Everyone worries and has fears in appropriate situations. In some circumstances, fear can be lifesaving, and the body's response to fear is called the fight-or-flight reaction. When anxiety (worry, fear, apprehension, or unease) happens over otherwise common things or events, is difficult for the individual to control, is excessive, and lasts at least 6 months, this is called generalized anxiety disorder. Along with the other types of anxiety disorders (obsessive-compulsive disorder, panic disorder, social anxiety disorder, posttraumatic stress disorder, and phobias), generalized anxiety disorder is fairly common. Unlike the separate episodes of severe panic anxiety that occur in panic disorder, the level of anxiety fluctuates gradually in persons who have generalized anxiety disorder. Anxiety disorders affect more than 40 million adults in the United States alone, about 18% of the population. Worldwide, approximately 20% of persons who receive primary health care have anxiety disorders or depression.
Fast or irregular heartbeat (palpitations or "fluttering" in the chest)
Sweating or flushing of the skin
Changes in appetite
Nausea, vomiting, and diarrhea
Edginess or irritability
Physical reasons for some of the symptoms of generalized anxiety disorder include heart problems, thyroid conditions, or other medical issues. Your doctor, after taking a medical history and performing a physical examination, may order testing to help rule out these medical problems. Mental health professionals (psychiatrists, psychologists, and licensed therapists) ask questions and use specific testing methods to examine an individual's symptoms to see if he/she has one of the anxiety disorders or another mental health issue, such as depression or bipolar disorder. Psychiatrists are medical doctors with specialized education in diagnosis and treatment of mental illnesses.
Treatment for generalized anxiety disorder usually has several approaches, combining some type of therapy with medication to help reduce the feelings and symptoms of anxiety.
Cognitive behavioral therapy (CBT) is effective for generalized anxiety disorder. CBT helps persons find ways of coping with their feelings and learn new methods to deal with the situations that make them anxious.
Relaxation techniques are often helpful and can include meditation, yoga, and biofeedback. Exercise helps elevate mood and improves overall health. Other types of therapy may be offered, depending on an individual's specific needs.
Medications may include one or more types of antianxiety medicines, many of which are also used to treat depression and other mental illnesses.
Substance abuse often goes along with the anxiety disorders. Treating substance abuse, including tobacco dependence, should be considered as part of the overall management of generalized anxiety disorder.
National Institute of Mental Health http://www.nimh.nih.gov
American Psychiatric Association http://www.healthyminds.org
Anxiety Disorders Association of America http://www.adaa.org
To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on obsessive-compulsive disorder was published in the October 27, 2004, issue; one on posttraumatic stress disorder was published in the August 1, 2007, issue; and one on bipolar disorder was published in the February 4, 2009, issue.
Sources: National Institute of Mental Health, American Psychiatric Association, Anxiety Disorders Association of America, American Academy of Family Physicians, World Health Organization, Mayo Clinic
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
TOPIC: MENTAL HEALTH
This article was corrected for errors on February 17, 2011.
Torpy JM, Burke AE, Golub RM. Generalized Anxiety Disorder. JAMA. 2011;305(5):522. doi:10.1001/jama.305.5.522