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Clinical resource

Generalized Anxiety Disorder

Living with generalized anxiety disorder can present many challenges, and without appropriate treatment, these challenges can quickly take the joy and happiness out of life.

Medically reviewed byDr. Sarah Boss, MD
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Quick Summary

  • Generalized anxiety disorder involves persistent, difficult-to-control worry that causes distress or disrupts social, occupational, or other areas of daily functioning.
  • Assessment considers symptoms, duration, impairment, and possible medical or substance-related causes; biological, environmental, personality, family, and trauma factors may contribute.
  • Management may combine professional assessment, medication, cognitive behavioral therapy, relaxation techniques, and supportive habits such as exercise, balanced meals, and adequate sleep.

Worrying is a normal part of life. Everybody stresses about something at some point in life, be it your electricity pills, an upcoming test, or troubles with marriage. But what happens if this worry becomes persistent and invasive? For individuals with a generalized anxiety disorder (GAD), worry and stress can exaggerate so much that they take over their lives. Such people do not experience rational qualms based on actual risk. Instead, they tend to worry regardless of the outside stressors and cannot rationalize it because of the exaggerated level of perceived risk.

A generalized anxiety disorder can be debilitating but manageable with appropriate therapy, medications, and lifestyle management.

  • Generalized anxiety disorder affects approximately 6.8 million people in the United States.
  • Only 43.5% of the people diagnosed with GAD receive treatment
  • More than 31% of U.S. citizens experience an anxiety disorder at some point in life
  • Women are twice as likely to develop GAD as men
  • GAD and depression often co-occur, leading to further complications and difficulties in the management
  • The prevalence of generalized anxiety disorder in children between the ages of 3 to 17 years is 8.5%

The medical and nursing diagnosis for generalized anxiety disorder follows the DSM-5 criteria, which include:

  • Excessive worry and anxiety about multiple activities or events, frequently occurring for at least six months
  • Difficulty in managing worry
  • Presence of three of the following symptoms in adults or one or more in children for the past six months: restlessness, being easily fatigued, irritability, sleep disturbances, muscle tense, difficulty concentrating
  • Significant impairment or distress in occupational, social, or other areas of functioning due to excessive stress
  • Screening negative for substance abuse or a medical condition that might be causing these symptoms
  • No alternative medical explanation for these symptoms
  • Apart from the medical criteria mentioned above, other symptoms of GAD include the following:
  • Feeling tired or weak
  • Sweating and trembling
  • Rapid breathing
  • Nervousness
  • Feeling a sense of panic or impending doom
  • Headaches
  • Unexplained body pains or muscle soreness
  • Problems with digestive health

As with most types of mental health issues, there is no single cause of GAD. The disorder is likely to stem from a complex interaction between an individual’s biology and environment.

Mentioned below is a list of factors that might trigger this issue, including the biological causes of generalized anxiety disorders:

  • Differences in the function, structure, and chemistry of the brain, such as in the amygdala, an area of the brain that processes and regulates different emotions, including fear and worry
  • Differences in the way an individual perceives a threat
  • A family history of an anxiety disorder or other mental health issues
  • Personality traits, such as a timid temperament, a pessimistic outlook, or a tendency to avoid anything dangerous
  • Presence of a chronic medical disease or mental health disorder
  • A history of traumatic past, negative experiences, or significant life changes

Living with GAD may seem difficult, but it is entirely possible with the right decisions and steps. Mentioned below are some key areas to look into for the comprehensive management of generalized anxiety disorder:

Seeking Professional Diagnosis and Treatment

Living with generalized anxiety disorder can present many challenges, and without appropriate treatment, these challenges can quickly take the joy and happiness out of life. The best thing for anyone struggling with anxiety is to get a professional assessment. A qualified psychiatrist or another mental health professional can determine if someone is suffering from GAD with the help of multiple interviews, observations, and evaluation tools. Once an accurate diagnosis forms, treatment can officially begin.

Treatment for GAD is critical to living well with this chronic ailment. While anxiety disorders have no definitive cure, it is possible to manage them with treatment and self-care. Medication is an essential element of overall treatment for GAD. Most experts advise using benzodiazepines to manage short-term anxiety and antidepressants for long-term management. In addition to medications, patients with anxiety disorders also benefit from therapy. In particular, cognitive behavioral therapy (CBT) is the gold standard for managing anxiety. This therapy helps patients learn how to recognize negative behaviors and thoughts and replace them with positive ones. In addition to this, a comprehensive treatment plan for GAD also includes teaching strategies to cope with stress, promote relaxation, and practice healthy habits.

When it comes to living with generalized anxiety disorder, having a treatment plan is only the beginning. For best management with long-term benefits, it is imperative to be proactive about managing and preventing anxiety. A good treatment plan will teach patients numerous strategies for controlling anxiety after the treatment ends. After this, it is entirely on the patient to continue practicing these strategies in daily life, both at home and outside.

Replacing Negative Thoughts with Positive

One of the best things someone seeking treatment for GAD can do is to learn how to replace negative behaviors and thoughts with positive ones. This is where the role of CBT kicks in. Once patients embrace this therapy, they can learn how to use these strategies even after the formal treatment is over.

Keep in mind that changing negative thoughts require awareness. It is easy to worry about different things without giving them much thought. CBT helps people to become more aware of their worries and determine where they stem from. Once they have identified the cause, they can learn to change the thoughts coming out of it and replace them with positive ones. For example, they can change “If I go to that party, everyone will make fun of me” with “If I go to that party, I can meet a lot of friends I have not spoken to in a while, and if things get uncomfortable, I can leave.”

While it may take some time to master this skill, active engagement in CBT under the supervision of a good therapist can make things easier. The more someone actively tries to identify and recognize their negative thoughts and worries, the easier it becomes to manage their anxiety.

Using Relaxation Techniques

Another essential tip to include in the treatment plan for anxiety is the use of relaxation techniques. Having multiple practical strategies can help a person manage a stressful situation while keeping calm and reducing anxiety. Relaxation techniques combine the mind and the body to bring quick relief when anxiety seems to be building and threatening to take over. Some examples of relaxation techniques include the following:

  • Deep breathing, which involves taking slow and deep breaths to bring the heart rate down and induce a sense of calmness
  • Mindful meditation involves diverting the attention away from an anxiety-provoking element to something else, such as the beating of the heart or breathing
  • Progressive muscle relaxation, which involves slowly tensing and relaxing different muscle groups of the body to draw the mind away from anxiety
  • Autogenic relaxation involves imagining mantras, suggestions, and words along with relaxing, peaceful images of tension leaving the body to promote calmness in a stressful situation
  • Visualization and guided imagery, which works by imagining a calm or peaceful place and focusing on what it sounds, looks or smells like to minimize stress

Relaxation strategies can be particularly beneficial in reducing stress and controlling anxiety; however, they require some work practice. The more someone practices them, the more valuable these techniques will become in times of stress.

Introducing positive changes in life and following healthy lifestyle habits are crucial for creating a life with minimal anxiety and stress. Some people find that introducing significant changes is necessary to reduce the element of stress in their day-to-day life. For instance, some may consider leaving a job significantly contributing to their stress levels. Similarly, others may call it quits on a relationship that’s bringing more toxicity into their lives than positivity.

Following are some healthy habits and smaller changes that can promote a positive mindset while minimizing anxiety:

  • Eating healthy meals
  • Avoiding alcohol, drugs, and smoking
  • Getting regular exercise and maintaining a healthy body weight
  • Being more active in social life
  • Spending time doing things you love
  • Taking some time out to reflect in solitude
  • Getting enough hours of high-quality sleep

Questions

Frequently Asked Questions

How is normal worry different from GAD?
Worries, fears, and doubts are usual in everyone’s life. It is natural to feel anxious about an upcoming test or worry about managing your expenses when you get hit by unexpectedly high bills. However, most people who experience this kind of worry are different from a generalized anxiety disorder. The worry stemming from GAD is excessive, persistent, intrusive, and disruptive.
Generalized anxiety disorder vs social anxiety disorder: What is the difference?
Social anxiety disorder refers to nervousness one experiences in a social setting, even in minor social engagements with one-on-one interactions. Generalized anxiety disorder, on the other hand, includes feelings of worry and anxiety over daily events of the future. This type of anxiety disorder can occur in and out of social settings. People struggling with GAD are more likely to worry about day-to-day functions, like finances. On the other hand, those with social anxiety disorder feel stressed about meeting new people or getting into social environments.
Can GAD go away?
Most cases of GAD are manageable with appropriate help from medications and psychotherapy. Experts also recommend making healthy lifestyle changes, using relaxation techniques, and learning effective coping skills to further manage the disorder.
What is the difference between generalized anxiety disorder and panic disorder?
While panic disorder and generalized anxiety disorder both involve similar heart racing, fear, lightheadedness, and pain, they are different, and you cannot use them interchangeably. In panic attacks, these symptoms are much more intense, and the victim may genuinely feel like they are going to die. These attacks require urgent medical attention more frequently, whereas an anxiety attack is likely to rectify on its own. There is also a difference in how both disorders initiate. Anxiety is a response to a specific worry or fear and develops slowly with mild to severe symptoms. In most cases, resolving the causative problems can cause the symptoms to subside. Panic attacks, on the other hand, happen suddenly and without warning. There is nothing much you can do to prevent them, as they can happen as you are asleep or feel calm. With no obvious cause, the reaction is often overwhelming and unrelated to the situation. Lastly, anxiety symptoms build up over time and persist for longer compared to panic attacks that start suddenly, peak within 10 minutes, and subside within 30 minutes of initiation.
What is the difference between generalized anxiety disorder and PTSD?
People with generalized anxiety disorder tend to have a long, consistent history of anxiety across a wide variety of situations and circumstances. On the other hand, people with PTSD often suffer from an intense experience of anxiety and other associated symptoms in response to a major traumatic event in life, such as a bereavement.

Editorial evidence

Evidence & sources

Selected clinical guidelines, peer-reviewed research, and public-health sources used in this article.

01American Academy of Child & Adolescent Psychiatry. (n.d.). Anxiety disorders.View source
03Cochrane Common Mental Disorders. (n.d.). Generalised anxiety disorder. Cochrane Library.View source
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04Williams, T., & Cochrane Common Mental Disorders Group. (2019). Psychological therapies for generalized anxiety disorder.View source
05MedlinePlus. (n.d.). Generalized anxiety disorder. National Library of Medicine.View source
06Anxiety & Depression Association of America. (n.d.). Generalized anxiety disorder (GAD). Anxiety & Depression Association of America.View source
07National Institute for Health and Care Excellence. (2011). Generalised anxiety disorder and panic disorder in adults: Management.View source
08Baldwin, D. S., Waldman, S., & Allgulander, C. (2011). Evidence-based pharmacological treatment of generalized anxiety disorder. International Journal of Neuropsychopharmacology, 14(5), 697u2013710.View source
09National Center for Biotechnology Information. (2023). Generalized anxiety disorder. National Library of Medicine.View source
10Substance Abuse and Mental Health Services Administration. (2022). National Survey on Drug Use and Health (NSDUH).View source
11World Health Organization. (n.d.). Anxiety disorders.View source
12American Psychiatric Association. (n.d.). What are anxiety disorders?View source
13National Health Service. (2022). Generalised anxiety disorder in adults.View source
14American Psychiatric Association. (n.d.). Diagnostic and statistical manual of mental disorders (5th ed., text rev.) (DSM-5-TR): Generalized anxiety disorder.View source
15National Center for PTSD. (n.d.). Generalized anxiety disorder. U.S. Department of Veterans Affairs.View source
16National Center for Biotechnology Information. (n.d.). Generalized Anxiety Disorder – StatPearls – NCBI Bookshelf.View source
17Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience.View source
What this includes
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Clinical context

Clear information is framed around complex and co-occurring presentations.

02

Individual factors

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Jil MooreClient Relations Director
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Cynthia NakhleAdmissions Manager

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