Generalized Anxiety Disorder

Compulsive Worrying

GAD is characterized by frequent or constant worrying about large and small issues in one's life. It is often accompanied by physical symptoms.

People with GAD can worry about numerous things, but some common examples are:

  • Their own health
  • The health or safety of their loved ones
  • Financial or money matters
  • Their own death, or the death of their loved ones
  • Relationship problems (with friends, family, or in romantic relationships)
  • Problems at work

Symptoms that often accompany GAD include:

  • Trouble sleeping
  • Muscle aches and pains
  • Nausea
  • Sweating
  • Hot flashes
  • Irritability
  • Difficulty concentrating
  • Shortness of breath
  • Rapid heartbeat
  • Restlessness
  • Being easily fatigued

Unlike many other anxiety disorders, GAD often takes a long time to appear. A stressful or worry-filled period in one's life is not necessarily indicative of GAD. In order to be diagnosed with GAD, one has to have had "excessive anxiety and worry" for at least 6 months. Many people with GAD have been suffering undiagnosed for years.

People with GAD may have constant worry or anxiety. Even if there is not a specific problem they are worrying about at a given moment, they may still feel a certain amount of unexplained anxiety or a "keyed-up" feeling. Some people with GAD may not remember the last time they felt relaxed or free of anxiety.

The anxiety that accompanies GAD is "excessive," in other words, it is more than would be reasonably expected for a particular problem or event. Also, GAD cannot be diagnosed if the anxiety is better explained by another condition, such as OCD or PTSD, or if it is caused by substance use.

Resources about GAD

Stories of Hope and Courage" Documentary for National Anxiety and Depression Awareness Week. Section on Generalized Anxiety Disorder.

Return to Anxiety Disorders Overview | Read About Treatments for GAD »

Example of Generalized Anxiety Disorder

Andrew had always been a worrier, but in the past few years his worry seems to have gotten out of control. Andrew's worries mostly surround his job, and to a lesser extent, his health. He is afraid that he will be fired from his job as an accountant, although he has no specific reason to think that his boss would want to fire him. This worry plagues him at work, and keeps him from being able to concentrate on tasks at work as much as he'd like. He's afraid if he did lose his job, then he wouldn't be able to support his family, and would perhaps have to live off of his parents, which would make him feel ashamed and worthless.

Andrew is also afraid that his health will deteriorate, although he currently has no medical problems. He is afraid that if his health does deteriorate, then he will no longer be able to work, and will again shame himself and his family. While Andrew manages to function at work and at home, he is often fatigued as these worries make it difficult for him to fall asleep. He also tends to have headaches and nausea while at work, especially if he thinks he may not be doing his best on a task. Sometimes he even avoids doing certain tasks at work because he is afraid that he will do them incorrectly.

Andrew's worry gets in the way at work, even though not doing his best at work is precisely what Andrew is afraid of. His family also finds his worry excessive and frustrating, as they don't see his worries as being very realistic.

Generalized Anxiety Disorder Treatment

Help for Persitent Anxiety and Worry

What is the treatment for Generalized Anxiety Disorder?

At the BWC, we are committed to empirically supported treatments. That means that we endorse treatments that have been proven, through research, to be effective for many people.

One recommended treatment for Generalized Anxiety Disorder is based on empirically supported cognitive-behavioral and mindfulness-based techniques. It is mostly based on the GAD treatment manuals by Lizabeth Roemer and Susan Orsillo (2005), and Michel Dugas (2002), but also uses techniques found to be helpful across anxiety disorders through research for the past few decades.

This treatment usually lasts between 13 and 20 sessions, although it can last slightly shorter or slightly longer depending on each individual's case.

In this treatment, we aim to combat a few major problems that often occur in GAD: the inability to identify the source of one's emotional responses, the desire to control one's internal experiences, specifically to avoid certain feared thoughts and experiences, and the interference that anxiety can have with one's relationships, work, and self-care.

We have found that while avoidance of what provokes our anxiety may make us feel better right now, overtime it allows these situations, thoughts and emotions to stay "scary" and therefore for anxiety about them to keep coming back. In this therapy, we aim to combat this avoidance in a few different ways.

What kind of changes to do we attempt to make in this therapy?

  1. Increase awareness of your anxiety and other emotions, and of the present moment
  2. Increase choice and flexibility in everyday life
  3. Help you act in a way that aligns with your personal values, rather than merely acting to avoid worry or anxiety
  4. Help you get confront and get used to situations, thoughts, and emotions that until now, you have been pushing away

What do the sessions involve?

  1. Education about what causes anxiety and what maintains anxiety
  2. Mindfulness practices and techniques to help you increase awareness
  3. "Imaginal Exposure": Confrontation of the worst possible scenarios that you might have anxiety about
  4. "In Vivo Exposure:" Confrontation of situations in your daily life that cause anxiety, and until now, may have been avoided.
  5. Exercises and methods aimed at helping you deal with your anxiety when in appears
  6. Discussion and examination of the ways in which anxiety has interfered with your life
  7. Discussion of actions that you can take to move your life back in the direction you wish it to go

This therapy involves active discussion and participation from both the therapist and the client. The client is expected to complete homework exercises between sessions to practice the techniques learned, and put them to use in their everyday life.

Resource: The Present Moment with Jon Kabat-Zinn

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