Generalized anxiety disorder (GAD) is characterized by frequent or persistent, generalized feelings of nervousness and excessive anxiety without a clear object or fixed content. This anxiety is not related to any specific surrounding situation, but is generally caused by excessive worry. The typical manifestation is often excessive worry or annoyance about certain problems in real life, such as worrying about illness or accidents of oneself or relatives, abnormal worry about financial situation, excessive worry about work or social competence. This nervousness, worry or annoyance is so disproportionate to reality that the patient feels unbearable but cannot get rid of it; it is often accompanied by autonomic hyperfunction, motor tension and hypervigilance. In general, the anxiety symptoms of GAD patients are variable, and a series of psychological as well as somatic symptoms can occur. I. Psychological manifestations 1. Anxiety: manifestation of fearful anticipation, irritability, sensitivity to noise, fidgeting, decreased attention span, and worry. 2.Motor restlessness: rubbing hands and feet, walking back and forth, nervousness and restlessness, inability to sit still, visible tremor of eyelids, facial muscles or fingers, or the patient feels trembling. Some patients have double frown, facial muscle and limb muscle tension, pain, or feel muscle twitching, often feel tired and weak. 3, over-vigilance performance for panic, easy to frighten, easy to external stimulus jump reaction; concentration is difficult; sometimes feel blank; difficult to sleep and easy to wake up; and irritable, etc.. Physical manifestations 1, digestive system: dry mouth, swallowing difficulties with a sense of obstruction, foreign body sensation in the esophagus, excessive exhaustion, increased or reduced intestinal peristalsis, stomach discomfort, nausea, abdominal pain, diarrhea. 2, Respiratory system: chest pressure, difficulty in inspiration, shortness of breath and choking sensation, hyperventilation. 3.Cardiovascular system: palpitations, precordial discomfort, cardiac arrhythmia. 4.Genitourinary system: urinary frequency and urgency, erectile dysfunction, dysmenorrhea, amenorrhea. 5.Nervous system: tremor, tingling, tinnitus, vertigo, headache, muscle pain. 6, sleep disorders: insomnia, night terrors. 7, other symptoms: depression, obsessive-compulsive thinking, depersonalization. 8.Autonomic nervous function excitement: excessive sweating, facial redness or pallor and other symptoms. The somatic symptoms of generalized anxiety disorder originate from overactivity of the sympathetic nervous system and increased tension of skeletal muscles. The specific symptoms are richer and can be subdivided according to each system. For example, hyperventilation originates from swallowing air; anxiety-induced inspiratory difficulties can be distinguished from the expiratory difficulties of asthma; and hyperventilation causes a range of somatic symptoms. Among the neurological symptoms, vertigo presents as a feeling of instability rather than a spinning in the sky. In addition, some patients report blurred vision, but physical examination reveals normal vision. Headaches are often distended or tight, mostly bilateral, and are more common in the occipital and frontal lobes. Pain is also more common, mostly in the shoulder and back. Notably, patients often complain of somatic symptoms rather than anxiety, and these somatic symptoms can also be caused by somatic disorders. Therefore, the above conditions must be fully considered in the differential diagnosis. According to ICD-10 (which refers to the international diagnostic criteria for psychiatric disorders), the diagnosis of GAD must be made by having anxiety symptoms for most of the time for at least a few weeks, usually for more than 6 months, and the anxiety symptoms include: ① Worry: such as worrying about the future, feeling “nervous and restless”, having difficulty concentrating, often worrying excessively, and having nervousness, irritability, etc.; ② motor tension, easy fatigue, poor sleep, restlessness, headache, tremor, inability to relax; ③ other symptoms of hypervigilance: such as sweating, rapid heart rate, dry mouth, stomach upset, vertigo, dizziness and other symptoms can diagnose the disease. The main diagnostic point is that patients who meet the criteria for GAD always see themselves as people who are easily troubled and seek medical attention not so much to treat their doubts but rather to remove their doubts about what they are worried about, such as the health of their children, the significance of a symptom. For patients who repeatedly go to the hospital for examination because of these complaints or tension headaches or other manifestations of anxiety, physicians should consider whether excessive worry is present. Both of these types of anxiety disorders are primary and not secondary to organic disorders, schizophrenia, affective disorders, and other types of neurological signs.