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Generalized anxiety disorder

It's normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that interfere with day-to-day activities may be a sign of generalized anxiety disorder.

It's possible to develop generalized anxiety disorder as a child or an adult. Generalized anxiety disorder has symptoms that are similar to panic disorder, obsessive-compulsive disorder and other types of anxiety, but they're all different conditions.

Living with generalized anxiety disorder can be a long-term challenge. In many cases, it occurs along with other anxiety or mood disorders. In most cases, generalized anxiety disorder improves with medications or talk therapy (psychotherapy). Making lifestyle changes, learning coping skills and using relaxation techniques also can help.

Symptoms Causes Risk factors Complications Prevention

Generalized anxiety disorder symptoms can vary. They may include:

  • Persistent worrying or obsession about small or large concerns that's out of proportion to the impact of the event
  • Inability to set aside or let go of a worry
  • Inability to relax, restlessness, and feeling keyed up or on edge
  • Difficulty concentrating, or the feeling that your mind "goes blank"
  • Worrying about excessively worrying
  • Distress about making decisions for fear of making the wrong decision
  • Carrying every option in a situation all the way out to its possible negative conclusion
  • Difficulty handling uncertainty or indecisiveness

Physical signs and symptoms may include:

  • Fatigue
  • Irritability
  • Muscle tension or muscle aches
  • Trembling, feeling twitchy
  • Being easily startled
  • Trouble sleeping
  • Sweating
  • Nausea, diarrhea or irritable bowel syndrome
  • Headaches

There may be times when your worries don't completely consume you, but you still feel anxious even when there's no apparent reason. For example, you may feel intense worry about your safety or that of your loved ones, or you may have a general sense that something bad is about to happen.

Your anxiety, worry or physical symptoms cause you significant distress in social, work or other areas of your life. Worries can shift from one concern to another and may change with time and age.

Symptoms in children and teenagers

In addition to the symptoms above, children and teenagers who have generalized anxiety disorder may have excessive worries about:

  • Performance at school or sporting events
  • Being on time (punctuality)
  • Earthquakes, nuclear war or other catastrophic events

A child or teen with generalized anxiety disorder may also:

  • Feel overly anxious to fit in
  • Be a perfectionist
  • Redo tasks because they aren't perfect the first time
  • Spend excessive time doing homework
  • Lack confidence
  • Strive for approval
  • Require a lot of reassurance about performance

When to see a doctor

Some anxiety is normal, but see your doctor if:

  • You feel like you're worrying too much, and it's interfering with your work, relationships or other parts of your life
  • You feel depressed, have trouble with drinking or drugs, or you have other mental health concerns along with anxiety
  • You have suicidal thoughts or behaviors — seek emergency treatment immediately

Your worries are unlikely to simply go away on their own, and they may actually get worse over time. Try to seek professional help before your anxiety becomes severe — it may be easier to treat early on.

As with many mental health conditions, the exact cause of generalized anxiety disorder isn't fully understood, but it may include genetics as well as other risk factors.

These factors may increase the risk of developing generalized anxiety disorder:

  • Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are.
  • Genetics. Generalized anxiety disorder may run in families.
  • Being female. Women are diagnosed with generalized anxiety disorder somewhat more often than men are.

Having generalized anxiety disorder does more than just make you worry. It can:

  • Impair your ability to perform tasks quickly and efficiently because you have trouble concentrating
  • Take your time and focus from other activities
  • Sap your energy
  • Disturb your sleep

Generalized anxiety disorder can also lead to or worsen other mental and physical health conditions, such as:

  • Depression (which often occurs with generalized anxiety disorder)
  • Substance abuse
  • Trouble sleeping (insomnia)
  • Digestive or bowel problems
  • Headaches
  • Heart-health issues

There's no way to predict for certain what will cause someone to develop generalized anxiety disorder, but you can take steps to reduce the impact of symptoms if you experience anxiety:

  • Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
  • Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
  • Prioritize issues in your life. You can reduce anxiety by carefully managing your time and energy.
  • Avoid unhealthy substance use. Alcohol and drug use and even caffeine or nicotine use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a treatment program or support group to help you.
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