Causes and Risk Factors

The exact cause of GAD is unknown, but a combination of biological and environmental factors likely contributes:

  • Genetics: GAD often runs in families.

  • Brain Chemistry: Imbalances in neurotransmitters like serotonin and norepinephrine may be involved.

  • Life Experiences: A history of stress, trauma, or abuse, particularly during childhood, can increase risk.

  • Substance Use: Use of caffeine, nicotine, alcohol, and recreational drugs can worsen or trigger anxiety.

  • Personality: Certain traits like shyness, timidity, or perfectionism may increase susceptibility.

Support groups can provide a sense of community and shared experience. You can find resources and local support groups through organizations like the Anxiety and Depression Association of America (ADAA). 

If you are struggling with GAD symptoms or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. In a life-threatening emergency, call 911. 

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is a common anxiety disorder characterized by excessive, persistent, and uncontrollable worry about everyday issues, such as health, work, or family, for at least six months. This worry is often out of proportion to the actual situation and significantly interferes with daily functioning.

Symptoms

GAD symptoms can be both psychological and physical, often making the person feel constantly "on edge". 

Psychological Symptoms:

  • Excessive and uncontrollable worry about a variety of topics

  • Restlessness or feeling keyed up

  • Difficulty concentrating or the mind going blank

  • Irritability

  • Fear of making the wrong decision and an inability to tolerate uncertainty

  • Overthinking and expecting the worst-case scenarios 

Physical Symptoms:

  • Fatigue

  • Trouble sleeping (falling or staying asleep, or restless sleep)

  • Muscle tension or aches

  • Headaches

  • Digestive problems, such as nausea, diarrhea, or irritable bowel syndrome

  • Sweating or hot flashes

  • Shortness of breath or lightheadedness 

Diagnosis and Treatment

A healthcare provider, such as a primary care doctor or mental health professional, will conduct a full assessment to diagnose GAD, which may include a physical exam and lab tests to rule out other medical conditions (e.g., thyroid problems). A diagnosis is made if symptoms, including excessive worry and at least three other physical or psychological symptoms, have been present on most days for at least six months. 

GAD is treatable, and outcomes are generally good with proper care. Treatment often involves a combination of: 

  • Psychotherapy: Cognitive-behavioral therapy (CBT) is highly effective. It helps individuals challenge and change negative thought patterns and develop better coping mechanisms. Other options include mindfulness-based therapy and psychodynamic therapy.

  • Medications: Antidepressants, specifically SSRIs (e.g., escitalopram, sertraline) and SNRIs (e.g., duloxetine, venlafaxine), are often first-line treatments. Other medications like buspirone or short-term benzodiazepines may also be used.

  • Lifestyle Adjustments: Self-care strategies can help manage symptoms, including regular exercise, maintaining a healthy diet, ensuring adequate sleep, and reducing or avoiding caffeine, alcohol, and nicotine.