Generalized Anxiety Disorder Overview

Reviewed by: HU Medical Review Board | Last reviewed: January 2012

Generalized Anxiety Disorder, or GAD, is characterized by excessive worry and tension most of the time, and can be diagnosed when this has gone on for 6 months or more. A person with GAD is consumed by worries over things that aren’t particularly important, and this worrying is bad enough to cause problems in everyday life. Of the estimated 6.8 million American adults with GAD, more than twice as many are women than men. Children may also have GAD.

Symptoms of Generalized Anxiety Disorder

Chronic excessive worrying about a variety of things is the key symptoms of GAD. A doctor will also look for both behavioral and physical symptoms.


To be formally diagnosed with GAD, the excessive anxiety must be causing a person to behave in one or more of these ways:

  • Avoiding situations they’re worried about — for example, staying home from a party because “I might say something stupid.”
  • Spending far too much time preparing for worrisome situations — for example, changing clothes again and again before going to a wedding because “people might laugh at my outfit.”
  • Putting off making decisions or doing tasks that he or she is anxious about. An example: Dinner is constantly late because you’re so worried about whether your family will like what you make that you don’t know where to begin.
  • Repeatedly asking for reassurance about the worries, such as the woman above asking a dozen people at the wedding reception if her outfit is all right.

Physical Symptoms

To be diagnosed with GAD, a person must also have one of more of these symptoms in addition to excessive anxiety:

  • Feel restless or “keyed up” most of the time
  • Get tired very easily
  • Have trouble concentrating or “go blank” from worry
  • Be irritable without reasonable cause
  • Suffer from muscle tension and aches
  • Have problems sleeping

Other symptoms

commonly associated with GAD are:

  • Headaches
  • Trouble swallowing
  • Trembling or twitching
  • Being easily startled
  • Sweating
  • Nausea or diarrhea
  • Lightheadedness
  • Frequent need to urinate
  • Shortness of breath
  • Rapid heartbeat
  • Hot flashes.

What Does GAD Look Like?

Ruth lives with muscle pain and poor sleep, always tense and anxious. Her life is full of “what ifs” that interfere with both her daily and ongoing life. “What if I lose my keys and am late to work? Will I get reprimanded? What if I get fired and can’t find another job? How will I live without income?” In fact, there’s no reason to worry about being late for work occasionally, but for Ruth, that unsubstantiated worry has led to a question that now she can’t stop thinking about. At the same time, a host of what would be small worries for most people are magnified all out of proportion, interfering with her enjoyment of life, making her irritable when people don’t understand why she’s anxious, and slowing her down at work because she’s so fearful of making mistakes.

GAD and Other Mental Disorders

Other anxiety disorders tend to a more specific focus or specialized symptoms than does GAD. For example, in Social Anxiety Disorder there is a particular fear of being with other people; likewise, the irrational anxiety in Panic Disorder leads to panic attacks (though these may occasionally appear in GAD). It’s not uncommon for GAD to be co-diagnosed along with other anxiety disorders and/or bipolar disorder, and there appears to be a strong relationship between GAD and depression.

Generalized Anxiety Disorder and Migraine

One study found that just over 9% of people who suffer from migraines also have Generalized Anxiety Disorder, though the number may be higher. Another study concluded that chronic migraines tend to begin after the symptoms of GAD appear, suggesting a cause-and-effect relationship.

In comparing control subjects with migraine but no mental disorders to GAD patients with migraine, a study found that migraine symptoms were more severe and lasted longer in the GAD patients. Migraine also increased the severity of GAD symptoms. Interestingly, patients with Generalized Anxiety Disorder were more likely to take analgesics before the onset of headache, either because of tension or because of fear they would get a headache or migraine.

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