Generalised Anxiety Disorder (GAD)

Generalised Anxiety Disorder

What Is Generalised Anxiety Disorder?

Generalised anxiety disorder (GAD) is marked by persistent, excessive worry that interferes with daily functioning. Unlike situational anxiety, which arises in response to specific events, GAD manifests as a constant state of heightened apprehension. 

This type of anxiety occurs in a range of issues such as health, relationships issues, work-related stress, and even matters that have not yet occurred.

The diagnostic criteria for GAD stipulate that this type of anxiety and worry must be present for a majority of days over six months. 

This makes it challenging for individuals to control their worry, leading to physical symptoms like fatigue, muscle tension, and sleep disturbances.

GAD can manifest at any age, although a significant proportion experience onset during childhood or adolescence. The condition often coexists with other mental health disorders and may be triggered by stressful life events. 

While GAD is often a chronic condition, its impact on daily life can vary in severity. Because of its moderate nature, it frequently goes undiagnosed. 

If you suspect you are experiencing symptoms of GAD, consult a professional therapist for a comprehensive diagnosis and tailored treatment plan.

Generalised Anxiety Disorder Symptoms

Generalised anxiety disorder manifests psychologically and physically, each with its own symptoms. 

Psychological Symptoms of GAD

Physical Symptoms of GAD

Generalised Anxiety Disorder Causes

GAD arises from a complex interplay of biological, psychological, and environmental influences. While its exact cause remains elusive, it is widely accepted that a blend of these factors contributes to its onset and progression.

Biological and Psychological Causes

Genetic predisposition plays a role, as people with a family history of anxiety disorders (eg social anxiety)  are more susceptible to developing GAD. 

Additionally, neurotransmitter imbalances, particularly involving serotonin and dopamine, also contribute to the disorder’s onset.

Psychological factors, such as cognitive distortions and maladaptive coping mechanisms, can increase the symptoms. For instance, individuals who engage in catastrophising or black-and-white thinking are more prone to chronic worry. 

Catastrophising is the tendency to imagine and fixate on the worst possible outcomes in a situation, often increasing anxiety. Black-and-white thinking, also known as all-or-nothing thinking, involves viewing things in extreme, either/or categories, leaving no room for nuance or middle ground. Both are cognitive distortions that can contribute to emotional distress or GAD.

Other Causes

Environmental triggers, including high-stress situations or traumatic events, can cause GAD. Occupational stress, relationship issues, or financial instability can all contribute to the onset of symptoms.

Lastly, societal and cultural norms can indirectly influence GAD. Societies that place high value on achievement and productivity may inadvertently create conditions that lead to anxiety disorders.

For example, hustle culture glorifies ceaseless work and equates productivity with self-worth. Individuals may feel immense pressure to succeed at all costs.

The constant message that “time is money” can lead people to overwork themselves, neglect self-care, and perpetually worry about falling behind. This societal norm can exacerbate or even trigger GAD.

Generalised Anxiety Disorder Treatment

People may wonder what the best treatment for GAD is. Effective treatment for generalised anxiety disorder often involves a tailored approach combining cognitive-behavioural therapy (CBT) and medication such as selective serotonin reuptake inhibitors. 

Lifestyle changes, including regular exercise and mindfulness techniques, can also help manage the symptoms. 


Navigating your life with GAD can be a daunting experience. However, psychotherapy, particularly Cognitive Behavioural Therapy (CBT), offers a structured pathway to better mental health. 

Unlike medication, which primarily addresses symptoms, CBT aims to recognise the root causes of your anxiety and equip you with valuable skills to manage it effectively.

Cognitive Behavioural Therapy (CBT)

CBT is an evidence-based treatment and is often the first line of intervention for GAD. The therapy is structured around the premise that thoughts, feelings, and behaviours are interconnected. 

By identifying and challenging irrational thought patterns, you can alter your emotional responses and behaviours, thereby reducing anxiety.

In a typical CBT session for GAD, the therapist first works with the client to identify specific triggers and thought patterns that trigger anxiety. For example, if you constantly worry about losing your job, the therapist will help you dissect this fear, breaking it down into its constituent thoughts, such as, “If I make a mistake, I’ll be fired.”

Once these thought patterns are identified, the next step is cognitive restructuring. The therapist guides you in challenging and replacing these irrational beliefs with more balanced thoughts. 

In the job loss example, a more balanced thought could be, “Everyone makes such mistakes; they are not grounds for termination.” 

The ultimate goal of CBT is to equip you with self-sustaining skills. Homework assignments between sessions often include journaling your thoughts, emotions, and behaviours or practising relaxation strategies like deep breathing or progressive muscle relaxation.

Applied Relaxation Techniques

Using applied relaxation techniques offers a targeted approach to managing GAD. Conducted under the guidance of a certified therapist, this method encompasses:

  • Engaging in progressive muscle relaxation to achieve a relaxed state.

  • Implementing cue-controlled relaxation (eg using a specific word or action to trigger immediate relaxation).
  • Systematically applying these skills in anxiety-inducing scenarios.

Typically, a commitment of weekly one-hour sessions over a 3- to 4-month period is recommended for optimal results. 

While applied relaxation is highly effective, availability may vary by location, making CBT a potential alternative. Consult your healthcare provider or psychologist for a tailored treatment plan.


Medications for generalised anxiety disorder offer a range of options tailored to individual needs. Your psychiatrist can guide you through it, considering factors such as symptom severity, coexisting conditions, and lifestyle.

Two primary categories of medications are commonly used: Selective Serotonin Reuptake Inhibitors (SSRIs) and Benzodiazepines. 

Doctors often recommend SSRIs like fluoxetine or sertraline for long-term management. They aim to balance neurotransmitters in the brain, thereby reducing anxiety symptoms. However, they may take several weeks to become fully effective.

Benzodiazepines such as lorazepam offer quicker relief but are generally prescribed for short-term usage due to the potential for dependency.

Your psychiatrist will discuss:

  • Types of medications suitable for you.

  • Duration of the treatment plan.
  • Possible side effects and interactions with other medications you may be taking.
  • Recommendations if you are pregnant, planning to conceive, or breastfeeding.

Regular follow-up appointments are crucial for monitoring your progress and making necessary adjustments. Typically, these occur every 2 to 4 weeks initially, transitioning to every three months after that.

If you experience side effects, consult your healthcare provider promptly for possible dosage modification or alternative medication options.

Diagnosing Generalised Anxiety Disorder

Diagnosing GAD involves a comprehensive approach, often initiated by your therapist or counsellor. 

During the initial consultation, your therapist will administer a mental health screening, which involves a series of questions to understand the duration and severity of your symptoms.

Sometimes, a referral to a mental health specialist like a psychologist or psychiatrist may be advised for a more in-depth evaluation. This could involve structured interviews or standardised questionnaires to confirm a GAD diagnosis.

It is crucial to rule out other medical conditions or substance abuse that could mimic anxiety symptoms. To this end, your therapist may recommend a range of diagnostic tests. 

Blood tests can assess hormone levels, potentially showing signs of thyroid issues. Urine tests can identify substance abuse, while specific tests like endoscopy or X-rays may be used to detect conditions like gastroesophageal reflux disease (GERD).

Moreover, stress tests or additional X-rays may be necessary if heart conditions are suspected. 

Overcoming GAD

Managing generalised anxiety disorder involves a multi-faceted approach. Regular movement, such as a 30-minute walk daily, can significantly alleviate symptoms. 

Prioritise sleep by maintaining a consistent sleep schedule. Mindfulness techniques, like meditation, offer immediate relief by grounding you in the present moment.

Nutritional choices also play a role; opt for foods rich in omega-3 fatty acids and try to reduce or avoid processed foods. 

To manage GAD symptoms on your own, you can try these three main self-help strategies: Problem-solving, mindfulness, and exercise.

Problem Solving

Using the strategy of problem-solving can be a transformative approach to managing GAD symptoms. This cognitive technique shifts your focus from worrying to actionable solutions. Here’s a concise guide to implementing this strategy:

Step One: Pinpoint the Problem

Be specific about what is causing your anxiety. Instead of saying, “I’m anxious about work,” you could say, “I’m anxious about meeting the project deadline next week.”

Step Two: Generate Solutions

List all possible solutions without judgement. Whether it is asking for an extension or delegating tasks, jot down every option.

Step Three: Evaluate Options

Assess each solution for its merits and drawbacks. Consider the feasibility, required resources, and potential impact on your anxiety levels.

Step Four: Choose a Solution

Think of a solution that is both practical and achievable in the short term. This ensures immediate relief and boosts your confidence in problem-solving.

Step Five: Develop an Action Plan

Detail the steps for implementing your solution. Include a timeline, required resources, and plans for any anticipated obstacles.

Step Six: Monitor and Revise

After implementation, evaluate the effectiveness of your plan. If necessary, make adjustments or try an alternative solution.


Firstly, mindfulness encourages a heightened awareness of the present moment, allowing you to disengage from habitual, unsolicited and anxiety-provoking thoughts.

Moreover, relaxation techniques, for example, focused breathing and body scanning, serve dual purposes: they not only induce a state of physical relaxation but also facilitate cognitive restructuring. 

Consequently, you create a mental space where anxiety reduces by consistently directing your attention to your breath or bodily sensations. In doing so, it helps make room for more healthy thinking patterns.

Furthermore, recent neuroscientific research on functional magnetic resonance imaging (fMRI) reveals that mindfulness practices can rewire neural pathways, reducing long-term anxiety. 

Specifically, mindfulness has been shown to decrease activity in the amygdala, the brain’s ‘fear centre,’ while enhancing activity in areas responsible for cognitive control.

To integrate mindfulness into your GAD management strategy, consider starting with a daily 10-minute session of focused breathing or guided meditation. Apps and online platforms offer a plethora of resources to guide you through these exercises. 

Consistency is key. The benefits of relaxation strategies increase over time, offering a sustainable and effective approach to managing your symptoms.


Including regular movements in your daily routine can offer an effective method to manage GAD symptoms. 

As a matter of fact, scientific studies indicate that exercise can significantly impact your mental well-being. For example, they suggest this impact happens through several mechanisms:

  • Neurotransmitter regulation: Regular physical activity has been shown to elevate serotonin levels, often called the ‘feel-good hormone,’ thereby regulating mood and reducing anxiety.

  • Cortisol reduction: Exercise helps regulate cortisol, the body’s primary stress hormone. Lower cortisol levels contribute to a calmer mental state, making it easier to manage GAD symptoms.
  • Cognitive reappraisal: Exercise provides a constructive outlet for stress. This cognitive shift (from focusing on mental energy to concentrating on physical energy) can be instrumental in breaking the cycle of persistent worry and anxious thoughts.
  • Improved sleep quality: Regular exercise can lead to better sleep patterns, which is crucial for mental well-being.  

Incorporating just 20-30 minutes of moderate exercise daily can yield noticeable improvements!

However, it is essential to consult mental health professionals for a tailored treatment plan that suits your needs.

Frequently Answered Questions

Is generalised anxiety serious?

GAD is more than just everyday worry; it is a medical issue that requires serious attention. 

The persistent, excessive anxiety can significantly hinder daily functioning, leading to difficulties in concentration and decision-making. 

This often results in decreased work performance and strained interpersonal relationships.

Moreover, GAD elevates the risk of developing other psychological issues, like depression, anxiety, obsessive-compulsive disorder, and even suicidal tendencies. It is also not uncommon for individuals with GAD to also suffer from phobias or panic disorders.

It impacts physical health equally. Researchers link GAD to a range of conditions, including digestive issues like irritable bowel syndrome, chronic pain, and sleep disturbances.

Given its pervasive impact on both mental and physical well-being, it is crucial to consult mental health professionals for diagnosis and treatment options tailored to individual needs. 

Early intervention and support can significantly increase the chances of managing symptoms and improving quality of life.

How to distinguish GAD from other mental health conditions?

People often confuse generalised anxiety disorder with other mental health conditions because of overlapping symptoms.

Unlike situational anxiety, which is triggered by specific events, GAD manifests as a constant, pervasive worry about multiple aspects of life, often without a discernible cause. This worry persists for six months or more, affecting daily functioning and quality of life.

In contrast, conditions like depression primarily include feelings of sadness or hopelessness, although anxiety may be a secondary symptom. Phobias involve intense, irrational fears centred around specific objects or situations, not the generalised worry characteristic of GAD. 

Obsessive-Compulsive Disorder (OCD) may also have anxiety symptoms, however, repetitive behaviours or thoughts aimed at reducing that anxiety distinguish it.

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