Generalized anxiety disorder (GAD) is a mental health condition marked by excessive, hard-to-control worry about many everyday things, such as health, money, work or family, on most days for at least six months. It often comes with physical symptoms like restlessness, muscle tension, fatigue and trouble sleeping. GAD is common and very treatable with therapy, medication or both.
Everyone worries sometimes. But if worry feels constant, out of proportion to what’s actually happening and impossible to shut off, it may be more than stress. Here is how to recognize GAD and what treatment looks like.
What Is Generalized Anxiety Disorder?
The National Institute of Mental Health (NIMH) explains that people with GAD feel extremely worried or nervous more often or more intensely than others, even when the worry is out of proportion to the situation. The worry is hard to control and gets in the way of daily life.
It is also common. According to NIMH statistics, an estimated 2.7% of U.S. adults had GAD in the past year, and about 5.7% will have it at some point in their lives. Past-year rates were higher for women (3.4%) than for men (1.9%).
Normal Worry vs. GAD
So what makes GAD different from ordinary worry? The Anxiety and Depression Association of America (ADAA) notes that people with GAD often realize their anxiety is more intense than the situation calls for, yet they don’t know how to stop the worry cycle and feel it is beyond their control. ADAA also notes that GAD can range from mild to severe and, when severe, can get in the way of daily life.
Symptoms of GAD
GAD affects both the mind and the body. The Mayo Clinic lists symptoms such as:
Emotional and Mental Symptoms
- Persistent worrying that is out of proportion to the situation
- Overthinking plans and solutions to all possible worst-case outcomes
- Seeing situations and events as threatening, even when they aren’t
- Difficulty handling uncertainty
- Trouble making decisions and fear of making the wrong one
- Being unable to set aside or let go of a worry
- Feeling restless, keyed up or on edge
- Trouble concentrating, or feeling like your mind “goes blank”
Physical Symptoms
- Fatigue
- Trouble sleeping
- Muscle tension or muscle aches
- Trembling or feeling twitchy
- Nervousness or being easily startled
- Sweating
- Nausea, diarrhea or irritable bowel syndrome
- Irritability
NIMH notes that for a diagnosis, a person has trouble controlling worry on more days than not for at least six months and has three or more of these symptoms: restlessness, getting tired easily, trouble concentrating, irritability, muscle tension or sleep problems.
GAD in Children and Teens
Mayo Clinic notes that children and teens with GAD may worry excessively about school or sports performance, family members’ safety or catastrophic events. They may also be perfectionists, avoid school or social situations, seek a lot of reassurance and have frequent stomachaches or other physical complaints.
GAD is different from sudden, intense episodes of fear. If you’re not sure what you’re experiencing, our guide to panic attacks vs. anxiety attacks explains the difference. If your worry centers mainly on being judged by others, you may want to read about social anxiety disorder.
Causes and Risk Factors
NIMH says GAD likely results from a mix of genetics, brain chemistry, biology and environment. Mayo Clinic lists risk factors including:
- A timid or negative temperament
- A family history of anxiety disorders
- Major life changes, or traumatic or negative experiences
- Chronic medical illnesses or other health conditions
- Other mental health conditions, such as depression
Complications of Untreated GAD
Mayo Clinic notes that GAD can make it hard to concentrate and work, take up time and energy, and increase the risk of depression. It can also lead to or worsen physical health problems like digestive problems such as irritable bowel syndrome, migraines, chronic pain, sleep problems and heart-health problems. GAD often occurs alongside other conditions, including depression, panic disorder, PTSD and substance misuse.
Some people use alcohol to calm their nerves, but this can backfire. Learn more about the link between alcohol and anxiety.
Treatment for Generalized Anxiety Disorder
According to Mayo Clinic’s guide to GAD treatment, the two main treatments are psychotherapy and medication. Your provider can help you decide which approach, or combination, fits you best.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is the most effective form of therapy for GAD, according to Mayo Clinic. NIMH calls it a “gold standard” treatment. CBT teaches specific skills to manage worry and helps you gradually return to activities you’ve avoided because of anxiety. NIMH also notes that acceptance and commitment therapy (ACT), which uses mindfulness and goal setting, may help.
Medications
Medication decisions should always be made with a prescriber. Mayo Clinic and NIMH describe several options:
- Antidepressants: SSRIs and SNRIs are first-line medication treatments for GAD. They may take several weeks to work.
- Buspirone: An anti-anxiety medicine that can be used long term. NIMH notes it is not sedating and can take a few weeks to work fully.
- Benzodiazepines: These may be used for short-term relief of severe anxiety. Mayo Clinic cautions that because they can be habit-forming, they aren’t a good choice for people who have or have had problems with alcohol or drug misuse.
For a deeper look at how these compare, see our guide to anxiety medications. If you’ve developed a dependence on anti-anxiety medicines, our benzodiazepine addiction resources can help you understand your options.
Lifestyle Habits That Help
Mayo Clinic recommends staying physically active, making sleep a priority, using relaxation techniques such as meditation or yoga, eating healthy foods and avoiding alcohol, recreational drugs, nicotine and too much caffeine. NIMH also notes that support groups can help.
More Structured Support
If anxiety is making it hard to work, sleep or leave the house, weekly therapy may not be enough. An intensive outpatient program or a partial hospitalization program for mental health offers more therapy hours and skill-building while you live at home.
Frequently Asked Questions
How long does GAD last?
It varies from person to person. By definition, GAD involves worry lasting at least six months. ADAA notes that with treatment, many people with GAD are able to keep up meaningful relationships and jobs.
Can GAD cause physical symptoms?
Yes. Muscle tension, fatigue, headaches, stomach problems, sweating and trouble sleeping are all common with GAD.
When should I see a doctor about anxiety?
Mayo Clinic suggests getting help if worry is interfering with your work, relationships or other parts of your life, if you also feel depressed or are using alcohol or drugs to cope, or if you have thoughts of suicide.
What if I’m having thoughts of suicide?
Seek help right away. Call or text the 988 Suicide & Crisis Lifeline, which is free, confidential and available 24/7. In an emergency, call 911.
Get Help for Generalized Anxiety Disorder in Lancaster, PA
You don’t have to live on edge. At The Ranch Pennsylvania Outpatient Services, our mental health treatment programs offer CBT, DBT, individual and group therapy, and psychiatric evaluation and medication management, with integrated care if you are also struggling with substance use. Visit our anxiety resource hub or read about anxiety treatment in Pennsylvania. You can verify your insurance online, and our admissions team is available 24/7. Calls are free and confidential.
