stress cloud

stress cloud

Are you plagued by persistent, excessive, and unrealistic worry about everyday things?

Does worrying infiltrate your thoughts and interfere with your life on a regular basis?

Is it difficult – or nearly impossible – for you to control your worrying, even though you know it is excessive and irrational?

If you answered “yes” to any of these questions, you might have Generalized Anxiety Disorder (GAD).

What IS GAD?

GAD is an anxiety disorder that is characterized by persistent, excessive, uncontrollable, and irrational worry.

Symptoms of GAD are not limited to the psychological – sufferers also experience physical manifestations of the disorder, including fatigue, muscle tension, headaches, nausea, and insomnia.

The disorder affects 6.8 million adults, or 3.1% of the U.S. population, in any given year. Women are twice as likely to be affected.

What causes GAD?

The disorder comes on gradually and can begin at any time, but the risk is highest between childhood and middle age. Although the exact cause of GAD is unknown, there is evidence that biological factors, family background, and life experiences – particularly stressful ones – play a role.

How is GAD diagnosed?

The diagnostic criterion for GAD, as defined by the Diagnostic and Statistical Manual of Mental Disorders DSM-5 (2013) published by the American Psychiatric Association, are as follows:

A) Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

B) The individual finds it difficult to control the worry.

C) The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months):

(Note: Only one item is required in children.)

  1. Restlessness or feeling keyed up or on edge
  2. Being easily fatigued
  3. Difficulty concentrating or mind going blank
  4. Irritability
  5. Muscle tension
  6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)


D) The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

E) The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).

F) The disturbance is not better explained by another mental disorder.

How is GAD treated?

GAD is usually treated with psychotherapy or medication, or a combination of both.

Cognitive-behavioral therapy (CBT) is especially useful for treating GAD.

There are four main features of GAD, from a CBT perspective. To learn more about each and how CBT approaches them, click on each item.

1. Intolerance of uncertainty
2. Positive beliefs about worry
3. Negative problem orientation
4. Cognitive avoidance

Two types of medication are commonly used to treat GAD: anti-anxiety medications and antidepressants.

Of course, medications come with side effects, and antidepressants are no exception, as the National Institute of Mental Health warns:

These medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.

It’s important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults. A “black box”—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts. Anyone taking antidepressants should be monitored closely, especially when they first start treatment with medications.

Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone; co-occurring conditions must also be treated with appropriate therapies.

Some people respond to treatment after a few weeks or months, and others may take more than a year to see significant results.

Relaxation techniques, meditation, yoga, exercise, herbal remedies, and other alternative treatments may also become part of a treatment plan.

Remember, GAD is treatable. If you think you or someone you care about could have GAD, consulting with a professional practitioner would be beneficial. It is important to understand that you are diagnosed based on the symptoms you report, so finding a practitioner you are comfortable enough to be open and honest with is important.

The following free self-assessments can help you identify what you worry about and how worrying is affecting your life:

Worry and Anxiety Questionnaire

Why-Worry II

What? Me Worry? Interactive worksheets

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