Generalized Anxiety Disorder

ByJohn W. Barnhill, MD, New York-Presbyterian Hospital
Reviewed/Revised Aug 2023
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Generalized anxiety disorder consists of excessive nervousness and worry about a number of activities or events. People have anxiety more days than not over a period of 6 months or longer. The cause is unknown, although it commonly coexists in people who have alcohol use disorder, major depression, or panic disorder.

  • People are anxious and worried about a variety of issues, activities, and situations, not just one type.

  • For this disorder to be diagnosed, several other symptoms (such as a tendency to tire easily, difficulty concentrating, and muscle tension) must accompany the anxiety.

  • Treatment involves a combination of medications (usually antianxiety medications and sometimes antidepressants) and psychotherapy.

Generalized anxiety disorder is a common type of anxiety disorder. About 3% of adults have it yearly. Women are twice as likely as men to have the disorder. The disorder more commonly begins in adulthood but may start at any age (see Generalized Anxiety Disorder in Children).

For most people, the disorder fluctuates, worsening at times (especially during times of stress), and persists over many years.

Symptoms of Generalized Anxiety Disorder

People with generalized anxiety disorder constantly feel worried or distressed and have difficulty controlling these feelings. The severity, frequency, or duration of the worries is greater than the situation warrants.

Worries are general in nature, include many topics, and often shift from one topic to another over time. Common worries include work and family responsibilities, money, health, safety, car repairs, and chores.

Diagnosis of Generalized Anxiety Disorder

  • A doctor's evaluation, based on standard psychiatric diagnostic criteria

For a doctor to diagnose generalized anxiety disorder, a person must experience worry or anxiety that

  • Is excessive

  • Concerns a number of activities and events

  • Is present more days than not over a period of 6 months or longer

In addition, the person must have 3 or more of the following symptoms:

  • Restlessness or a keyed-up or on-edge feeling

  • A tendency to tire easily

  • Difficulty concentrating

  • Irritability

  • Muscle tension

  • Disturbed sleep

Before diagnosing generalized anxiety disorder, doctors do a physical examination. They may do blood or other tests to make sure the symptoms are not caused by a physical disorder or use of a drug.

Treatment of Generalized Anxiety Disorder

  • A combination of psychotherapy and medications

The disorder is often managed with a combination of some form of psychotherapy and drug therapy. Psychotherapy can address the causes of anxiety and provide ways to cope.

Some antidepressantsnorepinephrineAntianxiety and Sedative Drugs), these medications are usually given for only a relatively short time. Once the antidepressant and psychotherapy becomes effective, the dose of the benzodiazepine may be decreased slowly, then stopped. Benzodiazepines should not be stopped abruptly.

Herbal products such as kava and may have antianxiety effects, although their effectiveness and safety for treating anxiety disorders such as generalized anxiety disorder require further study.

Cognitive-behavioral therapy has been shown to be beneficial for generalized anxiety disorder. With this therapy, people learn to do the following:

  • Recognize where their thinking is distorted

  • Control their distorted thinking

  • Modify their behavior accordingly

Relaxation, yoga, meditation, exercise, and biofeedback techniques may also be of some help (see Mind-Body Techniques).

More Information

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  1. National Institute of Mental Health, Generalized Anxiety Disorder: Basic information on many aspects of generalized anxiety disorder, including prevalence statistics

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