Generalized Anxiety Disorder

What Is Generalized Anxiety Disorder?


Generalized anxiety disorder (GAD) is a mental disorder characterized by excessive worry about everyday events and activities, such as school, work, family, friends, or money. The individual not only worries; he or she also finds it difficult to control the worry and ends up worrying about worrying. An individual with GAD may also have the following symptoms:

  • Restlessness or feeling keyed up or on edge
  • Being easily fatigued
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Sleep disturbance (difficulty falling asleep or restless, unsatisfying sleep)

Like other mental disorders, to meet criteria for generalized anxiety disorder, the symptoms must cause significant impairments in everyday functioning. For example, an adolescent's schoolwork may suffer as a result of his or her anxiety. An adult’s work or marriage may be affected by the symptoms. Level of impairment depends on the severity of the symptoms.

The 12-month prevalence of GAD is 0.9% among adolescents and 2.9% among adults in the U.S. The 12-month prevalence in other countries ranges from 0.4% to 3.6%. The lifetime risk for the disorder is 9.0%. Females are more likely than males to experience generalized anxiety disorder. The disorder peaks in middle age and declines in later years of life. Individuals of European descent or from developed countries are more likely to report symptoms that meet criteria for GAD.

Onset for generalized anxiety disorder is later than other anxiety disorders. The median age of onset of GAD is 30 years though the actual onset spread over a larger range. The symptoms may occur earlier in life as anxious temperament but onset of disorder rarely occurs before adolescence. The symptoms tend to be chronic over the lifespan, and rates of remission are low.

There are also cultural differences. In some cultures, somatic symptoms (e.g. muscle tension) predominate in the presentation of the disorder, while in other cultures, cognitive symptoms (e.g. worrying) occur more prominently.

Generalized anxiety disorder often co-occur with other anxiety and unipolar depressive disorders. The co-occurrence may be explained by underlying common pathways between GAD and these other disorders, such as more extreme mood swings and anxious personalities.

What Causes Generalized Anxiety Disorder?


There are cases in which generalized anxiety disorder runs in families, but a clear genetic link is unknown. Underlying anxiety and fear are associated with specific brain regions, which inform scientists in designing treatments for GAD.

Stress and other environmental factors also contribute to the occurrence of the disorder.

Treating Generalized Anxiety Disorder


Treatments for generalized anxiety disorder include psychotherapy, medication, or both. One form of psychotherapy that has been shown effective in treating GAD in research is cognitive behavior therapy (CBT). CBT targets a person’s thoughts and actions and attempts to change them in order to alleviate anxious feelings and worries. Medications include anti-anxiety medications and antidepressants. Antidepressants can be used to treat both depressive and anxiety disorders. They are different from anti-anxiety medications in that they generally take a few weeks to go into effect and one has to take them consistently. A combination of psychotherapy and medications has shown to be an effective in treating generalized anxiety disorder.