Signs and Symptoms of Anxiety Disorders

Generalized Anxiety Disorder Symptoms: Insomnia, Depression Excessive Worry and Other Signs of GAD

Chronic anxiety, tension and worry are the primary symptoms of generalized anxiety disorder (GAD). While it is normal to experience some level of anxiety throughout life, people with generalized anxiety disorder experience severe anxiety even in the absence of stress-inducing events. Individuals with GAD are often aware their anxiety is out of proportion to their circumstances, but simply knowing this does little to reduce generalized anxiety disorder symptoms.

Signs and Symptoms of Anxiety Disorders


Different types of anxiety disorders can present with similar symptoms. It can be difficult, for instance, to distinguish the symptoms of anxiety attacks (panic disorder) from generalized anxiety disorder symptoms. Symptoms of post traumatic stress disorder (PTSD), social anxiety, and phobias can also mimic generalized anxiety disorder symptoms.

GAD does, however, differ from other anxiety disorders in one important feature: most other anxiety disorders have specific symptom triggers. Social anxiety, for instance, only causes anxiety symptoms when the individual must socialize. Post traumatic stress disorder symptoms are triggered by sounds, activities or events that trigger memories of the traumatic incident, and phobia symptoms are triggered by the presence (or even just the thought of) the subject of the individual’s phobia.

Generalized anxiety disorder does not have a specific trigger. GAD causes anxiety about a range of events, activities and thoughts, and can cause symptoms without any identifiable cause of anxiety.

GAD Symptoms: Anxiety, Insomnia and More

Generalized anxiety disorder causes multiple symptoms in addition to tension and anxiety. Insomnia and other sleep disturbances are common amongst people with GAD, as are irritability and fatigue. Common symptoms of generalized anxiety disorder include:

  • anxiety in excess of what the situation demands
  • chronic anxiety over multiple concerns
  • depression symptoms
  • difficulty thinking
  • easily startled
  • feeling constantly “on edge,” or “keyed up”
  • inability to relax
  • incessant worry or anxiety without reason
  • irritability
  • mind “going blank”
  • restlessness

Physical Symptoms of Anxiety Disorders

Anxiety is a physical as well as emotional state, and triggers a number of physiological responses. With normal anxiety levels these physical responses make people more alert and ready to respond to events. In dangerous situations physical symptoms of anxiety prepare the body for avoiding or confronting potential threats.

Physical symptoms of anxiety are intended to be a short term response to stress or fear inducing events. These physical responses become problems if anxiety becomes chronic. Physical symptoms of anxiety include:

  • diarrhea
  • fatigue
  • feeling lightheaded
  • feeling out of breath
  • frequent urination
  • headaches
  • hot flashes
  • insomnia
  • muscle tension/muscle aches
  • nausea
  • rapid heartbeat
  • swallowing difficulties
  • sweating
  • trembling or twitching

Unlike other anxiety disorders, generalized anxiety disorder symptoms rarely cause people to avoid the source of their anxiety. Mental and physical symptoms of generalized anxiety disorder do, however, significantly impact all areas of life.

Depression and Anxiety Disorders

Generalized anxiety disorder rarely develops in isolation. More often GAD presents with another anxiety disorder, substance abuse or depression. Anxiety symptoms can be masked by symptoms of depression.

Childhood generalized anxiety disorder symptoms differ slightly from adult symptoms. Both adults and children should seek help if anxiety levels affect quality of life, or if anxiety symptoms occur in combination with depression symptoms or substance abuse.

As generalized anxiety disorder symptoms can worsen over time, the sooner a GAD diagnosis is made the better. GAD can trigger suicidal behavior, which should always be considered a medical emergency.

Acute Anxiety Treatment

Generalized Anxiety Disorder Treatment and Drugs: SSRIs, Benzodiazepines, and Anti-Anxiety Medication

Treatment for generalized anxiety disorder may require a combination of talk therapy and anti-anxiety medication. Medication for GAD reduces symptoms and improves daily functioning, which in turn improves the outcome of GAD psychotherapy and anxiety management techniques. Depending on individual needs anti-anxiety medication can be long term or designed to treat acute anxiety attacks.

Benzodiazepines and Acute Anxiety Treatment

Benzodiazepines have been used to treat acute anxiety for decades. Benzodiazepines have a sedating effect, reducing muscle tension and anxiety symptoms. Commonly prescribed benzodiazepines include:

  • alprazolam
  • clonazepam
  • diazepam
  • lorazepam.

While effective anti-anxiety medication for acute anxiety attacks, benzodiazepine medication is unsuited for long-term treatment of generalized anxiety disorder. The sedating effect of benzodiazepine medication affects response times, making driving or operating machinery dangerous.

Long-term use of benzodiazepines results in a tolerance to the medication’s effects. Over time patients require higher doses of the drug to achieve the same benefits. The risk of drug dependence increases with long-term use and drug tolerance.

SSRIs and Generalized Anxiety Disorder Treatment


Antidepressants that affect the brain’s neurotransmitter levels are, at present, the first choice for anti-anxiety medication. Neurotransmitters are chemical compounds vital for proper communication between brain cells. Low levels of two neurotransmitters – serotonin and norepinephrine – have been linked to depression and anxiety disorders.

SSRIs, or selective serotonin reuptake inhibitors, block the re-absorption of serotonin, increasing the amount of serotonin in the brain. SNRIs, or serotonin norepinephrine reuptake inhibitors, affect both types of neurotransmitter.

While generally well-tolerated treatments for generalized anxiety disorder, SSRIs and SNRIs can cause unwanted side effects, including:

  • headaches
  • insomnia
  • sexual dysfunction
  • sleepiness
  • stomach problems
  • weight gain.

In addition, SNRI can cause mild increase in blood pressure.

Both SSRI and SNRI anti-anxiety medications take time before providing symptom relief. For this reason the antidepressants are sometimes combined with an initial dose of benzodiazepines to treat acute anxiety. Once the antidepressant begins to work, benzodiazepine does are tapered off.

Tricyclic Antidepressants and GAD Treatment

Tricyclic antidepressants were an alternative to benzodiazepines prior to the use of SSRIs and SNRIS as anti-anxiety treatment. Tricyclic antidepressants are still occasionally used to manage anxiety, but as tricyclics can produce serious side effects other medication choices are tried first.

Buspirone and Anxiety

Buspirone, a non-benzodiazepine anti-anxiety medication, is another option for generalized anxiety disorder treatment. Buspirone lacks the sedative and addictive qualities of benzodiazepines, making it suitable for long-term treatment of generalized anxiety disorder. Buspirone does, however, take up to two weeks to begin relieving symptoms.

Anti-Anxiety Medication and Treatment Outcomes

Anti-anxiety treatment works best in combination with GAD psychotherapy treatments. By reducing symptoms of generalized anxiety disorder, anxiety medication provides an opportunity to learn the skills offered by cognitive behavioral therapy and anxiety management techniques.

Symptoms of Generalized Anxiety Disorder (1)

Generalized Anxiety Disorder, Treatment for GAD: Diagnosis and Treatment of GAD

Generalized anxiety disorder (GAD) affects twice as many women as men. GAD affects approximately 6.8 million adults in the United States. The disorder develops over time and can begin at any point, including childhood.

Symptoms of Generalized Anxiety Disorder

Symptoms of GAD can vary in severity. Patients can experience a combination of symptoms, which can include:

  • obsessive or constant worry about small to large concerns
  • fatigue
  • irritability
  • trouble sleeping
  • rapid heartbeat or shortness of breath
  • difficulty concentrating
  • trembling or being easily startled
  • restlessness
  • feeling on edge
  • muscle aches and tension
  • sweating
  • nausea
  • diarrhea

People suffering from GAD cannot remember when the last felt at ease or were not consumed with worry. GAD is a chronic condition and symptoms may come and go on a daily basis.

Diagnosis of Generalized Anxiety Disorder

People who are worrying so much that is has begun to interfere with work, home, and relationships should see a physician for proper diagnosis.

The Diagnostic and Statistical Manual of Mental Disorders has certain criteria a person must meet to be diagnosed with GAD. The criteria for diagnosis is:

  • Difficulty controlling feelings of worry;
  • Excessive anxiety and worry about multiple events or activities most days of the week, for at least a six month period;
  • Anxiety that is unrelated to another mental health condition; and
  • At least on of the following symptoms must be present in children and at least three in adults: sleep problems, irritability, muscle tension, restlessness, fatigue, or trouble concentrating.

Mental health care providers will conduct a thorough examination. Questions regarding symptoms and medical history will be discussed. Physicians may also perform a physical examination to check for medical conditions which may be related to the anxiety.

Treatment of GAD


Medications and psychotherapy are the two main treatments for generalized anxiety disorder. Combining these treatments could off the best benefit for some patients.

Several medications are used to treat GAD. These medications may be used alone or in combination of one another:

  • Antidepressants, work to influence activity in the brain chemicals. Examples of medications include Paxil, Prozac, Lexapro, Tofranil, Effexor, or Zoloft.
  • Benzodiazepines, used for short-term relief of anxiety. These medications are sedatives and can include Klonopin, Ativan, Valium, Librium, or Xanax.
  • Buspirone (BuSpar), is an anti-anxiety medication used on an every day basis.

Psychotherapy is helpful for many patients. Psychotherapy uses counseling to work on the root causes of stress and making behavioral changes.

Considerations on Generalized Anxiety Disorder

Several risk factors increase the likelihood of developing generalized anxiety disorder. Factors can include:

  • Being female
  • Childhood abuse or trauma
  • Chronic illness or serious health conditions
  • Stress
  • Personality type
  • Genetics
  • Drug or alcohol abuse

GAD is a chronic condition. Treatment is available. Lifestyle changes such as eating healthy, exercising regularly, avoiding alcohol, joining a support group, using relaxation techniques, getting proper amounts of sleep, and sticking to a treatment plan will assist in dealing with this condition.