Have you ever been called a worrier?  Do you constantly fret about everything—safety, health, money, being on time for appointments, completing your household chores, etc.?  If so, you may have an anxiety disorder called generalized anxiety disorder (GAD).

According to the DSM-5, the latest edition of the diagnostic manual published by the American Psychiatric Association, GAD is characterized by excessive worry and anxiety concerning a variety of situations (e.g., relationships, school, work).  In GAD, the worry and anxiety are difficult to control and are associated with at least three of the symptoms listed below:

  1. Feeling restless or on edge.
  2. Becoming fatigued easily.
  3. Trouble concentrating.
  4. Muscular tension.
  5. Irritability
  6. Sleep difficulties (e.g., trouble falling or staying asleep, not feeling well-rested upon waking).

How prevalent is GAD?

The National Institute of Mental Health says 3% of American adults met the criteria for GAD this last year.

The content of worry in people with GAD might depend on the person’s age or situation.  For instance, older adults may worry more about their health or their children, while younger adults’ worries might concern school or sports.

It is important to note that worry and various physical symptoms associated with worry are experienced by nearly everyone at some point in their lives.  This does not mean everybody has GAD.  In GAD, the intensity or frequency of the worry are disproportionate to the particular situation.  For example, while it is normal to lose sleep worrying about an upcoming major surgery, losing sleep over the possibility of being late for a dental appointment or business meeting is not, and thus may be a sign of GAD.

The DSM-5 further notes that for a diagnosis of GAD, the symptoms must “cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.” In other words, if the individual experiences some of these symptoms but is not bothered by them, and the symptoms do not interfere with functioning (e.g., at work or in relationships), then the diagnosis should not be made.

For the majority of people who do meet the criteria for generalized anxiety disorder, GAD is a chronic disorder; it waxes and wanes but does not go away on its own.

What are the risk factors?

The risk factors associated with GAD include temperament (neuroticism, harm avoidance, behavioral inhibition), environment (adverse childhood events, parental overprotection), and genes.  An article by Kendler, Neale, and colleagues, published in the Archives of General Psychiatry, estimates the heritability of GAD to be roughly 30%.

How is GAD different than other types of mental conditions?

GAD needs to be distinguished from medical conditions that may be associated with similar symptoms.  For instance, as explained in the DSM-5, hyperthyroidism is also linked with anxiety, sleeping difficulties, fatigue, and sweating.  Such medical conditions would need to be ruled out.

GAD should be differentiated from other anxiety disorders too.  One example is social phobia.  In social phobia, the individual fears social situations in which he or she might be evaluated negatively.  GAD, in contrast, is not related to evaluation anxiety, nor is it limited to social events.

GAD is sometimes confused with obsessive-compulsive disorder (OCD); however, obsessions are more irrational, distressing, and intrusive than worries.  Repetitive thoughts regarding accidentally setting the house on fire, for instance, are potentially obsessions; repetitive thoughts regarding being late for an exam are more likely worries.

Generalized anxiety disorder can cause significant impairment, but the good news is that effective treatments for GAD exist.  According to the Society of Clinical Psychology, there is strong research support for the effectiveness of cognitive and behavioral treatments for this condition.