Generalized Anxiety Disorder

What is Generalized Anxiety DisoRder (GAD)?

Generalized Anxiety Disorder (GAD) is a psychiatric diagnosis made when an individual has a persistent feelings of dread, worrying, or uneasiness that interferes with your life and occurs more days than not over a 6 month period. This could be characterized by muscle tension, irritability, restlessness, easily being fatigued.

People of all ages and all racial, ethnic and socioeconomic backgrounds experience GAD, and GAD can present different symptoms, depending on the person.

What causes GAD?

The cause of GAD is believed to be multifactorial, including biochemical (your body and how it functions), genetic (your family medical history), environmental (the things around you both past and present), and psychosocial (your experiences and relationships) factors. In the brain, GAD is currently theorized to be due to changes in neural circuits causing differing levels of neurotransmitters, especially serotonin, GABA, and norepinephrine. With better brain imaging and understanding of GAD, future research will help further delineate exactly what leads to GAD. Learn More.

What’s the difference between GAD and “being anxious”?

It’s normal to feel uneasy or worried when you’re faced with difficult life situations. Some people may say they feel “anxious” during these situations. GAD is different in that it is a clinical diagnosis made by a healthcare provider. It can be confusing because many people may call GAD (or other types of anxiety disorders such as Social Anxiety Disorder) just “anxiety,” and additionally many people without a diagnosis of GAD say they are feeling “anxious.” To help avoid confusion, we recommend describing feelings with terms such as “worried” or “distressed,” and describing a diagnosis with clear language such as “generalized anxiety disorder.”

are there treatments for GAD?

A number of treatments exist for GAD and other anxiety disorders, such as medications (including antidepressants and anti-anxiety), talk therapy (including Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and group therapy), and avoidance of triggers (including caffeine, nicotine, alcohol, and stress). There are also a number of coping strategies and habits people can do to help reduce or manage symptoms of anxiety, such as regular exercise, sufficient quality sleep, balanced nutrition, ecotherapy, mindfulness, meditation, and more.

The take-home message here is: there are numerous treatments that exist for GAD, so help exists, and if one method doesn’t work for you there are other approaches that you can try. You should always consult with your mental health professional about your treatment plan.

Here’s what people with GAD want you to know:

“[GAD] is not just being nervous. It can impair my day to day life.”

-Maddie S. (Washington State University)

“[GAD] is not ‘just stress’ and you can’t ‘just relax.’”

-Julia S. (New York, NY)

“Telling me to calm down doesn’t help. Sometimes I just need someone to listen.”

-Sophie C. (Villanova University)

“The frustrating thing about anxiety for me is that many people do not understand that it is not just nervousness. For me, anxiety manifested into a constant fear of judgment, an inability to enjoy anything without being on edge, and even physical symptoms like stomach aches.”

Julia J. (Clemson University)

Where to go for help with GAD:

• Your primary care physician (these are typically doctors specializing in Family Medicine or Internal Medicine)

• A psychiatrist (a doctor specializing in Psychiatry)

• A psychologist (a mental health provider with a PhD os PsyD degree), therapist, or counselor (note that these providers cannot prescribe medications but can provide valuable interventions such as therapy)

WHEN Do I go The Doctor?

• If you experience one or more of the symptoms of GAD (excessive anxiety or worry more days than not in addition to difficulties concentrating, easily fatigued, restlessness, irritability, and sleep disturbances).

• If any of your symptoms cause you distress or impair your day-to-day functioning.

• Any thoughts of suicide should prompt emergency treatment. Please call/see your physician, call 988, or visit your local emergency department if you have any thoughts of suicide.

When in doubt, see a healthcare provider or mental health professional. They can give you an accurate diagnosis, suggest treatment options, and recommend a different treatment plan if one isn’t working.

HOW Do I find a provider that takes my insurance/form of payment?

• Visit your insurance provider’s website and locate the provider finder page. This should assist you in finding care in your area that accepts your insurance.

• Call your insurance provider to have them assist you in finding a provider in your area.

• Use FindTreatment.gov.

• See “Mental Health Providers: Tips on Finding One” for more tips and suggestions.

With all that being said, this is your reminder that you don’t need to be a psychiatrist or psychologist to discuss your mental health or to be an empathetic ear to a friend. All you need is an open mind.

Where Can I Learn More?

• Wondermind, Here’s What to Know About Generalized Anxiety Disorder

• Wondermind, How to Know if Your Anxious Feels Might Be an Anxiety Disorder

• Anxiety and Depression Association of America, Understanding GAD

• National Alliance on Mental Illness, About Mental Illness, Anxiety

• American Psychiatric Association, Patients and Families, Anxiety

what people with GAD or feelings of anxiety have to share with you:

Disclaimer: The information above is intended to provide education regarding Generalized Anxiety Disorder. It is not medical advice and should not be used for medical diagnosis. For questions regarding diagnosis, treatment, and more regarding any mental health conditions, contact a mental health professional.

Published: December 2, 2023. Edited: January 21, 2023.

Written by Max Smith (Medical Student), Edited by Alexandra Lawlor (Medical Student).

References:

1. National Institute of Mental Health. Generalized Anxiety Disorder: When Worry Gets Out of Control. www.nimh.nih.gov. Published 2022. https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad

2. Maron E, Nutt D. Biological markers of generalized anxiety disorder. Dialogues in clinical neuroscience. 2017;19(2):147-158. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573559/

3. Substance Abuse and Mental Health Services Administration. Table 3.15, DSM-IV to DSM-5 Generalized Anxiety Disorder Comparison. Nih.gov. Published June 2018. https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t15/

4. Munir S, Takov V. Generalized Anxiety Disorder. [Updated 2022 Oct 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Available from: National Institute of Health, National Library of Medicine https://www-ncbi-nlm-nih-gov/books/NBK441870/