Anxiety is a feeling of worry, fear or uneasiness that can range in severity from mildly disconcerting to having a severe impact on daily living.

Some amount of anxiety is normal and is experienced by most individuals at some point in their lives. However, people with generalised anxiety disorder (GAD) suffer from a more severe form of anxiety that can be difficult to control and even disabling in terms of carrying out regular day-to-day activities.

Anxiety is a symptom that is seen in several mental health conditions including GAD, panic disorder, phobias and post traumatic stress disorder.

Symptoms of GAD

GAD is typically long lasting and people with GAD often may have difficulty in remembering the last time they felt at ease. Symptoms of GAD may be psychological, physical or both. Some of the symptoms of GAD include:

• Worry
• Irritability
• Mood swings
• Feeling of dread and impending danger
• Social withdrawal
• Difficulty in concentrating
• Headaches
• Nausea and vomiting
• Diarrhea or constipation
• Palpitations and chest pain
• Excessive sweating and hot flushes
• Difficulty in breathing
• Difficulty in falling asleep or maintaining sleeping state throughout the night
• Dizziness or vertigo
• Tremors
• Dry mouth
• Muscle weakness
• Urge to urinate frequently and excessive thirst
• Painful or missed menstrual periods

In GAD, feelings of anxiety are usually continuous, with individuals feeling anxious in general about a large number of circumstances and issues, rather than their anxiety being specific to a particular event.

Constant feelings of worry often means affected individuals have trouble dealing with situations on a daily basis and this can cause irritability, difficulty concentrating and disrupted sleep. The condition affects about 1 in 20 individuals in the UK and is more common among women than men.

Treatment

Treatment involves two main approaches, medication and psychological therapy, with most patients benefit from a combination of the two.

Psychological therapies include talking therapy, counselling and cognitive behavioural therapy (CBT), the main psychological treatment for GAD. Relaxation therapies, yoga, exercise and mediation are also successful in alleviating the symptoms of GAD in many patients.

There are various medications available for treating GAD, some of which are designed for treatment in the short-term and others for the long-term. Depending on an individual’s symptoms, drugs may be prescribed for physical symptoms, psychological symptoms or both.

Examples of medications used in the long-term include selective serotonin reuptake inhibitors (SSRIs) such as citalopram, paroxetine, sertraline and fluoxetine. Other agents include pregabalin and venlafaxine. Examples of short term medications include antihistamines, an anxiolytic called buspirone and sedatives such as diazepam, lorazepam and clonazepam.