Generalised anxiety

Generalised anxiety is worry that’s there most of the time, about many different things. For a lot of people it’s been around so long they think of it as part of their personality. It’s treatable, and it can change. Here’s how it shows up, the different kinds of anxiety, and what helps.

How generalised anxiety can show up

The worry is about many things, often small ones, most of the time. It feels hard or impossible to control, and it can make it hard to ever really relax (healthdirect).

Anxiety shows up in the body as much as the mind. Muscles stay tense, and your jaw or back can ache from it. Your heart races or your mouth goes dry. You can be tired all day and still not sleep properly at night. If you have chest pain or trouble breathing and you’re not sure it’s anxiety, call 000. It’s always better to check.

Concentrating gets harder, and you feel on edge, irritable or restless. It shows up in what you do, too. You might check things, ask for reassurance, or take a long time over tasks to get them exactly right. You might pull back from whatever sets the worry off. Over time it gets in the way of work, seeing friends and everyday life.

Many people feel their worry is doing a job, keeping things from going wrong, and that’s part of why it’s so hard to put down. I can’t switch my mind off looks at why telling yourself to stop doesn’t work.

You don’t need all of this for it to be generalised anxiety, and recognising some of it doesn’t mean it is. Only a proper assessment can say whether it’s generalised anxiety, and whatever it’s called, it can be treated.

Different kinds of anxiety

Anxiety is the most common kind of mental health condition in Australia. About 1 in 6 people aged 16 to 85 had an anxiety condition in the past year, and young people aged 16 to 24 had the highest rate (Australian Bureau of Statistics, 2020–22).

• Generalised anxiety is the everywhere kind: worry most days, about many things, going on for months. Clinicians usually look for about six months.
• Panic is sudden surges of intense fear with a pounding heart and breathlessness, and often worry about it happening again.
• Social anxiety is fear of being judged or embarrassed around other people.
• Specific fears, sometimes called phobias, are intense fears of particular things or situations.

Anxiety and low mood often come together. Depression looks at low mood.

What helps

The largest recent comparison of therapies for generalised anxiety pulled together 65 trials (Papola and colleagues, 2024). Cognitive behavioural therapy (CBTCognitive behavioural therapy (CBT) A structured, practical form of talking therapy. It's built on a simple idea: what you think affects how you feel, and both affect what you do. More in the jargon decoder Close) had the strongest evidence, and it was the only approachApproach (modality) The kind of therapy someone uses, such as CBT or psychodynamic therapy. You'll also see it called a modality. More in the jargon decoder Close still clearly helping three to twelve months after treatment ended.

Other approaches helped too, with less research behind them. Acceptance and commitment therapy (ACT) and mindfulness-based therapies reduced anxiety about as much as CBT in the short term. Relaxation therapy also helped, including applied relaxation, a structured way of learning to relax quickly when tension starts to build, though the evidence for it was weaker.

Therapy for generalised anxiety tends to help with low mood as well (Cuijpers and colleagues, 2014, on generalised anxiety).

Australia’s guideline for anxiety suggests starting with CBT, medication, or both (Royal Australian and New Zealand College of Psychiatrists, 2018). Which one depends on how severe things are, what you’d prefer, and what you can get to and afford. It counts online CBT programs as a genuine first option.

So CBT is the usual place to start, and it isn’t the only option. What suits you, and what you can get to, still matter. CBT has its own page, and therapy and medication covers what’s known about the two together.

Finding help and paying for it

When you’re looking for someone, ask how much of their work is with anxiety.

How you pay shapes what’s available. Paying the full fee has no session limit, and that includes seeing a counsellorCounsellor Someone trained to help people talk through and work on difficulties. The title isn't protected in Australia, so it's worth checking a counsellor's training and registration. Medicare doesn't give a rebate for counsellors. More in the jargon decoder Close or psychotherapistPsychotherapist Someone trained in therapy, often for longer-standing patterns. Like counsellor, the title isn't protected in Australia, and Medicare doesn't give a rebate for psychotherapists. More in the jargon decoder Close, whom MedicareMedicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder Close doesn’t cover. Workplace programs usually offer three to six sessions, and community health services tend to have a set number too. headspaceheadspace A national youth mental health service for anyone aged 12 to 25, with centres around Australia and support online and by phone. It's free or close to it, you don't need a referral or a parent, and you can book it yourself. More in the jargon decoder Close offers free or low-cost support for people aged 12 to 25. Groups and online CBT programs usually cost less than individual sessions.

A Mental Health Treatment PlanMental Health Treatment Plan A document your GP writes with you. It makes you eligible for a Medicare rebate on up to ten individual sessions a calendar year: six, then a review with your GP, then the remaining four. The plan itself isn't therapy. More in the jargon decoder Close from your GPGP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder Close gives you a Medicare rebateRebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder Close on ten sessions a calendar year. Ten sessions a calendar year is a funding limit, not a judgement about how much therapy anyone needs. Free and low-cost options covers other ways to keep costs down.

Beyond Blue, on 1300 22 4636, offers support and information about anxiety.

Kids Helpline is on 1800 55 1800, any time, for anyone aged 5 to 25. Lifeline is on 13 11 14 and, if you’re 15 or over, the Suicide Call Back Service is on 1300 659 467. In an emergency, call 000. Crisis and emergency support has the full list.

Where next

However good the treatment, how well you and your therapist work together matters a great deal. Why who you see matters more than what they do explains why.