Treatment of generalized anxiety disorder: medications, therapy, lifestyle
Generalized Anxiety Disorder (GAD) is a mental health condition characterized by excessive and chronic worry that interferes with a person’s ability to function in daily life.
GAD is usually treated with medications, such as antidepressants; psychotherapy, such as cognitive behavioral therapy; and lifestyle activities, such as relaxation techniques.
Learn more about GAD treatment options.
Medications can be very effective in treating GAD.
A review of scientific experiments known as randomized controlled trials regarding the use of drugs in the treatment of GAD showed response rates ranging from 44% to 81%.
The first-line drugs used to treat GAD are:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Other drugs used to treat GAD include:
- Tricyclic antidepressants
GAD medications and interactions
Medications used to treat GAD can have negative or dangerous effects when taken with other medications, including some herbal and “natural” treatments. GAD drugs can also interact with alcohol.
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs prescribed for GAD include:
- Prozac (fluoxetine)
- Zoloft (sertraline)
- Celexa (citalopram)
- Lexapro (escitalopram)
- Paxil (paroxetine)
Side effects of SSRIs can include:
- Weight gain
- Dry mouth
- Sexual problems
- Feeling nervous or restless
- Sleeping troubles
Should children and adolescents take medication for GAD?
While SSRIs have shown promise in treating younger people, there is little evidence on the effectiveness of antidepressants for GAD in children. Additionally, antidepressants can come with a variety of side effects and potential risks in children and adolescents. Therefore, other treatments, such as cognitive behavioral therapy (CBT), are often recommended as first-line treatment for GAD in children.
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Prescribed SNRIs for GAD include:
- Effexor (venlafaxine)
- Cymbalta (duloxetine)
Common side effects of SNRIs can include:
- Nervousness or anxiety
- Loss of appetite
- Sexual problems
- Increased blood pressure (at higher doses)
Buspirone (brand name BuSpar) is a common medication known as azapirones prescribed for GAD. It may take some time and dosage adjustments to be effective.
Some common side effects of buspirone include:
- Changes in dreams
- Scared of heights
Never Stop “Cold Turkey”
Medications used to treat GAD can have uncomfortable side effects when stopped abruptly. Always consult your health care provider before stopping your medications to develop a reduction plan under their guidance.
Some tricyclic antidepressants prescribed for GAD include:
- Trofranil (imipramine)
- Pamelor (nortriptyline)
- Norpramin (desipramine)
- Anafranil (clomipramine)
Side effects of tricyclic antidepressants can include:
- Blurred vision
- Difficulty urinating
- Dry mouth
- Weight gain
- Excessive sweating (especially at night)
- Heart rhythm problems, such as palpitations or tachycardia (a rapid heartbeat)
Benzodiazepines are intended for short-term use in addition to other medications and treatments for GAD.
Benzodiazepines used to treat GAD include:
- Xanax (alprazolam)
- Valium (diazepam)
- Ativan (lorazepam)
Side effects of benzodiazepines can include:
- Unstable (especially in older people)
- Speech disorders
- Muscular weakness
- Memory issues
- Dry mouth
- Blurred vision
Can benzodiazepines be addictive?
Although taking benzodiazepines on a short-term or occasional basis is unlikely to be addictive, regular long-term use can be habit-forming, which means you can become addicted to them and experience withdrawal symptoms when you stop. to take them.
Always consult your health care provider before taking benzodiazepines and follow their instructions for use.
Sometimes, in those who do not respond well to other options, antipsychotic drugs, especially newer drugs, are used. This is particularly the case if there are co-occurring psychiatric disorders.
Psychotherapy (talk therapy) is a common treatment for GAD, especially CBT.
Psychotherapy is often combined with medications and lifestyle coping strategies to treat GAD.
Cognitive-behavioral therapy (CBT)
Across all disorders and age groups, CBT is the most frequently endorsed evidence-based practice (an approach that uses the most current research) on the list compiled by the Promotion and Dissemination Task Force. psychological procedures.
CBT is a type of psychotherapy that works by challenging negative thought patterns. It helps a person replace thoughts and responses that contribute to GAD with ones that are more productive.
The five components of CBT for anxiety are:
- Education: Learn about generalized anxiety disorder and how to distinguish between helpful and unnecessary worry, creating a more tolerant and proactive response to anxiety.
- Monitoring: Learn to be aware of your anxiety episodes – what triggers them, the specific things that worry you, and the severity and duration of the episodes – to take a step back and track your progress
- Physical control strategies: Learn relaxation techniques to help decrease the physical fight or flight response caused by anxiety
- Cognitive control strategies: Learn to realistically assess, challenge and change negative thought patterns that contribute to GAD
- Behavioral strategies: Learn to face fears by imagining the things that scare you the most and focusing on your fears without trying to avoid or escape them
Mindfulness-Based Stress Reduction Therapy
An analysis of 36 randomized controlled trials on meditation found that meditative therapies reduce symptoms of anxiety; however, most studies have focused on anxiety symptoms rather than anxiety disorders.
Mindfulness-based stress reduction therapy (MBSR) involves focusing your attention on the present, acknowledging your emotional state, and meditating.
MBSR is an 8-week program of weekly group classes and daily mindfulness exercises practiced at home. Mindfulness is increased through yoga and meditation.
Mindfulness shows promise in helping not just with anxiety, but with many other health issues.
Sometimes used as part of mindfulness therapy and sometimes alone, yoga has been suggested as part of a treatment plan for GAD.
In a 2021 study, Kundalini yoga showed positive results, but was not as effective as CBT in helping patients with GAD. This suggests that yoga should be used as a complementary therapy, not a first-line treatment.
Way of life
While it’s not always possible to prevent anxiety disorders, there are ways to lessen the symptoms (or not make them worse):
- Check your medications: Some medications, including over-the-counter medications and herbal medications, can make anxiety symptoms worse. Consult your health care provider or pharmacist before starting any new treatment.
- Limit alcohol, nicotine and caffeine: Certain substances, including alcohol, cigarettes, and caffeinated foods and beverages, including coffee, tea, cola, and chocolate, can make anxiety worse.
- Develop healthy lifestyle habits: Eating healthy foods, getting plenty of exercise, staying hydrated and getting plenty of rest can help reduce symptoms of anxiety.
Other ways to deal with anxiety include:
- Join support groups
- Practicing yoga
- Listen to music
- Getting a massage
- Practice relaxation techniques
- Breathe deeply
- Slowly counting to 10
- Get involved in your community
- Talk to friends, family, or a therapist
- Build a strong support system
- Progressive muscle relaxation
Need to calm down quickly? Use your senses
Use your senses to help you calm down:
- View: Look at everything that relaxes you or simply name the things you see around you.
- Ring: Listen to music, sing, play an instrument, listen to nature sounds or any other sound that you find relaxing.
- Feel: Go outside and smell the flowers or the fresh air, or stay indoors and light scented candles, prepare an aromatic food or drink, or take a shower with your favorite scented bath products.
- To taste: Eat a favorite food, drink a specialty drink, chew gum, or suck on a mint or hard candy.
- To touch: Give or receive a massage (or treat yourself to one), cuddle a pet or stuffed animal, stand in the rain or breeze, or get cozy under a blanket
- Movement: Take a walk, do some jumping jacks, stretch, dance or do any other activity that gets your body moving
A word from Verywell
Seeking help for GAD is important, and it usually starts with talking to a health care provider. From there, you can seek appropriate treatment, whether through psychotherapy, medication, or lifestyle changes, or a combination of the three.
Once on a treatment plan, be honest with your healthcare provider about what helps and what doesn’t. Don’t be afraid to ask for adjustments to your care plan if you need them.
Although it can take time and trial and error to find a treatment plan that works for you, GAD can be managed.