What is Generalized Anxiety Disorder?

Generalized Anxiety Disorder (GAD) is marked by persistent, excessive, uncontrollable, or unrealistic worries about everyday things. Individuals who meet diagnostic criteria for GAD usually worry about the same things other people worry about (such as finances, health, or relationships), but people with GAD spend much more time worrying, and it is often more intense, disturbing, or distracting. About 5% of the U.S population will meet criteria for GAD at some point in their lives, and a larger percentage will experience subclinical symptoms that may still warrant attention and respond to intervention.

 

Generalized Anxiety Disorder Symptoms

Worrying itself is not abnormal, nor is feeling stressed out or anxious when life is difficult. A person who has GAD, however, might describe his or her experience of anxiety in terms such as:

  • I worry too much
  • I can't stop worrying
  • I feel overwhelmed
  • I can't concentrate
  • I'm not getting things done
  • I'm irritable
  • I'm tense
  • I can't eat
  • I can't sleep

 

How Generalized Anxiety Disorder is Diagnosed

A GAD diagnosis is typically based on a clinical interview with a psychologist or other mental health provider, and may be augmented by one or more standardized tests (such as the Beck Anxiety Inventory [BAI] or Generalized Anxiety Disorder 7-item scale [GAD-7]). These assessment procedures help determine whether anxiety is present, how severe it may be, and whether any other conditions (such as depression, or substance use) may be contributing to the person’s distress. A formal diagnosis is assigned by comparing the results of the assessment to the diagnostic criteria for GAD (see below). A valid diagnosis always involves the clinical judgment of a qualified mental health provider and cannot be determined by testing alone.

 

Impact of Generalized Anxiety Disorder on Daily Life

When our anxiety reaches the scope, severity, and duration associated with a GAD diagnosis, it has usually become quite distressing, and it also may be preventing us from functioning normally in important areas of our life. For example, we may argue more with loved ones, have difficulty sleeping, have trouble focusing at work, or find it impossible to relax. It is common for people with GAD to experience unpleasant physical symptoms, such as trembling, sweating, lightheadedness, palpitations, dizziness, stomach upset, headache, fatigue, and muscle tension. These symptoms, when left untreated, also put us at risk for other problems, such as depression and drug or alcohol abuse.

 

Generalized Anxiety Disorder is Treatable

There are a number of empirically supported treatments for GAD, including Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT).

CBT is a short-term, goal-oriented approach to psychotherapy. Its goal is to change patterns of maladaptive thinking (i.e., a belief that is false or irrational) or problem behavior patterns. Collectively, these changes help people with GAD change the way they feel.

ACT is a form of psychotherapy that uses acceptance and mindfulness approaches, along with commitment and behavior change strategies, to increase psychological flexibility (i.e., fully contacting the present moment and changing or persisting in behaviors that reflect chosen values).

Medication is generally not considered to be a first-line treatment for GAD.

 

What to Do Next

If you think you may meet criteria for Generalized Anxiety Disorder:

 

Generalized Anxiety Disorder Diagnostic Criteria

DSM-5 Code: 300.2

ICD-10 Code: F41.1

A: Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

B: The individual finds it difficult to control the worry.

C: The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months):

Note: Only one item is required in children.

1. Restlessness or feeling keyed up or on edge.

2. Being easily fatigued.

3. Difficulty concentrating or mind going blank.

4. Irritability.

5. Muscle tension.

6. Sleep disturbance (difficulty falling asleep or staying asleep, or restless, unsatisfying sleep).

D: The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

E: The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another condition (e.g., hyperthyroidism).

F: The disorder is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation is social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).