Generalized Anxiety Disorder: Criteria, Causes, And Mental Health Treatment Options
Worry is a natural emotional reaction that arises when you are uncertain about the future. However, for some, this uncertainty may persist and compound. Excessive worry and a vague, unsettled feeling may be symptoms of an anxiety disorder known as generalized anxiety disorder (GAD).
GAD is one of the most common mental health conditions. Read on to learn more about its physical and psychological symptoms, the criteria used to diagnose it, and recommended treatments for excessive anxiety and worry.
What is generalized anxiety disorder (GAD)?
GAD is a mental disorder that is characterized by worry, fear, and persistent overwhelm. A major component of generalized anxiety disorder is excessive worry about ordinary situations in day-to-day life, rather than being focused on a specific topic or problem. While anxiety and worry are typical human emotions, people with GAD may experience them to the point of distress or functional impairment in multiple areas of their lives, such as work, health, or finances. GAD may often include physical symptoms, but diagnosis does not require the presence of panic attacks.
According to the National Institute of Mental Health, “Generalized anxiety disorder usually involves persistent anxiety or dread, which can interfere with daily life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events.”
DSM-5 definition of generalized anxiety
When assessing someone for a GAD diagnosis, medical professionals look for the following criteria for identifying anxiety disorders found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association Publishing:
- You experience excessive worry or anxiety about multiple events or activities, such as school, work, or performance, which occurs most days and persists for at least six months
- You have difficulty controlling your worry
- You experience significant distress or impairment at work, socially, or in other vital areas due to anxiety, worry, and physical symptoms
- Your symptoms are not attributable to the effects of a substance or other medical condition
You experience three or more of the following symptoms, with at least some symptoms present for more days than not in the past six months:
- Restlessness, feeling on edge or feeling keyed up
- Easily fatigued
- Difficulty concentrating or the mind going blank
- Irritability
- Muscle tension
- Difficulty falling or staying asleep, or other sleep changes
- Another mental health condition does not better explain your symptoms
Other generalized anxiety disorder symptoms:
- Physical complaints such as headaches, muscle tension, stomachaches, or unexplained chest pain
- Excessive and persistent worry
- Perceiving a threat that is not present
- Difficulty relaxing
- Trouble handling uncertainty
- Easily startled or jumpy
Understanding the physical symptoms of GAD
Anxiety is more than being nervous. Among other things, it is your body’s response to perceived threats, triggering the “fight or flight” response. GAD involves constant tension, which can lead to physical symptoms like nausea, sweating, trembling, headaches, racing heart, hyperventilating, lightheadedness, fatigue, muscle tension, gastrointestinal issues, restlessness, pent-up energy, and other physical symptoms.
How is GAD diagnosed using generalized anxiety disorder criteria?
A primary care doctor or mental health professional can diagnose GAD. The process may start with a physical exam to identify and rule out other potential causes of anxiety symptoms, such as certain medications or an underlying medical condition. They may ask detailed questions about symptoms and medical history. Many clinicians use a series of psychological questionnaires to help determine a diagnosis, along with the generalized anxiety disorder criteria presented above from the DSM-5.
How common are anxiety disorders?
According to research published by the Anxiety and Depression Association of America (ADAA), the country’s most common mental health conditions are anxiety disorders. Research states that the lifetime prevalence of GAD in the U.S. reaches 19.1% of the population. The ADAA further says that anxiety disorders are “highly treatable,” though only 36.9% of people with the condition reach out to professionals in an attempt to treat anxiety.
Comorbidity of GAD
According to a recent study, generalized anxiety disorder is frequently comorbid — present in the same person at the same time — with various other mental health conditions. The disorder is commonly seen alongside mood disorders (e.g., major depression, bipolar disorder), other anxiety disorders (e.g., social anxiety disorder, panic disorder, post-traumatic stress disorder, phobia-related disorder), chronic pain conditions, eating disorders (e.g., anorexia nervosa), personality disorders, and sleep disorders. Individuals with GAD are at a higher risk of developing substance use disorder.
If you are struggling with substance use, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Recognizing GAD in children
Generalized anxiety disorder does not always present the same in children as in adults. According to child development experts at Boston Children’s Hospital, kids with GAD tend to show excessive and uncontrollable worry compared to non-anxious peers. In addition to typical anxiety symptoms, children with generalized anxiety disorder often exhibit fear over future events, such as what will happen to them if their caregivers get sick or die. They may also consistently expect the worst, fixate on certain events, show extreme concern over their academic or social performance, and display restless or excessive energy.
As with many mental health conditions, the causes of GAD are believed to be a complex interaction of several genetic and environmental factors. Variations in brain chemistry, developmental experiences, personality, and the body’s response to threats can all factor into whether a person develops a generalized anxiety disorder.
Treating GAD
Many mental health professionals develop a plan to treat generalized anxiety disorder based on how significantly the disorder affects your daily functioning and interferes with your life. GAD treatment typically involves psychotherapy or medication, though a comprehensive treatment plan may involve both. From these treatments, many people managing GAD notice a reduction in symptoms and improved quality of life.
Medication
Clinicians use a variety of medication categories to help treat GAD, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). The most common GAD medication categories include antidepressants, anti-anxiety medications, and benzodiazepines. If you are interested in how medication may affect your GAD symptoms and daily functioning, speak to your doctor or mental health provider about the possible risks, benefits, and potential side effects.
Anxiety medication side effects differ based on the type and individual reaction. Common side effects include drowsiness, dizziness, blurred vision, dry mouth, nausea, constipation, and losing or gaining weight. Some may experience severe reactions, such as allergies or breathing difficulties. Consult your healthcare provider if you have any concerns regarding medication side effects.
Psychotherapy
Talk therapy is a primary treatment for generalized anxiety disorder. Many patients have reported reduced symptoms and an improved ability to manage their anxiety while working with a licensed therapist. Cognitive behavioral therapy (also known as cognitive behavior therapy or CBT) is one of the most frequently used treatments for GAD, as it focuses on identifying and replacing harmful or maladaptive thought patterns and behaviors. In addition to the effectiveness of cognitive behavioral therapy, patients have also found success with acceptance and commitment therapy (ACT), which can help reduce anxiety-related discomfort through mindfulness and goal setting.
Support groups
For many people, group therapy can be helpful. In group therapy settings, you can meet other people who are likely experiencing similar issues and will understand much of what you’re going through. It can be difficult to explain mental health symptoms to people who do not know how the condition can affect a person’s thoughts and behaviors.
Lifestyle changes that can help
- Practice a mindful lifestyle focused on positive thinking. Work to shift your perspective about situations that cause anxiety
- Develop positive affirmations to help reassure yourself when you’re feeling anxious
- Practice deep breathing to recenter yourself and help with calm and focus
- Keep a journal. Writing about your emotions helps you process them and gives you a written record to track your progress, triggers, and effective coping methods
- Exercise and consume nutritious foods
- Try taking on a calming hobby
- Enjoy a walk in nature to ground yourself
Reach out for professional mental health support and guidance
Living with generalized anxiety disorder can be challenging, but you are not alone. Reach out for a licensed therapist for professional support and guidance and gain additional resources as you build a repertoire of practical coping skills to manage your anxiety symptoms and stress reactions.
How therapy can help you manage GAD symptoms
A licensed therapist can help you manage the symptoms of generalized anxiety disorder. Many people have successfully received treatment for GAD and other mental health conditions through online therapy providers such as BetterHelp. Flexible appointment formats make it easier to fit treatment into your busy schedule, and online therapy is often less expensive, with shorter wait times.
A recent study suggests that online therapy is a practical, affordable treatment option for anxiety disorders that can be as effective as in-person sessions. Professionals in the industry have stated that the efficacy of therapy increases with the number of sessions attended. According to patients, the convenience of receiving therapy from home meant they could attend more reliably. Many also said the added physical distance made opening up to their therapists easier.
Takeaway
Generalized anxiety disorder can significantly impact your life and mental stability. While symptoms can be challenging to manage alone, working with a licensed therapist can substantially reduce symptoms and their effects. The information presented in this article may offer some insight into GAD and how therapy can help reduce the interference of symptoms in your life.What are the DSM-5 generalized anxiety disorder criteria?
According to the DSM-5, for someone to be diagnosed with generalized anxiety disorder, they must exhibit excessive anxiety or apprehensive expectation and at least some symptoms from the following list: irritability, muscle tension, restlessness or feeling keyed up or on edge, becoming easily fatigued, difficulty concentrating, and unsatisfying sleep or difficulty falling or staying asleep.
What is the mental health diagnostic test for generalized anxiety disorder?
Mental health professionals utilize the DSM-5 along with the GAD-7 to diagnose generalized anxiety disorder. The GAD-7 is a brief measure used by primary care physicians and mental health professionals as a screening tool to assess an individual’s symptoms and their severity. Differential diagnosis is important when diagnosing GAD, as it can present with symptoms similar to other physical and mental health conditions.
For example, mental health professionals must determine that an individual’s worries are not due to another mental health condition (e.g., worrying about gaining weight in anorexia nervosa, negative evaluation in social phobia or social anxiety disorder, panic attacks in panic disorder, serious illness in illness anxiety disorder, being separated from attachment figures in separation anxiety disorder, memories of traumatic events in post-traumatic stress disorder, perceived appearance flaws in body dysmorphic disorder, or delusional beliefs in delusional disorder or schizophrenia). It must also be determined that the symptoms are not due to the physiological effects of a substance.
What is the difference between anxiety disorder and generalized anxiety disorder?
An anxiety disorder is a broad term that refers to conditions characterized by excessive worry or fear, such as illness anxiety disorder, separation anxiety disorder, specific phobia, post-traumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder or social phobia. Generalized anxiety disorder is a condition that falls under the umbrella term of “anxiety disorders.”
What is the first line of treatment for GAD?
Treatment for GAD depends on the individual’s symptoms and the severity of their anxiety. For example, an effective treatment plan for someone with GAD who experiences panic attacks may include medication (most commonly antidepressant medication, such as a selective serotonin reuptake inhibitor or a serotonin and norepinephrine reuptake inhibitor), therapy, or lifestyle interventions, while someone experiencing physical complaints, such as muscle aches, may manage stress through techniques like yoga, meditation, and mindfulness-based stress reduction.
What is high-functioning anxiety?
People with high-functioning anxiety may appear calm, cool, and successful to the outside observer, but may experience significant mental health distress and severe anxiety internally.
What is the most severe form of anxiety?
All forms of anxiety can range from mild to severe, from somatic symptom disorder to social anxiety. However, some may consider panic disorder one of the more severe types of anxiety disorders, as the symptoms of panic disorder can be debilitating and hard to predict.
Is GAD considered a severe mental illness?
GAD is a mental disorder that presents in a range of mild to severe symptoms. Just like other medical conditions, like post-traumatic stress disorder and obsessive-compulsive disorder, certain triggers, like traumatic events or a serious illness, may increase the severity of symptoms.
When does anxiety become a disorder that requires treatment?
Anxiety is normal and happens to most people at some point in their lives. However, anxiety may require treatment if you experience anxiety more days than not; if you are experiencing recurrent, unexpected panic attacks; if the symptoms are causing clinically significant distress; if the symptoms are affecting your ability to complete job responsibilities, go to school, or socialize; or if the anxiety is worsening another condition, such as delusional disorder (a disorder in which an individual holds one or more delusional beliefs), somatic symptom disorder, substance use disorder, or mood disorders.
Anxiety disorders that can affect school performance, work performance, and other day-to-day activities include post-traumatic stress disorder, illness anxiety disorder, separation anxiety disorder, and obsessive-compulsive disorder. If you are experiencing mental health concerns that are affecting your daily life, reach out to a mental health professional. You may also find help through the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-HELP (4357).
What happens to people with untreated GAD?
Someone with untreated anxiety may fixate on a certain part of their life or themselves, projecting their anxiety into that particular area. An individual with GAD might experience excessive worry and fear of negative evaluation from others, leading to avoidance of friends, family members, and social situations and impairment in daily functioning. A person with body dysmorphic disorder might fixate on perceived appearance flaws to the extent of causing clinically significant distress.
What is one of generalized anxiety disorder's worst characteristics?
The American Psychiatric Association notes that people with anxiety disorders often avoid situations that may trigger their anxiety. This may be one of the worst characteristics of anxiety, as it can prevent people from doing things they enjoy and completing day-to-day tasks.
- Previous Article
- Next Article