Generalised Anxiety and Constant Worry

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When worry keeps returning: generalised anxiety disorder (GAD, also spelled generalized anxiety disorder) involves persistent worry about several areas of life that feels hard to control and interferes with everyday living. You may feel as though your mind keeps finding another problem, even after the previous one is settled.

This guide is for adults. It cannot diagnose GAD. You can ask for help with distressing worry even if you do not know what to call it.

Symptoms · A practical first step · Treatment and support · Free worry handout

Safety first: do not assume new or medically worrying physical symptoms are anxiety. Seek medical advice. For immediate danger or inability to stay safe, use local emergency services; in Ireland call 112 or 999. HSE urgent mental health help also lists crisis-support options.

What can generalised anxiety feel like?

Alongside worry, you might notice restlessness, irritability, tiredness, difficulty concentrating, tense muscles or disrupted sleep. Worries can concern ordinary responsibilities, health, relationships or finances. The NHS overview of GAD describes the symptoms and assessment.

These experiences have more than one possible explanation. A clinician considers the pattern, its impact and other health conditions, medicines or substances. A symptom checklist on its own cannot tell you the cause.

How is GAD different from everyday worry?

Everyday concerns can still be painful and deserve support. With GAD, worry is typically frequent, difficult to put aside and disruptive across a range of situations. Assessment often considers whether it has been present on most days for at least six months. You do not need to wait six months to seek help.

There is no single explanation for everyone. The NIMH guide describes a combination of biological and environmental influences. Having anxiety is not a personal failure.

A small step when your mind will not switch off

Try choosing one current concern and asking whether there is a practical action available. “I need to clarify tomorrow’s appointment time” may lead to a short call. “What if every appointment goes badly?” asks for a certainty that no call can provide. These examples are prompts, not a diagnostic test.

You could note a possible action and when to take it, then gently return to the activity in front of you. If no useful action is available, practising leaving some uncertainty unresolved may be part of work with a therapist. The NHS guide to tackling worries explains problem-solving and planned worry time. The free two-page worry resource below offers another small starting point.

If the exercise turns into more checking or pressure to get it right, stop and discuss that with a qualified professional. Where intrusive thoughts and rituals dominate, use the OCD guidance and seek appropriate assessment.

What treatment and support can help?

NICE guidance for adults with GAD includes structured self-help, cognitive behavioural therapy (CBT), applied relaxation and medication options, depending on needs, preferences and how much symptoms affect life. CBT explores links between thoughts, feelings and behaviour; applied relaxation teaches a structured relaxation approach with a trained practitioner.

Medication choices, side effects, interactions and any changes to treatment need to be discussed with a qualified prescriber. Do not start, stop or alter medicines because of this page.

If worry is persistent, severe or impairing, a GP or qualified mental health professional can help you plan the next step. If it feels safe, you could begin: “I spend much of the day worrying and it is affecting my sleep. Could we talk about what help might fit?” You choose what to share and with whom.

Explore help with anxiety, the anxiety resource library, or anxiety therapy in Dublin and online. If work is a particular pressure, see anxiety at work.

Guide and current sources checked: 9 October 2026. General education; not an individual assessment or treatment plan.

generalized anxiety dr jonathan haverkampf psychiatry psychotherapy

Related information on this website

These links connect generalized anxiety with the questions readers often have next: worry, panic, social anxiety, OCD, depression, burnout, relationships, therapy, and local or online support.

Further anxiety resources

The links below point to established health services, clinical guidelines, public-health bodies, and mental-health organisations. They are offered for further reading and as additional support options — not as a substitute for individual assessment, diagnosis, medication advice, psychotherapy, or emergency care.

Ireland and UK

United States

Canada

Japan and global

Earlier references for background reading

These references accompanied earlier versions of this page. For current practical guidance, start with the NHS, NIMH and NICE sources above.

  1. Association, American Psychiatric (2013). Diagnostic and statistical manual of mental disorders : DSM-5. (5th ed.). Washington, D.C.: American Psychiatric Association. p. 222. ISBN 978-0-89042-554-1.
  2. “What Is Generalized Anxiety Disorder?”, National Institute of Mental Health.
  3. Torpy, Janet M.; Burke, AE; Golub, RM (2011). “Generalized Anxiety Disorder”. JAMA. 305 (5): 522. doi:10.1001/jama.305.5.522. PMID 21285432.
  4. International Classification of Diseases) ICD-10
  5. Spitzer, Robert L.; Kroenke, K; Williams, JB; Löwe, B (2006). “A Brief Measure for Assessing Generalized Anxiety Disorder”. Archives of Internal Medicine. 166 (10): 1092–7. doi:10.1001/archinte.166.10.1092. PMID 16717171.
  6. Ballenger, JC; Davidson, JR; Lecrubier, Y; Nutt, DJ; Borkovec, TD; Rickels, K; Stein, DJ; Wittchen, HU (2001). “Consensus statement on generalized anxiety disorder from the International Consensus Group on Depression and Anxiety”. The Journal of Clinical Psychiatry. 62 Suppl 11: 53–8. PMID 11414552.
  7. “The Numbers Count”, National Institute of Mental Health. Accessed 28 May 2007.
  8. Lieb, Roselind; Becker, Eni; Altamura, Carlo (2005). “The epidemiology of generalized anxiety disorder in Europe”. European Neuropsychopharmacology. 15 (4): 445–52. doi:10.1016/j.euroneuro.2005.04.010. PMID 15951160.
  9. Craske, MG; Stein, MB (24 June 2016). “Anxiety.”. Lancet (London, England). PMID 27349358.
  10. “In The Clinic: Generalized Anxiety Disorder”. Annals Of Internal Medicine. 159 (11). 2013.
  11. Rickels, K; Schweizer, E (1990). “The clinical course and long-term management of generalized anxiety disorder”. Journal of Clinical Psychopharmacology. 10 (3 Suppl): 101S–110S. doi:10.1097/00004714-199006001-00017. PMID 1973934.
  12. Hettema, J. M.; Neale, MC; Kendler, KS (2001). “A Review and Meta-Analysis of the Genetic Epidemiology of Anxiety Disorders”. American Journal of Psychiatry. 158 (10): 1568–78. doi:10.1176/appi.ajp.158.10.1568. PMID 11578982.
  13. Donner, Jonas; Pirkola, Sami; Silander, Kaisa; Kananen, Laura; Terwilliger, Joseph D.; Lönnqvist, Jouko; Peltonen, Leena; Hovatta, Iiris (2008). “An Association Analysis of Murine Anxiety Genes in Humans Implicates Novel Candidate Genes for Anxiety Disorders”. Biological Psychiatry. 64 (8): 672–80. doi:10.1016/j.biopsych.2008.06.002. PMC 2682432. PMID 18639233.
  14. Galanter, Marc (1 July 2008). The American Psychiatric Publishing Textbook of Substance Abuse Treatment (American Psychiatric Press Textbook of Substance Abuse Treatment) (4 ed.). American Psychiatric Publishing, Inc. p. 197. ISBN 978-1-58562-276-4.
  15. Ashton, Heather (2005). “The diagnosis and management of benzodiazepine dependence”. Current Opinion in Psychiatry. 18 (3): 249–55. doi:10.1097/01.yco.0000165594.60434.84. PMID 16639148.
  16. Lindsay, S.J.E.; Powell, Graham E., eds. (28 July 1998). The Handbook of Clinical Adult Psychology (2nd ed.). Routledge. p. 173. ISBN 978-0-415-07215-1.
  17. Cargiulo, T. (2007). “Understanding the health impact of alcohol dependence”. American Journal of Health-System Pharmacy. 64 (5 Supplement 3): S5–11. doi:10.2146/ajhp060647. PMID 17322182.
  18. Wetterling, T; Junghanns, K (2000). “Psychopathology of alcoholics during withdrawal and early abstinence”. European Psychiatry. 15 (8): 483–8. doi:10.1016/S0924-9338(00)00519-8. PMID 11175926.
  19. Cohen, SI (1995). “Alcohol and benzodiazepines generate anxiety, panic and phobias”. Journal of the Royal Society of Medicine. 88 (2): 73–7. PMC 1295099. PMID 7769598.
  20. Morissette, Sandra Baker; Tull, Matthew T.; Gulliver, Suzy Bird; Kamholz, Barbara Wolfsdorf; Zimering, Rose T. (2007). “Anxiety, anxiety disorders, tobacco use, and nicotine: A critical review of interrelationships”. Psychological Bulletin. 133 (2): 245–72. doi:10.1037/0033-2909.133.2.245. PMID 17338599.
  21. Bruce M. S., Lader M.; Lader (2009). “Caffeine abstention in the management of anxiety disorders”. Psychological Medicine. 19 (1): 211–4. doi:10.1017/S003329170001117X. PMID 2727208.
  22. Etkin, Amit; Prater, Katherine E.; Schatzberg, Alan F.; Menon, Vinod; Greicius, Michael D. (2009). “Disrupted Amygdalar Subregion Functional Connectivity and Evidence of a Compensatory Network in Generalized Anxiety Disorder”. Archives of General Psychiatry. 66 (12): 1361–72. doi:10.1001/archgenpsychiatry.2009.104. PMID 19996041.
  23. Möller, Hans-Jürgen; Bandelow, Borwin; Bauer, Michael; Hampel, Harald; Herpertz, Sabine C.; Soyka, Michael; Barnikol, Utako B.; Lista, Simone; Severus, Emanuel; Maier, Wolfgang (26 August 2014). “DSM-5 reviewed from different angles: goal attainment, rationality, use of evidence, consequences—part 2: bipolar disorders, schizophrenia spectrum disorders, anxiety disorders, obsessive–compulsive disorders, trauma- and stressor-related disorders, personality disorders, substance-related and addictive disorders, neurocognitive disorders”. European Archives of Psychiatry and Clinical Neuroscience. 265: 87–106. doi:10.1007/s00406-014-0521-9.

About this resource

This page is public educational information about generalized anxiety and worry. It cannot diagnose an anxiety disorder, rule out medical causes of physical symptoms, provide medication advice, replace psychotherapy, or respond to an emergency.

Guide and current sources checked 9 October 2026; older references are retained for background reading. This page is educational information and is not a substitute for individual medical, psychological, medication, or emergency advice.

© Dr Christian Jonathan Haverkampf. All rights reserved.

jonathanhaverkampf@gmail.com

Psychotherapy & Counselling, Communication, Medicine (Psychiatry); Dublin, Ireland

For psychotherapy, counselling and communication-focused therapy information, visit jonathanhaverkampf.com, read about psychotherapy and counselling in Dublin and online, or make an appointment.

This article is provided as a basis for academic discussion and general education. Nothing in it constitutes medical advice. Please consult a qualified professional if you believe you may be experiencing a physical or mental health condition.

Trademarks belong to their respective owners. They have not been verified.

Current helpful external links:

If someone close to you is caught in worry, reassurance loops or helplessness, how to help someone with anxiety offers supportive language, boundaries, and therapy routes.

Free practical resource · 2 pages · No sign-up

When worry keeps returning

One practical step, and some room for uncertainty. Choose what is useful to you; you do not need to complete every prompt.

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When worry keeps returning

One practical step, and some room for uncertainty

Worry can feel like a busy mind trying very hard to protect you. You may be tired of working through the same question. This sheet offers a brief way to choose a next step. You do not have to work out every possible outcome, or fill in every space.

1 Is there a practical problem to act on?

Ask once: is something happening now that I can usefully respond to? An unpaid bill may need a call or a plan. 'What if everything goes wrong?' asks for certainty that a plan cannot provide. Some concerns contain both parts. Treat this as a rough guide, not a test to get right. [1]

2 Choose one action within reach

If there is a practical step, make it small and specific: find the bill, ask for advice, or agree a time to talk. If it needs to wait, choose when you will return to it. Other people's help, money, time or safer circumstances may also be needed. [1]

One useful action, and when I could take it

For example: call the advice service tomorrow morning. A few words are enough.

Optional: reflect quietly or make a private note.

3 Let an unanswered what-if stay unanswered

If there is no useful action now, notice that your mind is asking for an answer. Gently turn towards something in the present: the next part of a task, a meal, or a conversation. Worry may come along too. You do not need to force it away before continuing. [1]

A phrase you could try once

I do not have the whole answer. I can choose what needs my attention now.

If sorting worries or repeating a helpful phrase becomes another search for certainty, put the sheet aside. You can ask for support with that pattern too.

Make the next step gentler

Use what helps; leave the rest

A little space for worry

If worries keep interrupting, you could try a short planned time to consider them. Note only enough to remember a practical issue, choose an action where possible, then finish. This is optional: avoid repeatedly reviewing, scoring or arguing with every thought. Stop if it increases distress or checking. [1]

One ordinary thing I would like to return to

Something manageable or meaningful, even while a little uncertainty remains.

Optional: reflect quietly or make a private note.

You can ask for help before it becomes a crisis

Speak with a GP or qualified mental health professional if worry is persistent, hard to manage, or affecting sleep, work or relationships. Describe its impact and ask about assessment and treatment, including CBT. New or concerning physical symptoms deserve medical advice; do not assume they are anxiety. [2, 3]

Words for a support conversation

I am spending a lot of time worrying, and it is affecting my day. Could we look at what is happening and what support might fit?

When things feel too much

In Ireland, contact your GP, out-of-hours GP or mental health team for urgent support. For someone to listen, call Samaritans 116 123 or text HELLO to 50808. Immediate danger or unable to stay safe: 112 / 999. Elsewhere, use local services. [4]

Sources and further reading

Practical guidance and research on treatment. These sources do not test this particular handout.

  1. NHS: Tackling your worries
  2. NICE CG113: Generalised anxiety – recommendations
  3. Papola et al. (2024): Psychotherapies for generalised anxiety
  4. HSE: Get urgent help for a mental health crisis

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More free resources: jonathanhaverkampf.com · Version 1.0, 3 October 2026. Sources checked 3 October 2026.

General information and support for adults. Not a substitute for professional assessment, advice, treatment or emergency care. Immediate danger: call 112 / 999 in Ireland, or local emergency services elsewhere. Find support · Full disclaimer.

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