Generalized Anxiety Disorder

The main symptom of general anxiety disorder is frequent or excessive worry about multiple issues, with little or no clear cause, that lasts for at least six months. An individual's worries shift from one problem to another and may include family or other relationships, work, school, money and health. 

People with GAD cannot seem to get rid of their concerns, which may interfere with their school or work performance. Their worries persist even though they usually realize that their anxiety is more intense than the situation warrants.

GAD affects almost 7 million Americans, although it occurs twice as often in women. Although they don't avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe.

Symptoms of GAD

Generalized anxiety disorder can cause many symptoms, such as:

  • Difficulty concentrating
  • Irritability
  • Easily startled
  • Easily fatigued
  • Restlessness
  • Sleep problems (falling asleep or staying asleep)
  • Headaches
  • Lightheadedness
  • Muscle tension
  • Having to use the bathroom frequently
  • Excessive sweating or hot flashes
  • Upset stomach
  • Breathlessness
  • Trembling or twitching


A physician or mental health professional will diagnose generalized anxiety disorder if the individual has:

  • Six months of excessive anxiety and worry

  • Three or of the above symptoms for most days for six or more months

  • Difficulty controlling his or her anxiety or worry

  • Symptoms are not due to another psychiatric disorder


GAD rarely occurs alone. A treatment plan may include Cognitive-behavioral therapy, medication or both and will take into account whether the individual is suffering from other anxiety disorders, depression, or substance abuse.

Cognitive-behavioral Therapy

In cognitive-behavioral therapy, the client and therapist examine negative responses to everyday situations. The client learns about how distorted thoughts can cause physical and behavioral responses that amplify anxiety. Individuals also learn the difference between helpful and unhelpful worry, what triggers their worries; and the physical, cognitive and behaviors strategies to control anxiety.



Serotonin-norepinephrine re-uptake inhibitors (SNRIs)

These medications influence the activity of the brain chemicals serotonin and norepinephrine which are neurotransmitters thought to play a role in anxiety disorders. A neurotransmitter is a chemical substance that carries messages between nerve cells. 

SNRIs correct serotonin and norepinephrine imbalances by reducing the re-uptake (re-absorption) of them into the brain and enabling it to build up. This increases brain activity, which in turn, boosts mood.

Examples of antidepressants used to treat generalized anxiety disorder include:

  • Desvenlafaxine (Pristiq): Similar to Venlafaxin;

  • Duloxetine (Cymbalta):

  • Venlafaxine (Effexor): Also used to treat generalized anxiety disorder, panic disorder and social anxiety disorder.


This anti-anxiety medication may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective. It may cause lightheadedness shortly after taking it. Less common side effects include headaches, nausea, nervousness and insomnia.

Examples include lorazepam (Ativan), diazepam (Valium), chlordiazepoxide (Librium) and alprazolam (Xanax). This class of drugs is frequently used for short-term management of anxiety. Benzodiazepines are effective in promoting relaxation and reducing muscular tension and other physical symptoms of anxiety. 

Long-term use may require increased doses to achieve the same effect, which may lead to problems related to tolerance and dependence. They can be habit forming and can cause a number of side effects, including drowsiness, reduced muscle coordination, and problems with balance and memory.