Generalized Anxiety Disorder

1. What is GAD?

GAD is a chronic anxiety disorder marked by excessive, uncontrollable worry about multiple aspects of life (health, finances, work, relationships) even when there is little or no reason for concern. Unlike phobias or panic disorder, GAD is not tied to a specific trigger—it’s a persistent state of anxiety.

Key Features (DSM-5 Criteria)

Excessive anxiety occurring more days than not for at least 6 months
Difficulty controlling worry
Anxiety causes significant distress or impairment in daily life
Not due to substance use, medical conditions, or another mental disorder

2. Symptoms of GAD

A. Cognitive & Emotional Symptoms

Persistent overthinking (“What if?” thoughts)
Catastrophizing (assuming the worst will happen)
Indecisiveness due to fear of making mistakes
Feeling on edge or mentally exhausted
Irritability (short temper, frustration over small things)

B. Physical Symptoms

Muscle tension (clenched jaw, back pain, headaches)
Fatigue (due to chronic stress)
Sleep disturbances (trouble falling/staying asleep, restless sleep)
Gastrointestinal issues (nausea, diarrhea, IBS-like symptoms)
Autonomic symptoms (sweating, trembling, dizziness, rapid heartbeat)

C. Behavioral Symptoms

Procrastination (avoiding tasks due to anxiety)
Seeking excessive reassurance (from friends, family, doctors)
Difficulty relaxing (always feeling “on alert”)

3. Causes & Risk Factors

A. Biological Factors

Neurotransmitter imbalances (low serotonin, GABA dysfunction, high norepinephrine)
Brain structure differences (overactive amygdala, prefrontal cortex issues)
Genetic predisposition (family history of anxiety/depression increases risk)

B. Psychological & Environmental Factors

Childhood trauma (abuse, neglect, overprotective parenting)
Chronic stress (job pressure, financial struggles, caregiving)
Personality traits (perfectionism, neuroticism, low distress tolerance)

C. Medical & Lifestyle Contributors

Thyroid disorders (hyperthyroidism mimics anxiety)
Substance use (caffeine, alcohol withdrawal, stimulants)
Sleep deprivation (worsens anxiety symptoms)

4. Diagnosis Process

GAD is diagnosed by a mental health professional (psychiatrist, psychologist) through:

A. Clinical Interview

Questions about duration, intensity, and impact of anxiety
Screening for other disorders (depression, OCD, PTSD)

B. Psychological Assessments

GAD-7 Questionnaire (standard screening tool)
Hamilton Anxiety Rating Scale (HAM-A)

C. Medical Evaluation

Blood tests (thyroid, vitamin deficiencies)
Review of medications/substances that may worsen anxiety

5. Treatment Options

A. Psychotherapy (First-Line Treatment)

Cognitive Behavioral Therapy (CBT)

Identifies & challenges irrational thoughts
Teaches coping skills (problem-solving, exposure techniques)

Acceptance and Commitment Therapy (ACT)

Focuses on accepting anxiety rather than fighting it
Encourages value-based living despite fear

Mindfulness-Based Stress Reduction (MBSR)

Meditation, deep breathing, body scans

B. Medications

Medication Type	Examples	Notes
SSRIs	Sertraline (Zoloft), Escitalopram (Lexapro)	First-line, takes 4-6 weeks to work
SNRIs	Venlafaxine (Effexor), Duloxetine (Cymbalta)	Also treats chronic pain
Benzodiazepines	Lorazepam (Ativan), Diazepam (Valium)	Short-term use only (risk of dependence)
Buspirone	Buspirone (Buspar)	Non-addictive, but weaker effect
Beta-Blockers	Propranolol	Reduces physical symptoms (shaking, fast heart rate)

C. Lifestyle & Self-Help Strategies

Exercise (30+ min of cardio reduces cortisol)
Sleep hygiene (consistent schedule, no screens before bed)
Diet adjustments (reduce caffeine, sugar; increase omega-3s, magnesium)
Relaxation techniques (progressive muscle relaxation, guided imagery)
Journaling (track triggers & coping strategies)

6. Complications if Untreated

Depression (50% of GAD patients develop it)
Substance abuse (self-medicating with alcohol/drugs)
Chronic health issues (high blood pressure, heart disease, weakened immune system)
Social & occupational impairment (strained relationships, poor work performance)

7. When to Seek Professional Help

If anxiety disrupts daily life for months
If physical symptoms worsen (panic attacks, insomnia)
If self-help methods aren’t enough

Therapy + medication is highly effective (70-80% improvement rate).

Final Thoughts

GAD is treatable, and many people regain control with the right strategies. If you or someone you know struggles with chronic anxiety, seeking help early leads to better outcomes.