What Is Generalized Anxiety Disorder? Exploring The DSM-5’s Diagnostic Criteria

If you worry about everyday things excessively or feel like you’re always waiting for disaster to strike, you may be experiencing the symptoms of generalized anxiety disorder. These worries often focus on everyday things, like your health, daily chores, or appointments. This condition can have physical symptoms, too. Learning how to identify signs of generalized anxiety and when to seek help from a professional can help you better control your symptoms so they don’t have as much of an effect on your day-to-day life.

What Is Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is characterized by general, uncontrolled feelings of anxiety, without a definitive trigger or source. This disorder might be sparked by trauma, but it usually has no specific cause. Generalized anxiety disorder involves chronic, persistent, and unresolved anxiety, often concerning everyday things that would not typically cause undue strain or stress. Although it can co-exist with other mental health disorders, anxiety symptoms are distinct from symptoms of other conditions.

Difficulty concentrating, relaxing, and letting go are all hallmarks of GAD. Your mind is essentially stuck in worry mode and cannot seem to divert itself to other ways of thinking and feeling. Physical symptoms are not unheard of in GAD, as headaches, stomachaches, muscle tension and muscle aches, throat closure, chest pain, and gastrointestinal issues can all be symptoms of anxiety disorders. GAD is a diagnosable mental health disorder and generally requires an evaluation by a psychotherapist or other mental health professional.

What Is The DSM-5?

The Diagnostic and Statistical Manual of Mental Disorders (edition 5) is a book identifying diagnosable mental health disorders and detailing the symptoms required to qualify for a diagnosis.

The DSM-5 is the standardized model by which most mental health professionals operate and is a source of guidance when evaluating, diagnosing, and treating patients. There are five iterations of the DSM now. Each version updates any changes in diagnostic criteria, symptoms, and research to provide accurate, safe, and effective information. The DSM-5 contains over ten years' worth of research and is considered the most up-to-date and reliable method of identifying disorders and determining how to proceed with treatment to pursue mental health.

The DSM-5 is used for diagnostics and medical and insurance coding. Because medical coding is essential in receiving reimbursement and allowing a treatment routine to be implemented, these manuals are an integral aspect of diagnosing, treating, and billing for therapy services. They allow insurance companies to determine what the patient's condition is and what treatment might involve.

The American Psychiatric Association, a national psychiatric institution, wrote and revised the DSM. As a national institute, the American Psychiatric Association focuses on creating a manual for assessment and diagnosis rather than treatment for each disorder.

Why Is The DSM-5 Used In Psychology?

Psychological symptoms of mental health, such as anxiety symptoms, can often mimic one another, and many of them seem to blend or overlap in patients. Psychology is a vast field, filled with countless patients and innumerable combinations of risk factors, family histories, and co-morbid conditions. Determining what a patient is dealing with and, by extension, what the doctor is dealing with, can be a lengthy process and often requires the objective assistance of a manual. The DSM-5 is that manual.

The DSM-5: Anxiety Disorder Qualifications

The anxiety symptoms of different DSM 5 anxiety disorders changed with the last DSM update, and the manual provides the insurance codes necessary to proceed with treatment. Qualifications include various symptoms unique to varying forms of anxiety disorders. Panic disorder, for instance, requires patients to experience panic attacks without a legitimate reason to incite panic, and attacks must happen with some regularity. Post-traumatic stress disorder requires that patients have experienced some form of traumatic event before experiencing stress and (potentially) panic attacks.

The DSM-5 identifies the symptoms that must be present to diagnose a disorder safely. Aside from that, the DSM also offers treatment suggestions, symptom duration requirements, and co-morbidity protocols.

Differences In The DSM-5 And Previous Iterations

The DSM-5 changed some of the categories previously delineated for anxiety disorders. The most significant change within anxiety disorders came in the form of organization. While the classic anxiety disorders remained intact, two new conditions were brought into the traditional sphere (selective mutism and separation anxiety disorder). Other anxiety disorders also changed, as they were grouped into several distinct categories, including obsessive-compulsive, traumatic, and dissociative.

Aside from changes made to the types of anxiety disorders, the DSM-5 also altered the symptoms and classification of both agoraphobia and panic disorder to more pared-down versions of themselves, allowing for a greater scope of patients to be diagnosed with each condition. The DSM-5 also identified potential crossovers in diagnoses and instructed providers on how to proceed with these crossovers.

Generalized Anxiety Disorders: DSM-5 Criteria

Generalized anxiety disorder is diagnosable when patients have experienced uncontrolled anxiety on most days for at least six months, as well as sleep disturbances, changes in physical health, difficulty concentrating, and significant impairment in functioning. They also must not have another mental or physical disorder that explains these symptoms.

Treatment According To The DSM-5

Generalized anxiety disorder is treated in one of two ways: psychotherapy or pharmaceutical drugs. The most common form of psychotherapeutic treatment for generalized anxiety disorder is cognitive behavioral therapy, which seeks to target thinking patterns that reinforce anxiety and the symptoms anxiety produces to pursue better mental health.

A doctor may prescribe benzodiazepines and antidepressants to treat GAD to improve brain chemistry and mental health, as the symptoms of anxiety disorders often intersect with the symptoms of depression and depressive disorders. These interventions typically work as a means of calming fear and other intense, adverse reactions on a biological level and can help alleviate some of the physical symptoms of anxiety. A medical professional can prescribe medication to treat depression, GAD symptoms, and other mental and physical illnesses after a physical exam.

Engaging in treatment with a qualified professional who has a strong history of treating anxiety disorders can help relieve many anxiety symptoms. Some research suggests that therapy can be more effective than medication.

Impact Of The Changes In The DSM-5

Although the alterations made to the DSM-5's classification and characterization of anxiety were not drastic, they did broaden some of the inclusion criteria for anxiety disorders, allowing people with less severe symptoms to receive treatment instead of focusing primarily on individuals with severe conditions. Allowing more people to receive treatment at the beginning stages of anxiety conditions could mitigate the symptoms early on.

As researchers learn more about anxiety disorders, their causes, and more effective treatment options, changes must be made to treatment modalities and the parameters for diagnosis. While the DSM focuses on identification and treatment, it encourages research that could allow professionals and laypeople to better understand anxiety, what causes it, and how to keep it at bay. 

Getting Help For Generalized Anxiety Disorder

Cognitive behavioral therapy is a recommended way to treat generalized anxiety disorder. If you’re curious about this type of treatment and want to learn more, consider online therapy with a BetterHelp therapist. 

Online therapy has many benefits for people with anxiety. It alleviates the stress of finding a local therapist and meeting face-to-face to discuss things you might not feel comfortable discussing in person. Some people find the distance and safety of being behind a computer comforting, making it easier to communicate. You also don’t have to worry about waiting weeks or months for an appointment. With online therapy, you’ll be matched with an available therapist so you can start treatment from the comfort of your own home right away.

Research shows that online therapy is effective, too. One study review showed that online CBT effectively treats various anxiety disorders, including GAD, social anxiety, phobia, panic disorders, and OCD, as well as depression, which commonly occurs with anxiety. If you’re ready to start online therapy, reach out to a BetterHelp therapist to learn more.