Generalised anxiety
Persistent, hard-to-control worry about many everyday matters (work, health, money, family) on most days for months, with muscle tension, restlessness, fatigue, poor sleep and irritability. The worry moves from topic to topic rather than fixing on one.
What drives it
Worry works as a mental rehearsal that feels like control and keeps intolerable uncertainty and strong emotion at arm's length; the person often believes the worrying is what keeps bad outcomes from happening.
How it shows
Work
Over-preparation, multiple checks with the boss ('just want to make sure'), long caveated emails, reluctance to delegate, difficulty deciding until every risk is covered. Often valued as thorough and reliable. Tension in the jaw and shoulders, frequent headaches, tiredness by mid-afternoon. 'What if the client…' is a constant opener.
Relationships
Frequent check-ins on where people are, worry about children's safety, catastrophic scenarios voiced at dinner, trouble relaxing on holiday. Reassurance helps for minutes. Partners find themselves managing the worry or tuning it out.
Self
Your mind jumps to the next thing as soon as one worry resolves. You feel you cannot stop even when you want to. Lying in bed you run through tomorrow's possible problems. A part of you thinks that if you stopped worrying you would be careless.
What tells it apart
ADHD in adults: Anxious distraction comes from worry crowding out attention and improves when the worry resolves; ADHD distraction is present in calm states, starts in childhood, and shows as boredom, lost items and missed details even on tasks the person enjoys.
Major depression: Generalised anxiety is future-focused ('what if') with tension and arousal; depression is past- and self-focused ('I've failed') with loss of interest and energy. They co-occur often, so look for which came first.
Conscientiousness: High conscientiousness plans thoroughly and then lets go; generalised anxiety keeps worrying after the plan is made, costs sleep and physical tension, and the person says they cannot switch it off.
A test
Ask whether they can stop worrying when they decide to and how much it costs them in sleep and tension; persistent, uncontrollable worry across several life areas for six months or more is worth a professional assessment, as cognitive-behavioural treatment works well.
Questions to carry
- When a decision is made to stop worrying, what happens, and what does the worry cost in sleep and tension?
- What do I believe my worrying is keeping from happening?
How strong the research is
strong
Where it comes from
Sigmund Freud's 'anxiety neurosis', 1895; generalised anxiety disorder defined in DSM-III, 1980; worry-as-avoidance model by Thomas Borkovec, 1980s–90s
On the family tree: Sigmund Freud