What does generalized anxiety feel like?
People often describe generalized anxiety as a mind that will not switch off. You finish worrying about the car and move straight on to your blood pressure, then to your daughter's marriage, then to whether you locked the barn. The National Institute of Mental Health says people with generalized anxiety disorder feel extremely worried or nervous more often or more intensely than the situation calls for, even when they know the worry is out of proportion.
MedlinePlus, from the National Library of Medicine, says the worries often seem to float from one problem to another. That floating quality is one of the clearest signs. The specific subject matters less than the steady sense that something is about to go wrong.
Common signs, in the words of the research
NIMH lists signs that adults with GAD commonly report. Not everyone has all of them, and having some does not mean you have the disorder:
- Worrying excessively about everyday things, and having trouble controlling it.
- Feeling irritable or on edge, restless, or unable to relax.
- Having a hard time concentrating.
- Trouble falling asleep or staying asleep, or feeling fatigued.
- Headaches, muscle aches, stomachaches or tension.
- Trembling or twitching, sweating, feeling lightheaded or out of breath.
- Frequent trips to the bathroom, or a hard time swallowing.
How it can look from the outside
Generalized anxiety is often invisible to neighbors. People with it may be the most reliable person on the church committee, the one who plans every detail of the family visit, the business owner who never takes a day off. Over-preparing, checking, asking for reassurance and putting off decisions can all be ways of managing worry that others only see as conscientiousness.
How is it different from ordinary worry?
Everyone worries. NIMH says occasional anxiety is a normal part of life and that many people worry about health, money, work or family. What sets GAD apart is persistence and control. To be diagnosed, NIMH says a person must find it difficult to control worry on most days for at least six months and have at least three of the symptoms above.
Symptoms also tend to rise and fall. NIMH notes they are often worse during stressful times such as a physical illness or a family conflict. So a hard season, such as a parent's decline or a slow business year, can bring generalized anxiety into sharper focus even if it has been there quietly for a long time.
Only a qualified professional can make a diagnosis, and it usually starts with a conversation and sometimes a physical exam to rule out other causes. If you are still sorting out whether what you feel is stress or something more, see is it anxiety or stress.
How common is it?
More common than most people assume. NIMH, drawing on the National Comorbidity Survey Replication, estimates that 2.7% of U.S. adults had GAD in the past year and 5.7% will have it at some point in their lives. Women are affected more often than men. In a county the size of Polk, that is hundreds of people, most of whom are getting on with their days without anyone knowing.
NIMH also notes that GAD often appears alongside other conditions, including depression, other anxiety disorders, chronic pain and heart problems, and that it is commonly associated with alcohol and substance misuse. Using a drink at night to quiet the mind is a pattern worth mentioning to a doctor or counselor.
What treatment usually involves
NIMH says GAD treatment typically involves psychotherapy, medication or both, chosen according to a person's needs, preferences and medical situation, and that finding the right fit can take some trial and error.
Talk therapy
NIMH describes cognitive behavioral therapy as a well studied, research-supported approach for GAD that helps people notice and question automatic, unhelpful thoughts and change self-defeating patterns. It also mentions acceptance and commitment therapy, which uses mindfulness and goal setting, as an option with a growing body of research. Different therapies suit different people. Our page on how counseling helps anxiety explains what the work tends to look like week to week.
Medication
According to NIMH, doctors may prescribe antidepressants such as SSRIs and SNRIs, buspirone, or, for short periods, benzodiazepines, which can lead to tolerance and dependence. This is general information only. Whether medication makes sense for you, and how to start or stop it, is a conversation for your doctor. Therapy or medication for anxiety sets out the questions to bring to that conversation.
Everyday habits
NIMH reports that habits such as cutting back on caffeine, getting enough sleep, exercise and mindfulness can reduce anxiety symptoms when paired with standard care, though they are not a replacement for it.
Talking to someone in Polk County
Because generalized anxiety is so good at looking like responsibility, people often wait a long time before mentioning it. A primary care doctor is a reasonable first stop. So is a counselor. Laura Bass is a psychotherapist who works with adults, and anxiety is among the concerns she sees. She has a part-time office at The Healing Cottage in Columbus; call 704-706-3264 or use the contact page and ask which days she is there.
If worry ever becomes a crisis, or you have thoughts of harming yourself, call or text 988, or call Vaya Health at 1-800-849-6127. If anyone is in immediate danger, call 911.
Common questions
Is generalized anxiety just being a worrier?
Not quite. Plenty of people are cautious by nature and sleep fine. Generalized anxiety is worry that is hard to control, shows up most days over months, and comes with physical or mental strain such as tension, fatigue, irritability or poor sleep. If worry is costing you rest, focus or enjoyment, it is worth discussing with a professional, whatever you call it.
Can generalized anxiety cause physical symptoms?
Yes. NIMH lists headaches, muscle aches, stomachaches, tension and fatigue among common signs, and MedlinePlus adds sweating and difficulty breathing. Because physical symptoms can have other causes too, see a doctor about anything new or worrying. Our page on anxiety in the body looks at this in more detail.
Does generalized anxiety go away on its own?
Symptoms can ease and return, often rising during stressful periods. Some people find they manage well for long stretches. Others find the worry settles in. NIMH says that with the right treatment and support, people with GAD can manage their anxiety and improve their quality of life, so there is no need to wait and see for months on end.
Will a counselor tell me I have GAD?
A counselor may talk with you about whether your experience fits a diagnosis, particularly if you are using insurance, which usually requires one for billing. But the focus of counseling is understanding the worry and finding ways to live with less of it. You can ask any counselor how they think about diagnosis and what it would mean in your records.