Symptom guide
Constant worry and anxiety: causes, red flags and where to get help
Worrying about many things most days, finding it hard to control, and feeling on edge, tired, tense or unable to sleep for six months or more is the picture of generalised anxiety disorder (GAD). It is common and responds well to treatment. Physical causes such as an overactive thyroid and caffeine can mimic or worsen anxiety, so a basic medical check is sensible.
Last checked: 2026-10-03
Key facts
At a glance.
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Pattern
Excessive worry about everyday things that is hard to control and lasts for months.
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Physical signs
Muscle tension, headaches, palpitations, stomach upset, sweating, trembling and poor sleep.
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Mimics
Overactive thyroid, caffeine, medicines and some conditions can cause anxiety-like symptoms.
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Treatable
CBT, guided self-help, applied relaxation and medicines help many people.
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Who to see
GP; NHS Talking Therapies (self-referral in England); psychology or psychiatry.
What this symptom usually means
Worry is a normal response that prepares us to deal with threats. In generalised anxiety the alarm system stays switched on, producing worry across many areas of life without a clear trigger, along with physical tension and exhaustion. It tends to run in families and is influenced by stress, life events and learned patterns of thinking.
Possible causes, from most to least common
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Generalised anxiety disorder, with persistent, hard-to-control worry about several areas.
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Situational stress: work, money, health, relationships and caring responsibilities.
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Panic disorder, social anxiety and health anxiety.
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Depression, which commonly co-exists with anxiety.
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Caffeine, nicotine, alcohol and drug use, including withdrawal.
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Overactive thyroid, heart rhythm problems, low blood sugar and menopause.
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Medicines: steroids, stimulants, some asthma drugs and decongestants.
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PTSD, OCD, ADHD, and rare medical conditions such as phaeochromocytoma.
Features that point to something more serious
Thoughts of self-harm, panic attacks with chest pain or breathlessness, intrusive memories after trauma, compulsions or rituals taking hours each day, inability to work, heavy alcohol use to cope, unexplained weight loss, and symptoms starting suddenly in later life warrant prompt assessment.
Red flags: when to seek help
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Call 999, go to A&E, or call Samaritans on 116 123 (free, 24 hours) if you have thoughts of harming yourself or ending your life. In England you can also call NHS 111 and choose the mental health option.
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Call 999: chest pain, severe breathlessness or collapse, even if you think it is anxiety.
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GP within days to weeks: worry that is affecting work, sleep or relationships, or lasting more than a few weeks.
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Support: speak to someone you trust and consider self-referring to NHS Talking Therapies.
What a doctor will ask and examine
The doctor asks about worries, duration, physical symptoms, sleep, mood, panic attacks, avoidance, caffeine, alcohol, drugs, medicines, past experiences and family history. They use the GAD-7 questionnaire, check pulse, blood pressure and may examine the thyroid.
Tests that are commonly used and why
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GAD-7 and PHQ-9 questionnaires: measure anxiety and depression severity.
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Blood tests: thyroid function, full blood count, glucose and others as indicated.
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ECG: if palpitations or chest symptoms are prominent.
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Screening for alcohol and substance use.
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Assessment for co-existing conditions such as depression, OCD or PTSD.
Self-care and the usual route
Regular exercise, consistent sleep, reduced caffeine and alcohol, relaxation and breathing techniques, and structured problem-solving can reduce anxiety. Schedule worry time and challenge unhelpful thoughts. Psychoeducation and guided self-help are first-line, with CBT and applied relaxation for more persistent anxiety. Medicines such as SSRIs or SNRIs are prescribed after assessment.
In England you can self-refer to NHS Talking Therapies. Private psychology, counselling and psychiatry are available directly.
Frequently asked
Questions people ask.
Quick, plain-English answers to the questions we hear most.
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How do I know if my worry is a disorder?
If worry is excessive, hard to control, lasts for months and causes distress or interferes with life, it may be GAD and is worth discussing with a GP.
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What are physical symptoms of anxiety?
Muscle tension, headaches, palpitations, sweating, trembling, stomach upset, fatigue and trouble sleeping.
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What treatments work?
CBT, guided self-help, applied relaxation, exercise and, where needed, medicines such as SSRIs.
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Can caffeine cause anxiety?
It can worsen anxiety, palpitations and sleep problems, and cutting back helps many people.
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Could it be my thyroid?
An overactive thyroid can cause anxiety-like symptoms, so thyroid function is often checked.
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Is anxiety hereditary?
It tends to run in families, but environment and learned patterns are also important.
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Can I self-refer for therapy?
In England, yes. NHS Talking Therapies accepts self-referral without a GP appointment.
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When is anxiety an emergency?
If you have thoughts of self-harm, or chest pain or severe breathlessness, seek urgent help.
Where this comes from
Sources and checking.
This guide is for information, not medical advice.
Your GP or consultant knows your history and can tell you which parts apply to you. If your symptoms are severe, rapidly worsening, or come with red-flag features, seek urgent medical care. Figures and availability change, so treat them as a guide and confirm with the provider.
Published 2026-10-03, next review 2027-10-03.
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NHS: Generalised anxiety disorder in adults (nhs.uk/mental-health/conditions/generalised-anxiety-disorder/)
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NICE guideline CG113: Generalised anxiety disorder and panic disorder in adults - management
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NHS: Every Mind Matters - anxiety (nhs.uk/every-mind-matters/)