Generalized Anxiety Disorder Treatment: Medication, Therapy, Lifestyle
6 min readGeneralized anxiety disorder (GAD) is a mental health condition characterized by excessive, chronic worry that interferes with a person’s ability to function in daily life.
GAD is commonly 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.
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Prescription Medications
Medications can be very effective at treating GAD.
An examination of scientific experiments known as randomized controlled trials regarding the use of medication in treating GAD showed response rates ranging from 44%–81%.
The first line of medications used to treat GAD are:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Azapirones
Other medications used to treat GAD include:
- Tricyclic antidepressants
- Benzodiazepines
- Antipsychotics
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 medications 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 might include:
- Nausea
- Diarrhea
- Weight gain
- Dry mouth
- Headaches
- Anxiety
- Sedation
- Sexual problems
- Jittery or restless feeling
- Sleep difficulties
Should Children and Adolescents Take Medication for GAD?
While SSRIs have shown some promise in treating younger people, there is limited evidence on how effective antidepressants are for childhood GAD. Also, antidepressants can come with a variety of potential side effects and risks in children and adolescents. Therefore, other treatments, such as cognitive behavioral therapy (CBT), are often recommended as a first-line treatment for childhood GAD.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs prescribed for GAD include:
- Effexor (venlafaxine)
- Cymbalta (duloxetine)
Common side effects of SNRIs might include:
- Nausea
- Drowsiness
- Dizziness
- Nervousness or anxiety
- Fatigue
- Loss of appetite
- Sexual problems
- Increased blood pressure (in higher doses)
Azapirones
Buspirone (brand name BuSpar) is a common drug known as azapirones prescribed for GAD. It can take some time and dosage adjustments to be effective.
Some common side effects of buspirone include:
- Nausea
- Headache
- Changes in dreams
- Feeling dizzy
- Drowsiness
- Light-headedness
Never Stop “Cold Turkey”
Medications used to treat GAD can have some uncomfortable side effects when stopped abruptly. Always consult your healthcare provider before discontinuing your medication to make a plan to taper off under their guidance.
Tricyclic Antidepressants
Some tricyclic antidepressants prescribed for GAD include:
- Trofranil (imipramine)
- Pamelor (nortriptyline)
- Norpramin (desipramine)
- Anafranil (clomipramine)
Side-effects of tricyclic antidepressants can include:
- Dizziness
- Constipation
- Blurred vision
- Trouble urinating
- Dry mouth
- Drowsiness
- Weight gain
- Excessive sweating (especially at night)
- Heart rhythm problems, such as palpitations or tachycardia (a fast heartbeat)
Benzodiazepines
Benzodiazepines are meant to be used short term as a supplement to other medications and treatments for GAD.
Benzodiazepines that are used to treat GAD include:
- Xanax (alprazolam)
- Valium (diazepam)
- Ativan (lorazepam)
Side effects of benzodiazepines can include:
- Drowsiness
- Light-headedness
- Confusion
- Unsteadiness (especially in older people)
- Dizziness
- Slurred speech
- Muscle weakness
- Memory problems
- Constipation
- Nausea
- Dry mouth
- Blurred vision
Can Benzodiazepines Be Habit-Forming?
While taking benzodiazepines short term or occasionally is unlikely to cause a dependency, regular long-term use can be habit-forming, meaning you can become dependent on them and experience withdrawal symptoms when you stop taking them.
Always talk to your healthcare provider before taking benzodiazepines and follow their directions for use.
Sometimes, in those not responding well to other options, antipsychotic medications—especially the newer drugs—are used. This is particularly the case if there are co-occurring psychiatric conditions.
Therapies
Psychotherapy (talk therapy) is a common treatment for GAD, particularly CBT.
Psychotherapy is often paired 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 Task Force on Promotion and Dissemination of Psychological Procedures.
CBT is a type of psychotherapy that works by challenging negative thinking 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: Learning about generalized anxiety disorder and how to distinguish between helpful and unhelpful worry, creating a more accepting and proactive response to anxiety
- Monitoring: Learning to be aware of your episodes of anxiety—what triggers them, the specific things you worry about, and the severity and length of episodes—to get perspective and track your progress
- Physical control strategies: Learning relaxation techniques to help decrease the physical fight-or-flight response caused by anxiety
- Cognitive control strategies: Learning to realistically evaluate, challenge, and change the negative thinking patterns that contribute to GAD
- Behavioral strategies: Learning to confront fears by imagining the things you’re most afraid of 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 has revealed that meditative therapies reduce anxiety symptoms; however, most studies focused on anxiety symptoms rather than anxiety disorders.
Mindfulness-based stress reduction therapy (MBSR) involves focusing attention on the present, acknowledging your emotional state, and meditating.
MBSR is an 8-week program of weekly group classes and daily mindfulness exercises that are practiced at home. Mindfulness is increased through yoga and meditation.
Mindfulness is showing promising results to help not just with anxiety, but with many other health conditions.
Alternative Treatments
Yoga
Sometimes used as part of mindfulness therapy and sometimes on its own, 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 GAD patients. This suggests that yoga should be used as a supplemental therapy, not a first-line treatment.
Lifestyle
While anxiety disorders can’t always be prevented, there are some ways to lessen the symptoms (or not make them worse):
- Check your medications: Some medications, including over-the-counter and herbal medications, can make anxiety symptoms worse. Check with your healthcare provider or pharmacist before starting a new treatment.
- Limit alcohol, nicotine, and caffeine: Some substances, including alcohol, cigarettes, and drinks and food items containing caffeine, including coffee, tea, cola, and chocolate, can make anxiety worse.
- Develop healthy lifestyle habits: Eating healthy food, getting plenty of exercise, staying hydrated, and being well-rested can help reduce anxiety symptoms.
Other ways to cope with anxiety include:
- Meditation
- Joining support groups
- Practicing yoga
- Listening to music
- Getting a massage
- Practicing relaxation techniques
- Taking deep breaths
- Slowly counting to 10
- Getting involved in your community
- Talking to friends, family, or a therapist
- Building a strong support system
- Progressive muscle relaxation
Need to Calm Down Fast? Make Use of Your Senses
Use your senses to help you calm down:
- Sight: Look at anything that makes you feel relaxed, or even just name the things that you see around you.
- Sound: Listen to music, sing, play an instrument, listen to nature sounds, or any other sounds you find relaxing.
- Smell: Go outside and smell flowers or the fresh air, or stay in and light scented candles, make an aromatic food or beverage, or take a shower with your favorite scented bath products.
- Taste: Eat a favorite food, drink a special beverage, chew gum, or suck on a mint or hard candy.
- Touch: Give or receive a massage (or give one to yourself), cuddle with a pet or stuffed animal, stand in the rain or the breeze, or get cozy under a blanket
- Movement: Take a walk, do jumping jacks, stretch, dance, or do any other activity that gets your body moving
A Word From Verywell
It is important to seek help for GAD, and that usually starts with talking to a healthcare provider. From there, you will be able to seek appropriate treatment, whether it be through psychotherapy, medications, or lifestyle changes, or a combination of the three.
Once on a treatment plan, be honest with your healthcare provider about what is helping and what is not. Don’t be afraid to ask for adjustments to be made to your care plan if you need them.
While it can take some time and trial and error to find a treatment plan that works for you, GAD can be managed.
