Generalized Anxiety Disorder: What You Need to Know

What is generalized anxiety disorder?

Occasional anxiety is a normal part of life. Many people worry about things such as health, money, school, work, or family. But people with generalized anxiety disorder (GAD) feel extremely worried or nervous more frequently or more intensely about these and other things—even when the worry is out of proportion with the situation.

GAD usually involves a persistent feeling of anxiety or dread that interferes with how you live your life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events. For people with GAD, these feelings of anxiety can last for months or even years.

GAD develops gradually and usually starts in early adulthood, although it can occur at any age. Women are more likely than men to experience GAD, with some women experiencing it during pregnancy and the postpartum period. With the right treatment and support, people with GAD can manage their anxiety and improve their quality of life.

What are the signs and symptoms of generalized anxiety disorder?

People with GAD may:

• Worry excessively about everyday things
• Have trouble controlling their worries or feelings of nervousness
• Feel irritable or “on edge” frequently
• Feel restless or have trouble relaxing
• Have a hard time concentrating
• Have trouble falling asleep or staying asleep, or feel fatigued
• Experience pain such as headaches, muscle aches, stomachaches, or tension
• Tremble or twitch
• Sweat a lot, feel lightheaded, or feel out of breath
• Have a hard time swallowing
• Make frequent trips to the bathroom

Adults with GAD are often highly nervous about everyday circumstances, such as:

• Job security or performance
• Health
• Finances
• The health and well-being of their children or other family members
• Being late
• Completing household chores and other responsibilities

Children and teens with GAD may worry about many of the same things as adults, but their concerns often center on school, extracurricular activities, friendships, and the future. They may struggle with uncertainty, fear of making mistakes, or worry about disappointing others. Children and teens with GAD may strive for perfection as a way to manage their anxiety.

For all people with GAD, symptoms may fluctuate over time and are often worse during times of stress—for example, during a physical illness, school exams, or a family or relationship conflict.

What causes generalized anxiety disorder?

GAD may run in families, but the exact cause of the disorder is unknown. Research suggests that GAD results from a mix of genetics, brain chemistry, biology, and environment. Researchers have found that external causes, such as experiencing a traumatic event or being in a stressful environment, may put a person at higher risk for developing GAD.

How is generalized anxiety disorder diagnosed?

To be diagnosed with GAD, a person must find it difficult to control worry on most days for at least 6 months. They must also have at least three of these symptoms: feeling restless or “on edge,” fatigue, trouble concentrating, irritability, muscle tension, or problems with sleep.

If you think you’re experiencing symptoms of GAD, talk to a health care provider, such as a primary care doctor, psychiatrist, psychologist, or clinical social worker. During the visit, the provider may ask when your symptoms began, how long they have lasted, how often they occur, and their impact on your life. After discussing your history, the provider may conduct a physical exam to ensure that an unrelated physical problem is not causing your symptoms.

What other illnesses can co-occur with generalized anxiety disorder?

Some people with GAD have other mental and physical health disorders or conditions, including depression, other anxiety disorders, post-traumatic stress disorder, chronic pain syndromes, cardiovascular problems, or suicidal thoughts or behaviors. GAD is also commonly associated with alcohol and substance misuse.

The presence of multiple disorders can make treatment more complex, and people with GAD and co-occurring mental disorders may benefit from a comprehensive treatment plan that addresses all aspects of their mental health.

How is generalized anxiety disorder treated?

GAD treatment typically involves psychotherapy, medication, or both. Choosing the right treatment plan is based on a person’s needs, preferences, and medical situation, as well as consultation with a mental health professional or a health care provider. Finding the best treatment may take trial and error, and psychotherapy and medication can take some time to work.

Psychotherapy

Psychotherapy (also called talk therapy or counseling) can be effective when delivered in person or virtually via telehealth. A provider may support or supplement therapy using digital or mobile technology, like apps or other tools. Different therapies work for different types of people.

Cognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat GAD. CBT helps people become aware of automatic ways of thinking that are inaccurate or harmful and then question those thoughts, understand how the thoughts affect their emotions and behavior, and change self-defeating behavior patterns to feel less anxious and worried. CBT has been well studied and is the “gold standard” choice for psychotherapy.

Another treatment option for GAD is acceptance and commitment therapy (ACT). ACT takes a different approach than CBT, encouraging nonjudgmental acceptance of thoughts and behaviors and promoting engagement in meaningful activities. ACT uses strategies such as mindfulness and goal setting to reduce a person’s discomfort and anxiety. There is a growing body of research demonstrating its effectiveness for treating GAD.

Learn more about psychotherapy.

Medication

Health care providers may prescribe medication to treat GAD. Different types of medication can be effective, including:

• Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Anti-anxiety medications, such as benzodiazepines and buspirone

SSRI and SNRI antidepressants are commonly used to treat depression, but they also can help treat the symptoms of GAD. They may take several weeks to start working. These medications also may cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts low and is increased slowly over time.

Benzodiazepines, which are anti-anxiety sedative medications, also can be used to manage severe forms of GAD. These medications can be very effective in rapidly decreasing anxiety, but some people build up a tolerance to them and need increasing doses to get the same effect. Some people even become dependent on them. Therefore, a health care provider may prescribe them only for brief periods of time.

Buspirone is another anti-anxiety medication that can be helpful in treating GAD. Unlike benzodiazepines, buspirone is not a sedative and has less potential to be addictive. Buspirone needs to be taken for 3–4 weeks for it to be fully effective.

Learn more about mental health medications. Read the most up-to-date information on medications, side effects, and warnings on the U.S. Food and Drug Administration (FDA) website .

Support groups

Some people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others. Support groups are available both in person and online. However, any advice you receive from a support group member should be used cautiously and does not replace treatment recommendations from a health care provider.

Healthy habits

Practicing a healthy lifestyle also can help combat anxiety, although this alone cannot replace treatment. Researchers have found that implementing certain healthy choices in daily life—such as reducing caffeine intake and getting enough sleep—can reduce anxiety symptoms when paired with standard care—such as psychotherapy and medication.

Stress management techniques, such as exercise, mindfulness, and meditation, also can reduce anxiety symptoms and enhance the effects of psychotherapy. You can learn more about how these techniques benefit your treatment by talking with a health care provider.

Learn more ways to take care of your mental health.

How can I support myself or a loved one with generalized anxiety disorder?

Educate yourself

A good way to help yourself or a loved one who may be struggling with GAD is to seek information. Research the signs and symptoms, learn about treatment options, and keep up to date with current research.

Communicate

If you are experiencing GAD symptoms, have an honest conversation about how you’re feeling with someone you trust. If you think a friend or family member may be struggling with GAD, set aside a time to talk with them to express your concern and reassure them of your support.

Know when to seek help

If your anxiety, or the anxiety of a loved one, starts to cause problems in everyday life—such as at school, at work, or with friends and family—it’s time to seek professional help.

Practice compassion

Be kind and patient with yourself and others. Acknowledge progress, no matter how small, and recognize that managing GAD may involve setbacks along the way.

How can I find help?

If you have concerns about your mental health, talk to a primary care provider. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out the next steps. Find  tips for talking with a health care provider about your mental health.

You can learn more about getting help on the NIMH website. You can also learn about finding support  and locating mental health services  in your area on the Substance Abuse and Mental Health Services Administration (SAMHSA) website.

What are clinical trials and why are they important?

Clinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.

NIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about participating in clinical trials.

For more information

Learn more about mental health disorders and topics. For information about various health topics, visit the National Library of Medicine’s MedlinePlus  resource.

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U.S. Department of Health and Human Services
National Institutes of Health
Revised 2025