Written by Rachel De La Merced and reviewed by Board Certified Psychiatric Nurse Practitioner Kate Filippelli, PMHNP who specializes in evidence-based psychiatry practices with personalized treatment plans for all mental health challenges, including psychiatric medication management, research-based supplements and behavioral interventions for major depressive disorder, bipolar disorder, anxiety, panic, OCD, ADHD and eating disorders.
Everyone worries sometimes. You might feel stressed before a major deadline, anxious about your finances, or concerned about your health or family. In most cases, those worries come and go as situations change.
But for people with generalized anxiety disorder (GAD), worry can feel constant, excessive, and difficult to control. Even when there is not an immediate problem, the mind may continue jumping from one concern to another, making it hard to relax or feel at ease. As a psychiatric nurse practitioner at Remedy Psychiatry, I often observe that individuals with GAD feel mentally “stuck” in cycles of overthinking, even when they logically understand that their worries may be disproportionate to the situation.
If you have ever wondered, “Why am I always anxious?”, generalized anxiety disorder may be part of the answer.
GAD is one of the most common anxiety disorders and affects millions of adults each year. [2] Unlike short-term stress, generalized anxiety disorder involves persistent anxiety that interferes with daily life, relationships, sleep, concentration, and overall well-being.
What Is Generalized Anxiety Disorder?
Generalized anxiety disorder is a mental health condition characterized by excessive and ongoing worry about multiple areas of life. [1]
Rather than focusing on a single fear or situation, people with GAD often worry about many different things at once. Concerns may involve work, finances, health, relationships, school, or everyday responsibilities. Often, the level of worry feels much larger than the actual situation would normally justify.
One of the defining features of GAD is that the worry feels difficult to control. Even when people recognize that their fears may be exaggerated, they often struggle to stop overthinking or mentally preparing for worst-case scenarios.
To meet diagnostic criteria, symptoms typically occur more days than not for at least six months and cause noticeable distress or impairment in daily functioning. [1]
Generalized Anxiety Disorder Symptoms
The symptoms of GAD can affect both the mind and the body.
Emotionally, many people experience:
- Persistent worry
- Racing thoughts
- Feeling on edge
- Difficulty relaxing
- Fear that something bad may happen
- Trouble concentrating
Physically, anxiety often shows up in ways people do not immediately recognize as anxiety. Common physical symptoms include muscle tension, headaches, fatigue, dizziness, rapid heartbeat, insomnia, and stomach problems. [2] In our clinical practice at Remedy Psychiatry, we frequently see patients whose physical symptoms, such as chronic muscle tension, fatigue, or gastrointestinal discomfort are initially evaluated as medical issues before anxiety is identified as a primary underlying factor.
Some people develop digestive symptoms and begin wondering, can anxiety cause nausea? The answer is yes. Anxiety commonly affects the gastrointestinal system through the gut-brain connection, which can lead to nausea, stomach discomfort, appetite changes, or diarrhea.
Sleep problems are also extremely common. Many people with GAD struggle to fall asleep because their minds continue racing at night, while others wake frequently thinking about responsibilities or future worries.
Stress vs Anxiety: What Is the Difference?
Understanding stress vs anxiety can help clarify when worry may have crossed into an anxiety disorder.
Stress is usually connected to a specific external situation, such as work pressure, financial strain, or a family conflict. Once the stressful event improves, stress levels often decrease as well.
Anxiety can be different. With GAD, the sense of worry may continue even when there is not a clear reason to feel anxious. Some people describe always feeling tense or mentally “on alert,” even during calm periods.
Another key difference is duration. Everyday stress tends to be temporary, while generalized anxiety disorder involves ongoing symptoms that persist for months or longer. [1,2]
What Causes Generalized Anxiety Disorder?
There is not one single cause of GAD. Researchers believe it develops through a combination of biological, psychological, and environmental factors.
Genetics can play a role, and anxiety disorders often run in families. [2,4] Brain chemistry and the way the brain processes fear and uncertainty may also contribute.
Life experiences matter as well. Chronic stress, childhood adversity, trauma, medical illness, major life changes, and ongoing uncertainty can all increase the likelihood of developing generalized anxiety disorder.
Women are diagnosed with GAD at roughly twice the rate of men, and the condition commonly occurs alongside depression or other anxiety disorders. [2,3]
How GAD Affects Daily Life
Many people assume anxiety only affects thoughts and emotions, but generalized anxiety disorder can impact nearly every part of daily functioning.
Constant worry can make it difficult to focus at work, complete tasks efficiently, or make decisions. Relationships may become strained when anxiety causes irritability, reassurance-seeking, or difficulty relaxing during social interactions. In our experience at Remedy Psychiatry, we often see that chronic worry can significantly impair decision-making and productivity, with many patients describing difficulty completing even routine tasks due to constant mental preoccupation.
Some people avoid situations that trigger uncertainty or become overwhelmed by routine responsibilities. Others feel physically exhausted from constantly being mentally “on.”
In some cases, people with GAD also experience panic disorder, social anxiety disorder, or episodes of intense nighttime anxiety such as nocturnal panic attacks.
Because symptoms often develop gradually, many people do not realize how much anxiety has been affecting their quality of life until treatment begins and they finally experience relief.
How Is Generalized Anxiety Disorder Diagnosed?
There is not a single test that can diagnose generalized anxiety disorder. Instead, a psychiatric provider will discuss your symptoms, medical history, and how anxiety is affecting your daily life.
One commonly used screening tool is the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. This brief assessment asks about symptoms you have experienced over the past two weeks and can help identify whether further evaluation is needed. While the GAD-7 is a valuable screening tool, it is not a diagnosis on its own. A complete evaluation looks at how long your symptoms have been present, how severe they are, and whether they may be related to another medical or mental health condition. [2]
Your provider may also consider other possible causes of anxiety-like symptoms, including thyroid disorders, certain medications, excessive caffeine use, or heart conditions before making a diagnosis. [1,4]
Treatment for Generalized Anxiety Disorder
The encouraging news is that generalized anxiety disorder is highly treatable. Many people experience significant improvement with evidence-based treatment, allowing them to regain control over their daily lives.
Treatment often includes psychotherapy, medication, or a combination of both, depending on the severity of symptoms and your individual needs.
Psychiatric Medication Management
For people with moderate to severe GAD, medication can be an effective way to reduce excessive worry and physical symptoms of anxiety.
Current clinical guidelines recommend selective serotonin reuptake inhibitors (SSRIs), such as sertraline and escitalopram, and serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine and venlafaxine, as first-line medications for generalized anxiety disorder. [3-5]
These medications do not work immediately. Many people notice gradual improvement within two to four weeks, while the full benefit may take several months. Continuing treatment as directed can help reduce the risk of symptoms returning.
Some medications, such as buspirone or pregabalin, may be appropriate for certain individuals, while benzodiazepines are generally reserved for select situations because of the risks of tolerance, dependence, and withdrawal with long-term use. [2,4]
Lifestyle Habits That Can Help
Professional treatment is often the foundation of managing generalized anxiety disorder, but healthy lifestyle habits can also support long-term improvement.
Regular exercise, consistent sleep, mindfulness, and relaxation techniques can help lower overall anxiety levels. If you are looking for ways to manage anxiety naturally, these strategies can complement professional treatment, although they typically are not enough on their own for moderate or severe GAD.
Many people also find it helpful to identify common triggers, limit caffeine if it worsens symptoms, and practice evidence-based relaxation techniques. If you are looking for practical coping strategies, our article on how to calm down covers several methods that can help during periods of heightened anxiety.
When Should You Seek Help?
Occasional worry is a normal part of life, but persistent anxiety does not have to be something you simply “live with.”
Consider speaking with a psychiatric provider if:
- You feel anxious most days for several months.
- Worry is interfering with work, school, or relationships.
- Physical symptoms like muscle tension, insomnia, headaches, or nausea occur regularly.
- You find it difficult to control your thoughts or relax.
- Anxiety is causing you to avoid situations or activities you once enjoyed.
Seeking help early can make treatment more effective and may prevent symptoms from becoming more severe over time.
If you are experiencing thoughts of harming yourself or believe you are having a medical emergency, seek immediate emergency care or call 911.
You Do Not Have to Live With Constant Worry
Living with generalized anxiety disorder can feel exhausting. When your mind is constantly preparing for the worst, even ordinary tasks can become emotionally draining. The good news is that effective treatments are available, and many people experience significant improvement with the right care. In our experience at Remedy Psychiatry, patients often report that receiving an accurate diagnosis and starting evidence-based treatment provides significant relief, helping them regain a sense of control and improve overall quality of life.
Whether you have been asking yourself “Why am I always anxious?”, trying to understand your anxiety disorder symptoms, or wondering whether your worry has become more than everyday stress, help is available.
Disclaimer: This article is intended for educational purposes only and should not be considered medical advice. It is not a substitute for diagnosis or treatment from a qualified healthcare professional. Always consult a licensed healthcare provider regarding your individual health concerns.
