# Anxiety Disorders

> Anxiety disorder notes for NEET-PG Psychiatry covering generalised anxiety disorder criteria, SSRI and SNRI first-line use, buspirone, CBT and benzodiazepine caution.

- Canonical URL: https://prepelephant.com/topics/neet-pg/psychiatry/anxiety-disorders
- Exam / course: NEET-PG · Subject: Psychiatry
- Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team
- First published: 2026-10-02
- Last updated: 2026-10-02
- How to cite: "Anxiety Disorders", PrepElephant, https://prepelephant.com/topics/neet-pg/psychiatry/anxiety-disorders

## Direct answer

Generalised anxiety disorder (GAD), the prototype anxiety disorder in exams, is excessive anxiety and worry, difficult to control, occurring more days than not for at least six months, with at least three of six somatic symptoms. First-line treatment is an SSRI or SNRI plus cognitive behavioural therapy; benzodiazepines are reserved for short-term use because of tolerance and dependence. Panic disorder, phobias and social anxiety disorder complete the examinable spectrum.

## What you must remember

- **GAD criteria:** excessive worry about several events or activities, hard to control, more days than not for six months, plus three or more of — restlessness, fatigability, difficulty concentrating, irritability, muscle tension and sleep disturbance.
- **Course:** chronic and fluctuating, commoner in women; always exclude hyperthyroidism, arrhythmia, caffeine and stimulant use before diagnosing.
- **First-line drugs:** SSRIs and SNRIs — escitalopram, sertraline, paroxetine, venlafaxine and duloxetine all have evidence; benefit takes two to four weeks.
- **Buspirone:** a 5-HT1A partial agonist effective in GAD with no dependence or withdrawal; takes about two weeks to act — the classic non-sedating, non-addictive option.
- **Pregabalin** has supporting evidence in GAD in several countries, but carries its own dependence caution.
- **Benzodiazepines:** rapid relief but tolerance and dependence develop — acceptable for short courses or crises, not for long-term management.
- **Psychotherapy:** cognitive behavioural therapy with worry management and relaxation is as effective as drugs in many patients and combines well with them.

## Common confusion

GAD differs from panic disorder in shape: GAD worry is persistent and diffuse, while panic disorder features discrete unexpected attacks with anticipatory fear. Adjustment disorder with anxious mood follows an identifiable stressor, remains below diagnostic threshold and resolves within six months of the stressor ending. The organic differentials matter clinically — hyperthyroidism can mimic GAD almost exactly, and anxiety with palpitations deserves a thyroid function test and ECG before a psychiatric label. In phobias the anxiety is reliably cue-bound to a specific object or situation, unlike the free-floating worry of GAD.

## Exam-focused takeaway

NEET-PG tests this spectrum through the six-month duration rule and the six somatic symptoms of GAD, the two-to-four-week latency of SSRI benefit (a "why no improvement yet" question), and drug-matching — buspirone for a patient needing anxiolysis without sedation or dependence, benzodiazepines only for short-term use. Expect stems distinguishing GAD from panic disorder and from adjustment disorder, and a vignette of an anxious patient with weight loss and tachycardia where the answer is thyroid testing before anxiolytics. Combination of CBT with an SSRI is the standard management answer for moderate-to-severe GAD.

## Frequently asked questions

### What defines generalised anxiety disorder?

Excessive, hard-to-control worry more days than not for six months with at least three somatic symptoms such as restlessness, muscle tension and sleep disturbance.

### What is the first-line drug treatment for GAD?

An SSRI or SNRI, with cognitive behavioural therapy; response takes two to four weeks.

### Why is buspirone a popular exam answer?

It is a 5-HT1A partial agonist that relieves anxiety without sedation, dependence or withdrawal, though it takes about two weeks to work.

### Are benzodiazepines acceptable long-term?

No — tolerance and dependence develop, so they are reserved for short courses or acute crises.

### Which medical condition mimics generalised anxiety?

Hyperthyroidism is the classic mimic; check thyroid function and an ECG when pointers such as weight loss or tachycardia exist.

### How does GAD differ from panic disorder?

GAD produces persistent diffuse worry, whereas panic disorder produces recurrent discrete attacks with fear of further attacks.