Generalized Anxiety Disorder


Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. Without provoking, it is chronic and exaggerated worry and tension. This disorder involves anticipating disaster, often worrying excessively about health, money, family or work. Sometimes, though, just the thought of getting through the day brings on anxiety.

People with GAD can’t shake their concerns, even though they usually realize that much of their anxiety is unwarranted. People with GAD also seem unable to relax and often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, hot flashes and feeling lightheaded or out of breath.

Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating and may suffer from depression. GAD may involve nausea, frequent trips to the bathroom or feeling like there is a lump in the throat.

When their anxiety level is mild, people with GAD can function socially and hold down a job. Although they don’t avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe.

How many people have GAD?
GAD affects about 6.8 million American adults, including twice as many women as men. The disorder develops gradually and can begin at any point in the life cycle but usually develops between childhood and middle age. There is evidence that genes play a modest role in GAD.

What are the symptoms?

Generalized anxiety disorder (GAD) is characterized by six months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. People with this disorder usually:

• Expect the worst
• Worry excessively about money, health, family or work, when there are no signs of trouble
• Are unable to relax
• Are irritable
• are easily startled
• can’t control their excessive worrying
• Suffer from insomnia

Common body symptoms are:
• feeling tired for no reason;
• headaches;
• muscle tension and aches;
• having a hard time swallowing;
• trembling or twitching;
• sweating;
• nausea;
• feeling lightheaded;
• feeling out of breath;
• having to go to the bathroom a lot; and
• hot flashes

In children and adolescents with Generalized Anxiety Disorder, their anxieties and worries are often associated with the quality of performance or competence at school or sporting events. Additionally, worries may include punctuality, conformity, perfectionism and are so unsure of themselves that they will redo tasks in order to reach that level of perfection.

What are the treatment options for GAD?

Cognitive behavioral therapy (CBT) and some medications have been proven effective.

CBT involves education about the disorder, learning personal coping skills to manage and change fearful thinking and anxious feelings, and gradually going back into feared or avoided situations (this technique is called “exposure”). A major aim of CBT and behavioral therapy is to reduce anxiety by eliminating beliefs or behaviors that help to maintain the disorder.

There are several different types of medications used to treat GAD, including: antidepressants, tranquilizers (benzodiazepines), and beta-blockers (often used to treat heart conditions, may also be used to minimize certain physical symptoms of anxiety, such as shaking and rapid heartbeat).

Created by Dominique Samuels, PsyD. Much of the information was taken from
To contact Dr. Samuels, please call 415.358.4906 or email her at

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