Generalised anxiety disorder (GAD)

Anxiety is a feeling of unease, like worry or fear, and it can be mild or severe. It's the main symptom of several conditions, including:

• panic disorder
• phobias
• post-traumatic stress disorder (PTSD)
• social anxiety disorder (social phobia)

This page is about a different, specific condition called generalised anxiety disorder (GAD).

Generalised anxiety disorder (GAD) is a long-term condition. It makes you feel anxious about many different issues, rather than 1 specific event.

People with GAD feel anxious on most days. They often struggle to remember the last time they felt relaxed. And as soon as 1 anxious thought goes away, another may appear about something else.

Everyone feels anxious at some point in life. You may feel worried about sitting an exam, or going to a job interview, for example. At times like these, feeling anxious is perfectly normal.

But some people find it hard to control their worries. Their anxiety is more constant, and it often affects their daily lives.

Generalised anxiety disorder (GAD) can change how you behave and the way you think and feel about things. It can also change how your body feels. Together, these changes cause symptoms like:

• restlessness
• a sense of dread
• feeling constantly "on edge"
• difficulty concentrating
• irritability
• dizziness
• tiredness
• a noticeably strong, fast or irregular heartbeat (palpitations)
• muscle aches and tension
• trembling or shaking
• dry mouth
• excessive sweating
• shortness of breath
• stomach ache
• feeling sick
• headache
• pins and needles
• difficulty falling or staying asleep (insomnia)

Your symptoms may lead you to pull away from other people, so you can avoid the worry and dread.

You may also find going to work difficult and stressful, and you may take time off sick. This can make you worry even more about yourself and lower your self-esteem further.

• your mental health is affecting your daily life
• you're not looking after yourself
• you're finding it hard to manage any responsibilities you have

Find out how to get urgent help for your mental health.

If your anxiety comes from a specific phobia or from panic disorder, you'll usually know what sets it off. Say you have claustrophobia (a fear of enclosed spaces). You know that being shut in a small space will bring on your anxiety.

With generalised anxiety disorder (GAD), it's often not so clear what you're anxious about. Not knowing the trigger can make the anxiety worse, and you may start to worry that there'll be no solution.

No one knows the exact cause of generalised anxiety disorder (GAD). It's likely that several factors work together, such as:

• overactivity in areas of the brain involved in emotions and behaviour
• an imbalance of the brain chemicals serotonin and noradrenaline, which help control and regulate mood
• the genes you inherit from your parents (you're more likely to develop GAD if a close relative has it)
• having a history of stressful or traumatic experiences, like domestic violence, child abuse or bullying
• having a painful long-term health condition, like arthritis
• having a history of drug or alcohol misuse

Still, many people develop GAD for no obvious reason.

Generalised anxiety disorder (GAD) can have a big effect on your daily life. The good news is that several different treatments can help. These include:

• talking therapies, like cognitive behavioural therapy (CBT)
• medicine, like a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs)

There are also many things you can do yourself to help reduce your anxiety, like:

• trying a self-help course
• exercising regularly
• stopping smoking
• cutting down on alcohol
• drinking less caffeine

With treatment, many people with GAD are able to control their levels of anxiety. Some treatments may need to be continued for a long time. And there may be periods when your symptoms get worse.

Self-help guides for anxiety are often based on Cognitive Behavioural Therapy (CBT), and they've proven highly successful in helping people with anxiety and other mental health issues.

Daylight is a digital programme built on CBT to improve anxiety. It's clinically proven to help people improve their anxiety symptoms, and it takes just a few minutes of use each day. You can use Daylight through the app on iOS and Android devices.

If the treatments you've tried aren't helping with generalised anxiety disorder (GAD), you may want to talk to your doctor about being referred to a mental health specialist.

You'll usually be referred to your community mental health team. These teams include several kinds of specialist:

• psychiatrists
• psychiatric nurses
• clinical psychologists
• occupational therapists
• social workers

A mental health specialist will reassess your condition. They'll ask you about the treatment you've had before and how well it worked for you.

Your specialist will then be able to devise a treatment plan for you.

As part of this plan, you may be offered a treatment you've not tried before. Or you may be offered a combination of a psychological treatment with medicine.