Presenting Complaints

• May present initially with tension-related physical symptoms (headache, pounding heart), but inquiry will reveal prominent anxiety and excessive worry.

Diagnostic Features

The key feature is months of uncontrollable worry over everyday things

• Multiple symptoms of worry, anxiety or tension:
  • Mental tension (worry, feeling tense or nervous, poor concentration
  • Physical tension (restlessness, headaches, tremors, can't relax)
  • Physical arousal (dizziness, sweating, fast or pounding heart, dry mouth, stomach pains)
• May last for months and often recurs.
• Often triggered by stressful events in those with a chronic tendency to worry.
  

Differential Diagnosis

• If low or sad mood is also present, see section on Depression
• If sudden attacks of unprovoked anxiety are present, see section on Panic Disorder.
• If fear and avoidance of specific situations are present, see section on Phobic Disorders.
• If heavy alcohol or drug use is present, see sections on Alcohol Use disorders, or Drug Use Disorder.
• Certain physical conditions (thyrotoxicosis) or medications (methyl xanthines, beta agonists) may cause anxiety symptoms but few cause excessive worry.