Sleep problems (i.e., insomnia)
• Muscle tension, spasms, or aches
• Trouble swallowing
• Trembling
• Constant sweating
• Feeling always out of breath
• Nausea or stomachaches
• Headaches

Common mental symptoms of generalized anxiety disorder include:

• Excessive stress, anxiety, and worry
• Trouble concentrating
• Constant feelings of restlessness
• Feeling on edge
• Constantly feeling tired
• Irritability
• Feeling self-conscious about your anxious feelings
• Difficulty concentrating
• Developing specific phobias

Generalized Anxiety Disorder and Addiction

Because the symptoms of generalized anxiety disorder can be so intense and long-lasting, some people may begin self-medicating with alcohol or other substances. They may drink or use drugs to dull their senses or escape reality.

However, substance use is only a short-term solution: as the substances wear off, anxiety symptoms return—sometimes even more intensely—and can cause a cycle of substance use.

Eventually, this regular substance use can lead to dependence and increase the risk of developing substance use disorder.

Research from the National Institute on Drug Abuse (NIDA) indicates that individuals with some form of anxiety (including GAD) are twice as likely to struggle with substance abuse as their counterparts.

Comorbidity between mental health issues and substance use disorder is also prevalent. The 2022 National Survey on Drug Use and Health (NSDUH) reports that 1 in 12 adults with substance use disorder also had a co-occurring mental illness.

Furthermore, 1 in 5 adolescents (ages 12-17) experienced a major depressive episode while also qualifying for a substance use disorder.

Treatment for Generalized Anxiety Disorder

While there is no known cure for generalized anxiety disorder, there are several treatment options to manage GAD’s symptoms.

The most successful forms of treatment for GAD include:

• Psychotherapy (i.e., talk therapy)
• Medication
• Support groups
• Lifestyle changes

Typically, a therapist or primary physician can work with you to develop a treatment plan to manage your specific symptoms and concerns. Your doctor may also perform a physical examination to rule out any other factors that can cause anxiety symptoms.

Psychotherapy

Psychotherapy—also known as “talk therapy”—helps people with generalized anxiety disorder come up with new, healthy ways to manage anxiety triggers and symptoms of anxiety.

The most popular type of talk therapy used to treat GAD is cognitive-behavioral therapy (CBT). However, dialectical behavioral therapy (DBT) and acceptance and commitment therapy (ACT) have also proven effective.

GAD Medications

Your doctor or healthcare provider might prescribe medication either alongside or in place of psychotherapy treatment to help manage symptoms of GAD.

Some of the most common medications used to treat GAD include:

• Selective Serotonin Reuptake Inhibitors (SSRI): A specific type of antidepressant that treats anxiety by helping the brain manage its serotonin.

Examples of SSRIs include:

• Fluoxetine (Prozac®)
• Sertraline (Zoloft®)
• Escitalopram (Lexapro®)
• Citalopram (Celexa®)
• Paroxetine (Paxil®)

Serotonin and Norepinephrine Reuptake Inhibitors (SNRI) Increase serotonin and norepinephrine levels in the brain. These brain neurotransmitters help stabilize mood, which can decrease symptoms of anxiety.

Examples of SNRIs include:

• Duloxetine (Cymbalta®)
• Venlafaxine (Effexor®)

Benzodiazepines: An anti-anxiety medication that creates a sedative effect on the brain. Benzodiazepines are usually prescribed to manage short-term symptoms (like panic attacks) rather than work as a long-term anxiety management solution.

Examples of benzodiazepines include:

• Alprazolam (Xanax®)
• Lorazepam (Ativan®)
• Clonazepam (Klonopin®)
• Diazepam (Valium®)

Buspirone: Originally developed as an antipsychotic, buspirone was found to help treat symptoms of anxiety by balancing dopamine and serotonin in the brain.

(Note: Brand-name buspirone, BuSpar®, was discontinued in 2010 due to the potential for abuse, but anxiety patients can still get generic buspirone for anxiety management.)

GAD Support Groups

In addition to taking medication and going to psychotherapy, some people might also benefit from a like-minded community. Support groups offer a judgment-free community of peers who understand the challenges of generalized anxiety disorder.

The Anxiety and Depression Association of America, for instance, offers local and online support groups and similar resources for people dealing with anxiety and similar mental health struggles.

But they aren’t the only ones. There are countless support groups for GAD and anxiety disorders throughout the United States, as well as apps, forums, and other online resources for people with GAD to participate in healthy communities of others dealing with the same challenges.

Lifestyle Changes

Although no amount of mindfulness techniques or breathing exercises can eliminate mental illness, research shows that specific lifestyle changes can make a significant positive impact on those dealing with anxiety, including GAD.

Some adjustments that can help you manage your GAD symptoms include:

• Adopting a healthier diet
• Yoga
• Meditation
• Exercise
• Avoiding caffeine and other stimulants
• Limiting or avoiding alcohol
• Relaxation techniques such as deep breathing
• Getting enough sleep

Find Help for Generalized Anxiety Disorder

If you or a loved one are one of the nearly 7 million people who suffer from generalized anxiety disorder, it’s ok to ask for help.

If you don’t know where to start, check out SAMHSA’s free online treatment locator or call them at 1-800-662-4357. They provide resource information and referrals for mental health professionals, from psychiatrists to licensed counselors.