Generalised Anxiety Disorder

Generalised anxiety disorder (or GAD) is excessively worrying about issues to a disproportionate level, leading to stress, sleeplessness and difficulty concentrating.

  1. Categorised as lasting for at least 6 months
  2. Can be triggered by emotional and physical trauma
  3. Treatment can involve drug or behavioural therapy

If you think you may be experiencing symptoms of GAD, our doctors might be able to help. Our online video consultation service enables you to speak to one of our UK doctors securely, at a time convenient for you.


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What is generalised anxiety disorder?

Generalised anxiety disorder (GAD) is a feeling of being worried, fearful and tense most of the time, for a sustained period. It is a long-term condition that has both physical and psychological symptoms. The physical symptoms of anxiety are usually not as consistent as the anxious feelings. It is difficult for people with GAD to control these feelings. 

Who gets generalised anxiety disorder?

The estimated prevalence of GAD is around one in 20 people in the UK, and it can be accompanied by another mental disorder in many cases. It more commonly affects women than men, and is commonly diagnosed in people aged 35-60. However, it is thought that more than half have developed the condition during childhood or adolescence. There is also an increased risk of developing GAD during pregnancy; the prevalence in pregnant women is around 4%.

Generalised anxiety disorder can generally be categorised as presenting itself in two different ways. 

There is the mental aspect of the condition:

  • Worrying that cannot be controlled
  • Feeling incapable of relaxing
  • Feeling irritable and easily startled
  • Having difficulty concentrating
  • Expecting the worst in various situations.

And the physical aspects:

  • Feeling muscle tension
  • Sweating
  • Feeling sick
  • Trembling and experiencing hot flushes
  • Feeling nauseous.

What causes generalised anxiety disorder?

The exact cause of GAD is impossible to pinpoint, as there are many factors that can lead to it. Genetic makeup may be an important factor, as it is natural for some people to have anxious tendencies, which can lead to GAD. There has also been a link established between childhood traumas, such as a death in the family or exposure to bullying, and being more susceptible to an anxiety disorder.

There are several stages a doctor will follow with a patient who potentially has GAD. Talking in-depth about symptoms is important, as the most appropriate method of treatment has to be determined and there is a lot of information to take in regarding how to self-help and participate in group therapy. A doctor will most likely recommend a course of cognitive behavioural therapy (CBT), followed by a form of medication. However, if CBT is successful on its own, medication may not be necessary.

If you think you may be experiencing GAD, you should speak to a doctor. They’ll be able to help you identify the cause of symptoms, and discuss therapy options where required. 

In terms of medicinal treatment, antidepressants may be prescribed. This can include treatments such as Duloxetine, which is in a family of medicines known as serotonin–norepinephrine reuptake inhibitors (SNRIs). Venlafaxine is another antidepressant treatment in this family. Selective serotonin reupate inhibitors (SSRIs) work similarly to SNRIs. Treatments of this kind include Paroxetine, which is also used for other anxiety-related mental health conditions.

Our service enables you to speak to a doctor about generalised anxiety disorder online. You can book an appointment at a time that suits you, to discuss your symptoms over secure video link. Our prescribers will be able to provide advice on the therapies available, and refer you to a specialist where required.

Page last reviewed:  12/06/2020
Diagnosis and treatment

How does someone know they have generalised anxiety disorder (GAD)?

To get a proper diagnosis you should always contact your GP to discuss symptoms further.

However, there are some symptoms that may indicate generalised anxiety disorder. If you feel that you have been nervous most of the time for a period of more than six months, have trouble falling asleep and wake up worrying, or feel very tense in your body, then these are possible indications of GAD. 

There are also often physical symptoms of GAD. They include sweating, dizziness and an upset stomach. They can occur more prominently in particular situations, but in GAD they may be fairly constant for no attributable reason. 

How is GAD diagnosed?

GAD can be diagnosed by a GP or mental health specialist. During consultation, a doctor will likely ask a patient whether they have experienced muscle tension, sleep disturbance, irritability and poor concentration for chronic periods in the previous six months. Sometimes, these symptoms may be caused by conditions like anemia or hyperthyroidism, so a doctor may conduct a blood test to rule them out.

After this, a doctor will want to assess the mental health of the patient. In some cases, they might refer them to a specialist. 

A doctor or specialist will ask questions to better understand the extent of anxiety symptoms. They will likely examine how persistent and strong the feeling of anxiety is, and whether physical symptoms are concurrent with it. A doctor will also want to know how well someone is able to control their anxiety, and whether it escalates in specific situations.

Does GAD require treatment?

GAD does not necessarily require treatment. However, treatment can be very effective in alleviating symptoms and reducing them in situations which would normally induce high levels of stress.

A doctor may or may not recommend medication, but cognitive behavioural therapy is very likely to be advised. Because GAD varies in severity, a few sessions can be sufficient, but it may be the case that a longer course or additional counseling is recommended.

What treatments are there for GAD?

Once a doctor has established the presence of GAD and identified possible environmental factors that could be having an influence, it's likely that cognitive behavioural therapy (CBT) will be recommended as the next stage.

CBT is a type of psychological therapy that looks at ways of altering behavioural patterns to help cope with negative thoughts. It's an effective treatment, provided that it is appropriately administered.  

It’s normally delivered in weekly sessions that last around two hours, undertaken over a period of up to four months.

A doctor may also suggest anxiety management courses. These are usually done in groups and focus on relaxation methods and coping strategies.

Additionally, there are medications that a doctor may recommend. These include antidepressants (SSRIs and SNRIs), which can help alter the way in which serotonin is released in the brain. In some cases, Pregabalin (a drug used in epilepsy) or a short term course of benzodiazepines may be prescribed if SSRIs or SNRIs are not suitable.

Page last reviewed:  12/06/2020
Questions and Answers

What should I do if I think I might have GAD?

If you have symptoms of GAD that have lasted for at least six months, and it is disrupting your thinking on a day-to-day basis, then seeking a doctor’s opinion is recommended. Anxiety complaints are very common, and a GP will be able to help you to discuss your symptoms and recommend treatment if they deem it necessary.

What treatments are there?

GAD is usually initially treated with cognitive behavioural therapy, or CBT. There are various degrees of CBT, but for GAD it is recommended to conduct sessions in two hour weekly periods, for up to four months. 

There are numerous medications that can be prescribed for GAD, but the most common are antidepressant medications. SSRIs and SNRIs are typically recommended, but in some cases benzodiazepine or pregabalin may be prescribed.

Are there side effects?

There are no physical side effects to CBT. However, because it is a therapy that involves discussing issues that you are facing, it may be difficult or stressful in some circumstances to open up about certain problems.

Antidepressants can have the adverse effect of making you feel lethargic and disturb sleeping patterns.

Can I consult a doctor about generalised anxiety disorder online?

Yes. Our online video consultation service enables you to speak to one of our UK doctors. Depending on what your circumstances are, our doctors can prescribe or refer you for treatment, or put you in touch with a specialist. They can also talk you through self-help techniques if you do not wish to engage in therapy.

Page last reviewed:  12/06/2020

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