What is generalized anxiety disorder (GAD)?

Consider some of the common daily stresses: health, family, work, and money. Most people deal with these issues on a daily basis. Furthermore, most people will feel some degree of stress and anxiety about these things from time to time.

People with anxiety disorders, on the other hand, experience heightened levels of anxiety. These worries may be tied to concrete concerns such as these or may stem from more abstract, general feelings of unease.

Some anxiety disorders have definitive fears and worries at their roots. Social anxiety, for example, stems from a deep-seated fear of scrutiny, ostracization, social rejection, or humiliation.

As its name would suggest, generalized anxiety disorder³ is just that: generalized. It is characterized by a high baseline level of anxiety, stress, and worry. This anxiety can also be heightened (or triggered) by certain thoughts, feelings, or situations.

GAD can be described in different ways. Some people describe it as a constant, nagging feeling that something bad is going to happen. Others fixate on the possibility of something devastating occurring: a partner leaving, being fired, becoming sick, or even dying (even if they’re in perfectly good health). Some worry abstractly about the future with no tangible reason for doing so. Some people even have anxiety about their anxiety.

Whatever the case, the anxiety characteristic of GAD is chronic, intense, and out of proportion.

Generalized anxiety disorder can manifest itself both physically and mentally. Those experiencing GAD symptoms may feel very real discomfort, from a racing heart and muscle tension to an upset stomach and excessive sweating. They might act irritable and appear fearful or skittish.

You should keep in mind that people with GAD are not simply “blowing things out of proportion”: they can’t necessarily help that they’re feeling anxiety. Many people with the condition fully understand that their worries aren’t based on reality; this realization can make them feel even worse. It’s important to approach people with GAD (including yourself, if you have the condition) with compassion, patience, and understanding.

How common is GAD?

At any given time, about 3.1% of Americans⁴ are dealing with generalized anxiety disorder. Roughly 1 in every 20 Americans will battle with GAD at some point in their life.

Some studies show that GAD is more common with age. Women are also twice as likely to have GAD as men.

That said, it’s important to note that these numbers are only estimates. Unlike conditions that manifest themselves physically and can be quantitatively measured (such as obesity or heart disease), GAD is a psychological disorder that manifests itself in a variety of different ways in different people.

What causes anxiety disorders?

As with many other mental health conditions, the cause of social anxiety disorder cannot be pinpointed to one specific factor. Rather, the condition likely results from⁵ a combination of biological and environmental factors.

Some factors that may contribute to the development of anxiety disorders include:

• Family history/genetics: Anxiety disorders have been shown to run in families. If someone in your family—especially one of your parents—has an anxiety disorder, your risk of the condition increases.
• Major life stress: Periods in your life during which you’re under high levels of stress, such as major transitions or after the death of a loved one, may cause high levels of anxiety.
• Traumatic events: Experiencing a traumatic event or having a history of physical, sexual, or emotional abuse may cause anxiety disorders (such as post-traumatic stress disorder).
• Brain structure: A part of the brain called the amygdala has been suggested to play a role in controlling fear responses. People with overactive amygdalas may have increased fear responses, leading them to respond to social situations with anxiety or fear (causing social anxiety disorder).

Risk factors for GAD

The following risk factors⁶ are associated with a higher chance of developing GAD:

• Biological sex: As stated before, women are twice as likely to be diagnosed with GAD than men. This may be due to biological reasons, like hormone fluctuations. It may also be that women statistically visit therapists more frequently, and are therefore more likely to be diagnosed with the condition than men.
• Genetics: If a first-degree relative (parent or sibling) has GAD, you have a one in four chance of having the disorder too.
• Family situation: Beyond genetics, the way you are raised and the culture that exists in your home while growing up plays a big role in developing GAD (especially considering that most cases of the disorder develop in childhood and early adolescence). Having a history of abuse or violence or being exposed to passive-aggressive or avoidant tendencies may increase the possibility of developing GAD.
• Depression: Depression, especially major depression, is one of the biggest indicators of GAD. As many as two in every three people with GAD also suffer from major depression. Children and adolescents with depression are at a particularly high risk of developing GAD later in life.
• Panic disorder: Like depression, panic disorder is common in people with GAD. One in every four people with GAD also has panic disorder.
• Self-harm: If you have a history of intentionally harming yourself (especially before the age of sixteen), you are at a higher risk of developing GAD. If you have experienced suicidal ideations, the chances are even higher.
• Medical history: Some illnesses and sicknesses can put you at risk of GAD.
• Substance use: Drugs and alcohol can contribute to (and, in some cases, trigger) anxiety disorders.
• Personality and temperament: Some people respond to fears and potential threats differently than others. Those with higher sensitivities may be more prone to developing GAD.
• Financial situation: Ongoing financial struggles can put someone at a higher risk of developing GAD.
• Ethnic factors: Statistically, minorities, especially those who are immigrants and impoverished, have a higher chance of being diagnosed with GAD. This may be due to the feelings of inadequacy or alienation that can stem from these situations.

Being aware of your risk of GAD can help you stay vigilant and watch for the signs and symptoms of the disorder in yourself.

Anxiety disorder symptoms

Because GAD is a psychological disorder⁷, its symptoms often develop slowly. Furthermore, not everyone will necessarily present with all the signs and symptoms of GAD.

Unlike occasional anxiety or nervousness, anxiety disorders may stem from undue fear and distress in certain situations. The signs and symptoms⁸ of anxiety disorders are often both emotional/behavioral and physical.

Psychological/mental symptoms of anxiety:

• Excessive, out-of-proportion worry about everyday things
• When you worry or feel nervous, it often gets out of control and you have trouble calming yourself down
• Being “jumpy” or easily startled
• Feeling constantly restless and having difficulty calming down/relaxing
• Being easily annoyed, provoked, or triggered
• Difficulty concentrating or focusing on tasks at hand

Physical symptoms of anxiety:

• Difficulty getting to sleep or staying asleep
• Frequent tiredness, exhaustion, or fatigue
• Frequent and unexplained headaches, muscle pains, and stomach upset
• Feeling faint or out of breath
• Needing to use the bathroom frequently
• Difficulty swallowing
• Excessive perspiration (sweating)

It’s also important to note that GAD can manifest itself differently in children and adults.

• GAD in children: Children tend to have performance-related anxiety. That could mean excessive worrying about grades or agonizing over sports. It’s also common for children with GAD to have strong anxiety about uncontrollable situations, like natural disasters and war.
• GAD in adults: In adults, GAD can manifest itself with constant fear about things that are (mostly) outside of your control, like your health or the health and wellbeing of your family. Some adults with GAD worry excessively about job security or finances. Others may experience intense anxiety about being late or not getting certain chores or errands done.

Sometimes, a self-defeating cycle forms in which people worry about chores or tasks so much that they avoid them entirely, leading to more anxiety. In some cases, procrastination is a result of excessive anxiety about starting projects, potentially rooted in fear of failure (“What’s the use?”).

The symptoms of anxiety disorders can vary with time. They may get better or worse, depending on other life events. If you’re experiencing family strife, a stressful time at work or school, or significant illness, GAD can fluctuate by the day or the week.

It’s important to remember that none of the following symptoms are definitive proof that you are suffering from GAD. It’s always best to consult a medical professional if you or your child are struggling with anxiety. This is especially true if the symptoms begin to take a toll on your ability to handle everyday tasks, maintain personal relationships, or enjoy the things you usually do.

Complications from GAD

Generalized anxiety disorder can pose a significant challenge to day-to-day functioning. Some people become so overwhelmed by their anxieties that they begin to avoid potentially triggering situations or responsibilities entirely.

Severe anxiety can:

• Have a negative impact on performance at work or school
• Impact concentration, hindering your ability to fully or efficiently complete tasks
• Divert your time and focus away from other activities
• Drain your energy
• Increase your risk of depression

Generalized anxiety can impact physical health, as well. It may lead to the following health conditions:

• Digestive or bowel problems, such as irritable bowel syndrome (IBS) or ulcers
• Chronic pain and/or sickness
• Headaches (including migraines)
• Difficulty sleeping or insomnia
• Heart-related conditions (cardiovascular issues)

GAD also has high comorbidity (overlapping incidence) with other mental health problems, potentially making diagnosing and treating the condition a challenge. These disorders include:

• Phobias (excessive or irrational fears or aversions)
• Panic disorder and panic attacks
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Depression
• Substance abuse
• Suicidal ideation or attempted suicide

What are anxiety disorders?

Most people experience some degree of anxiety¹ in life. This may range from being nervous about an upcoming test to worrying whether you’ll have enough money to pay the electricity bill this month.

While occasional anxiety is normal, some people experience chronic and severe anxiety. Rather than experiencing anxiety in response to particularly stressful events, some people suffer from intense anxiety about everyday issues and situations. These symptoms are often indicative of anxiety disorders.

Anxiety disorders² are conditions that cause chronic excessive worry and fear. Along with generalized anxiety disorder, some other anxiety disorders include social anxiety disorder, post-traumatic stress disorder (PTSD), and obsessive compulsive disorder (OCD).

All anxiety disorders share some of the same physical and emotional symptoms. These symptoms are chronic (ongoing) and may occur as frequently as coming and going throughout the course of a day. People with anxiety disorders feel fear or worry without any discernible cause (such as feeling apprehensive about meeting a close friend for lunch but not knowing why). Oftentimes, their anxiety levels are much more severe than the situation would generally warrant. It’s also common for people with anxiety disorders to have a hard time controlling their fears and to experience lingering anxiety long after a situation has resolved itself.

Anxiety disorders tend to develop in childhood or adolescence. They often last into adulthood, and some are challenging to live with. However, the signs and symptoms of anxiety disorders are often managed and even overcome with the right treatment.