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Generalized Anxiety Disorder (GAD)

Written by:
Rabia Khaliq
MSc in Applied Psychology
Reviewer:
Dr. William Grigg
DO

Generalized anxiety disorder (GAD) is a prevalent mental health condition marked by disproportionate, relentless concern over an array of daily circumstances. In contrast to specific phobias or panic disorders, which typically have precise triggers, GAD is not restricted to a single concern or event. It instead infuses a person’s everyday life, possibly disrupting professional, academic, and personal areas.

According to the National Institute of Mental Health (NIMH), generalized anxiety disorder impacts 5.7% of U.S. adults [1*] at some time in their lives. It’s more frequently diagnosed in women, who are twice as susceptible as men. Recognized as a long-term disorder, it has the potential to last many years or even a lifetime, especially without an appropriate treatment.

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Symptoms of GAD

Generalized anxiety disorder in adults presents itself through various psychological, emotional, and physical symptoms. The key sign is enduring and extreme apprehension about multiple facets of life, encompassing career, well-being, family, finance, and educational matters. This anxiety tends to exceed the real probability or consequences of the worry-inducing situation.

Beyond mental symptoms, individuals with GAD may also experience a variety of physical ones, including:

  • Restlessness or feeling keyed up
  • Fatigue
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbances

For a confirmed diagnosis of GAD, these symptoms need to persist for a minimum of six months and must cause substantial distress or hinder daily activities.

Distinguishing GAD from Other Mental Health Issues

Identifying generalized anxiety disorder can be complex, given its symptoms overlap with other mental health conditions. Here’s a distinctive comparison of GAD and typical anxiety, panic disorder, post-traumatic stress disorder, and more.

GAD vs. Anxiety

Anxiety is a common emotion characterized by tension and worry, usually occurring in response to stressors. On the other hand, generalized anxiety disorder is a mental health condition marked by chronic, disproportionate worry affecting daily life. Unlike normal anxiety caused by stress, GAD persists even without a direct trigger, often focusing on health, finances, or family problems.

GAD vs. Panic Disorder

While both GAD and panic disorder involve significant anxiety, their nature differs. In panic disorder, anxiety is episodic, coming on suddenly in the form of panic attacks, causing both emotional and physical distress. Whereas in GAD, the anxiety is persistent and chronic, associated with excessive worry about a variety of life circumstances.

GAD vs. Post-traumatic Stress Disorder (PTSD)

PTSD is typically triggered by a traumatic event, leading to symptoms like flashbacks, nightmares, and severe anxiety. In GAD, the worry is not usually linked to one specific event and is more diffused across everyday situations.

GAD vs. Obsessive-compulsive Disorder (OCD)

OCD is characterized by a cycle of recurring, relentless thoughts (obsessions) and repetitive actions performed in response to obsessions (compulsions). Even though OCD and GAD may both feature high levels of worry, OCD involves intrusive thoughts and habitual behaviors, which stands in contrast to the widespread anxiety that defines the characteristics of generalized anxiety disorder.

Causes and Risk Factors for GAD

The precise causes of GAD are not fully understood. It’s thought that various factors working together play a role in its development. These include:

  • Biological factors. Changes in the brain’s neurotransmitters, particularly serotonin and noradrenaline, could make an impact.
  • Genetic factors. If a close family member, such as a parent or sibling, has GAD, an individual is more likely to develop it too.
  • Life experiences. A history of significant life changes, traumatic events, long-term stress, and other psychological causes can contribute to GAD. Childhood abuse, neglect, or losing a parent at a young age, also increases risk.
  • Personality features. Specific personality traits, like perfectionism, low self-esteem, or an increased need for control may predispose someone to GAD.

The risk factors for generalized anxiety disorder include:

  • Gender. GAD is more commonly diagnosed in females than in males.
  • Age. Generalized anxiety disorder can occur in adults at any time, but it often develops gradually and tends to start between childhood and middle age.
  • Chronic medical conditions. People with chronic health conditions, such as heart disease or diabetes, are more likely to have GAD. Conversely, GAD can worsen these medical conditions.
  • Substance abuse. Caffeine, drug abuse, and alcohol can contribute to GAD.

If you believe you are experiencing the symptoms of GAD, schedule a telehealth visit to assess your symptoms and get appropriate treatment.

Warning signs of generalized anxiety disorder

How Is GAD Diagnosed?

The process of diagnosing generalized anxiety disorder typically includes the following steps:

  • Medical examination. A comprehensive medical examination helps to assess GAD symptoms and rule out physical or substance-related causes of anxiety. This step may also involve medical tests and a review of health history.
  • Psychological evaluation. It requires a person to fill out the questionnaire and discuss symptoms, thoughts, feelings, and behaviors with a mental health professional.
  • Diagnostic criteria. If symptoms and other health aspects meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a healthcare provider can make a GAD diagnosis.

How Is Generalized Anxiety Disorder Treated?

The approach to treating GAD is usually comprehensive, often involving a combination of psychological therapies, medication, and lifestyle changes tailored to the individual’s needs.

Cognitive-behavioral Therapy

Cognitive behavioral therapy (CBT) is particularly effective for generalized anxiety disorder. It teaches people new ways of thinking and behaving in situations that cause anxiety. CBT can also help understand and manage physical symptoms of anxiety.

Medication

The following types of medications [2*] can be used to treat GAD:

  • Antidepressant medications, particularly those falling under the categories of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Certain other antidepressants, such as venlafaxine or duloxetine, may also be recommended as anti-anxiety medications.
  • Benzodiazepines for short-term relief of acute symptoms of anxiety, although they carry a risk of dependency when used long-term.
  • The anti-anxiety medication buspirone.

Lifestyle Changes to Help Ease Symptoms of GAD

Regular exercise, a healthy diet, avoiding caffeine and alcohol, maintaining a consistent sleep schedule, and practicing mindfulness and yoga can help manage anxiety.

Complications of GAD

Generalized anxiety disorder can significantly impact an individual’s life quality if left untreated. The ongoing nature of this disorder and its impact on mental and physical health can lead to various problems:

  • Development of depression and substance use disorder.
  • Specific physical health problems, including heart conditions, gastrointestinal issues, respiratory disorders, and chronic pain.
  • Hindered ability to perform everyday tasks, hold down a job, or maintain relationships, leading to social isolation.
  • Suicidal thoughts or exhibiting suicidal behaviors because of extreme generalized anxiety disorder.

Consult a mental health professional to avoid the complications of GAD.

How to prevent generalized anxiety disorder

Prevention Options

Though it may not be feasible to prevent generalized anxiety disorder in every instance, certain measures can help reduce the risk and help manage symptoms more efficiently:

  • Early diagnosis
  • Regular exercise
  • Healthy diet
  • Sleep hygiene
  • Stress management techniques
  • Strong social connections
  • Limited alcohol and avoidance of illicit drugs
  • Regular check-ups

Bottom Line

The stigma around mental health issues often isolates people, discouraging them from seeking help. But, it’s important to know that anxiety is treatable. Consulting a healthcare provider not only allows for precise diagnoses, identifying underlying triggers, and choosing the most suitable treatment options.

FAQ

Anxiety can feel like a constant, unpredictable mental alarm causing distress and bringing physical and emotional discomfort. People with generalized anxiety disorder may have intrusive worries and experience fatigue, restlessness, and sleep issues. They may find it difficult to relax, often overthink and catastrophize insignificant events, and have challenges in social settings. Remember that anxiety disorders are treatable and it’s important to seek professional support if any symptoms are severe and disrupt your daily life.

Yes, people with GAD can lead fulfilling lives. Appropriate treatment, such as medication, psychotherapy, and self-help coping strategies can help manage symptoms effectively and reduce the impact of this condition.

Warning signs of generalized anxiety disorder include continuous and excessive worry about various everyday situations. For example, an individual may constantly worry about job stability, personal health, or family safety, even when there are no reasons to be so anxious. This worry is hard to control and may lead to physical symptoms such as fatigue, restlessness, and sleep problems.

GAD can affect anyone, but some individuals are more at risk. Women are diagnosed with GAD more frequently [3*] than men. The disorder can begin at any age but commonly emerges between childhood and adulthood. Genetic factors also play a role: having a close family member with GAD can increase the risk. People who have experienced trauma or adversity, particularly in childhood, are more susceptible.

Anxiety is a normal response to stress, but GAD is a chronic condition involving excessive worry that disrupts daily life. GAD persists regardless of specific triggers and often concerns health, finances, or family. It’s diagnosed when such extensive worry lasts for six months or more.

Sources

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3 sources
  1. Generalized Anxiety Disorder
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  2. Pharmacotherapy for Generalized Anxiety Disorder in Adults and Pediatric Patients: An Evidence-Based Treatment Review. (2018)
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  3. Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness. (2011)
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Written by:
Rabia Khaliq
MSc in Applied Psychology
Reviewer:
Dr. William Grigg
DO
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Evidence Based

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This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.