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Generalised anxiety disorder

Perturbatio anxia generalisata · Generalizovaná úzkostná porucha

What it is

Uncontrollable worry with a body permanently on alert.

Symptoms & signs

  • Constant worry
  • restlessness
  • muscle tension
  • poor sleep
  • irritability
  • palpitations

🚩 Get help if…

  • call 112 / 911 now Chest pain, fainting or breathlessness that is new or unlike your usual anxiety
  • call 112 / 911 now Thoughts of suicide
  • see a doctor soon Anxiety stopping work, school or leaving home
  • see a doctor soon Using alcohol or pills to cope

Where it strikes

Medical treatment

  • CBT — as effective as the drugs, and it keeps working after it stops trials support
  • SSRIs and SNRIs mixed evidence
  • Buspirone mixed evidence
  • Benzodiazepines beyond two weeks — tolerance, dependence and rebound anxiety not confirmed in trials
  • Propranolol for the physical symptoms mixed evidence

Natural & lifestyle

  • Aerobic exercise
  • breathwork (slow exhale)
  • mindfulness
  • caffeine cut
  • sleep repair
  • reduced alcohol

Emerging & experimental

  • VR exposure therapy
  • MDMA-assisted therapy trials
  • neurofeedback

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Lavender oil capsules (Silexan) — trials comparable to paroxetine and lorazepam trials support
  • Kava — trials show benefit; rare liver injury mixed evidence
  • Chamomile — small trials reduce anxiety mixed evidence
  • Ashwagandha — small trials early / small studies
  • CBD — small trials early / small studies

ICD codes