Generalized Anxiety Disorder (GAD)

A lump in your throat before you give a presentation at work or the nervousness you feel as you slowly inch up the hill of a 400 ft tall roller coaster are normal stress and anxiety responses that arise as needed throughout life.  Some anxiety is good for us, it keeps us on our toes and helps us stay safe. When these feelings linger for longer than usual, however, or you find yourself feeling a pervasive sense of impending doom that arises out of nowhere for no reason, you may be experiencing symptoms of generalized anxiety disorder. GAD can have a far-reaching impact on a person’s livelihood—making day-to-day tasks seem daunting and causing issues with work, family, friends, school, and personal self-worth.

If this sounds like something you or a loved one are going through, you are not alone. Generalized anxiety disorder affects 5.7% of adults in the US at one point in their lives, and this is only based on the number of people who have been diagnosed. Of both those who have been diagnosed with generalized anxiety disorder, a significant percentage do not seek treatment to manage their symptoms. While there is no one-size-fits-all cure that works for everyone with GAD, there are a variety of treatment options available to help with the symptoms and make life more manageable. 

What is Generalized Anxiety Disorder?

Generalized anxiety disorder is the most common form of anxiety. This condition causes excessive worry over everyday events. These feelings are oftentimes disproportionate to the situation at hand and can become uncontrollable. These thoughts and feelings can make it difficult for a person to concentrate. GAD tends to develop slowly, beginning in the adolescent to young adult years. 

As anxiety increases over time, so does its impact on a person’s ability to function in life. Anxiety at its worst can be debilitating, and panic attacks may result. Once someone experiences a panic attack, it is possible to suffer from anxiety surrounding the fear of having another one. This can cause one to refrain from venturing to public places and situations of high stress. 

With GAD, there is often a pattern of pessimistic thoughts and physical sensations (stress responses) that are at play throughout the day—obsessing over the worst-case-scenario of every situation. The more stressful the situation (such as one’s job and financial security), the more pervasive and worrisome the dialogue can be. 

The areas of day-to-day life that most plague the thoughts of a person with GAD include:

  • Work performance
  • Financial security
  • Health
  • Safety and wellbeing of offspring and/or pets
  • Tardiness
  • Household tasks

A person with GAD may find oneself in a fictitious argument with a boss or colleague—arguing with a made-up voice expressing one’s present fears. This can happen while thinking about a worst-case-scenario situation that may or may not happen at the next company meeting. These negative, worrisome ways of thinking and feeling work against a person’s efforts to not only survive this life, but to thrive in it. 


While each case of GAD is unique and symptoms present differently from one individual to the next, those most commonly associated with GAD include:

  • Excessive worry in the absence of a clear and present threat
  • Feeling worried more often than feeling calm, centered, or at peace
  • The focus of worry can be difficult to control and may change from one topic to the next. 
  • These symptoms have been present for six months or longer, and are accompanied by at least three of the following:
    • Restless 
    • Irritability
    • Concentration difficulties
    • Difficulty falling asleep and/or staying asleep
    • Fatigue
    • Muscle soreness and joint aches
  • Additional symptoms of GAD may include:
    • Changes in eating habits
    • An inability to relax or remain calm and centered
    • Difficult swallowing
    • Headaches and stomachaches
    • Irregular bowel movements
    • Lightheadedness
    • Sweating, feeling out of breath
    • A nervous twitch
    • Panic attacks

Anxiety disorders oftentimes occur alongside a variety of additional conditions such as depression, PTSD, substance use disorder, etc. 

Causes of Generalized Anxiety Disorder

The root cause of anxiety differs from one unique individual to the next. There is no one-size-fits-all root cause for each and every case of anxiety, and if there is, researchers have yet to discover it. 

Biological Influences

Our genetics come into play when it comes to our level of resilience and susceptibility to developing a mental health disorder. Our DNA does not predetermine whether or not we will develop such a disorder, but once triggered by a chemical imbalance or a traumatic event, genetics hold the power to tip the scales. 

Stress Coping Mechanisms

Research shows us that the ways we learn to respond to stress, process our emotions, and cope with stressful situations by the time we are teens influence the likelihood of developing a mental health disorder, such as GAD, later on in life. This is especially true for those who grow up in high-stress or high-conflict environments. 


Witnessing a traumatic event or being in a situation where one’s safety is at risk can cause trauma. Common causes of trauma. Everyone responds to trauma differently. Being able to process the traumatic event with a trusted therapist is the best defense against developing an adverse reaction. 

A Neurochemical Imbalance

Our brains contain chemicals called neurotransmitters that account for a variety of functions from our mood and feelings of pleasure, to learning and concentration. When these chemicals are out of balance, it can cause us to experience symptoms of anxiety and depression. 

Dopamine and serotonin are two neurotransmitters that play an integral role in our mental health. They can become imbalanced when we do not get enough sleep, if we deplete these chemicals from the use of drugs, and when we aren’t taking care of ourselves as we should by getting the nutrients, exercise, and sunshine that we need. Diet is another important factor, as we have more neurotransmitters located in our gut (our gastrointestinal system) than in our brains.

Treating Generalized Anxiety Disorder

Generalized anxiety disorder is a treatable condition. As mentioned earlier, there is no one-size-fits-all treatment option that works for everyone. Each unique individual responds to treatment differently, and so it may take some time to find the combination of options that works best for each person at the start of treatment. 

Therapeutic Interventions

There are a variety of therapy options available for those who suffer from GAD. Some of the most common forms of therapy that have been used to treat GAD include:

  • Cognitive-Behavioral Therapy (CBT)
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Trauma-Focused CBT (TF-CBT)
  • Dialectical Behavioral Therapy (DBT)

Cognitive-Behavioral Therapy (CBT)

CBT is the most common form of therapy for treating all types of anxiety disorders.  Treatment goals can be achieved with CBT in fewer sessions than most other forms of therapy. This evidence-based practice focuses on changing negative thought patterns and challenging detrimental core beliefs while developing healthy coping skills. 

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR involves eye movement desensitization. This is done to activate the hippocampus and timestamp the traumatic memory so that it can be successfully stored, and in turn, less powerful. This form of therapy is effective in treating trauma with fewer sessions required than other methods of treatment, including CBT.

Trauma-Focused CBT (TF-CBT)

TF-CBT is designed for working with families who have experienced trauma. The goal of this therapy model is to bring families together so they may cope with the aftermath as a family—strengthening  its bonds, building trust, and coping skills while improving communication.

Dialectical Behavioral Therapy (DBT)

DBT is a form of therapy that is rooted in CBT and designed to help clients achieve emotional regulation and balance in life through individual and group therapy sessions designed to help manage emotions, change behavioral patterns, and form healthy coping skills. DBT typically lasts six months, although this can vary from one individual to the next. 

Pharmaceutical Treatment Options

Antidepressants are typically a first line of defense in treating symptoms of anxiety with pharmaceuticals. This is usually done with a selective serotonin reuptake inhibitor (SSRI), also used to treat major depression. It is important to note that SSRIs are not effective in treating every case of anxiety. Some sources report as many as 50% do not respond to these medications.

Benzodiazepines (such as Xanax, Valium, etc.)  may also be used to treat episodes of extreme anxiety or panic. It is important to stray away from using these medications as a daily treatment method as they are physically addictive, and the withdrawals can be fatal. 

Holistic Treatment Options

There are a variety of holistic treatment options available for managing GAD symptoms. People have found relief from natural supplements such as GABA, micronutrient supplements, lavender essential oil, lifestyle changes that support a healthy diet and exercise, diaphragmatic breathing, mindfulness, meditation, and more. 

Final Thoughts 

Living with GAD can feel like a constant struggle with one’s own mind. It can make a person feel isolated from friends and family and can cause one to worry that he or she will never feel well, whole, happy, or at peace again.

The good news is that this condition is treatable. While it may take some time to figure out the right combination of treatment that works best for each individual, it is well worth it. No one should have to suffer with anxiety alone. Support and help is available for those who need it.