Suzanne Watson MD, MDiv, MEd

Del Mar Psychiatry


In-Person Appointments & Telemedicine Available, 317 14th Street, Suite D
 Del Mar, CA 92014

Generalized Anxiety Disorder

Generalized anxiety disorder, or GAD, is a psychiatric problem in which anxiety is not a temporary state but a chronic condition. While it is normal for all individuals to worry about an upcoming event such as an examination or job interview, patients with GAD are in a perpetual state of anxiety, unable to relax. The disorder may become so severe that it interferes with school, work or relationships. GAD is a very common disorder, affecting millions of individuals in the United States alone.

Causes of GAD

While precise causes for GAD have not been determined, the disorder is believed to be the result of abnormalities in the brain that may be, at least partially, hereditary. Hormonal changes, like those that occur prior to or during menstruation or during menopause, may be a factor in the development of the disorder as well.  GAD is thought to be exacerbated by environmental factors like trauma or extreme stress.

Symptoms of GAD

Symptoms of GAD, which most commonly begin during childhood or adolescence, may begin in adulthood as well. These symptoms may be both psychological and physiological. Often diffuse, these symptoms may be accompanied by a fear of dying.

Psychological Symptoms

  • Excessive worry about small things
  • Perpetual worry
  • Anxiety without a perceived cause
  • Fear or dread
  • Inability to relax
  • Restlessness, irritability, tension
  • Difficulty concentrating
  • Extreme or frequent startle response

Physiological Symptoms

  • Insomnia or other sleep disturbances
  • Headaches, fatigue, nausea, lightheadedness
  • Muscle aches, muscle twitching
  • Palpitations, chest pain
  • Gastrointestinal distress
  • Other aches and pains
  • Frequent urge to urinate
  • Breathlessness
  • Hot flashes or sweating
  • Trembling
  • Difficulty swallowing
  • Dry mouth

Diagnosing GAD

Generalized anxiety disorder is typically diagnosed through a full medical history and a psychological evaluation. In order to be diagnosed with GAD, a patient has to meet the following criteria:

  • Experience extreme anxiety for at least 6 months
  • Be unable to overcome or control anxiety
  • Have difficulty with everyday activities because of anxiety
  • Have anxiety unrelated to another medical or psychiatric disorder

In addition, in order to be diagnosed with GAD, adult patient must experience three of the following and children must experience at least one:

  • Fatigue
  • Sleep disturbances
  • Irritability
  • Restlessness
  • Muscle tension
  • Difficulty concentrating

Treatment for Generalized Anxiety Disorder

Generalized anxiety disorder is typically treated through a combination of medication and psychotherapy. The types of medications typically prescribed for generalized anxiety disorder include antidepressants, buspirone, beta blockers, and benzodiazepines. These medications may differ in the length of time they require to provide symptomatic relief. Sometimes patients are given benzodiazepines, such as Xanax or Valium, to use temporarily until other medications, such as antidepressants, take effect. Several varieties of psychotherapy may be used in treating GAD. Cognitive behavioral therapy has been found to be particularly helpful.

Alternative therapies, including various relaxation techniques and meditation are reported to assist some patients in maintaining a sense of calm. Maintaining a healthy lifestyle, including eating a healthy diet, getting regular exercise, and avoiding alcohol, caffeine and other stimulants can also help relieve the symptoms of GAD. A strong support system of family and friends is also beneficial.

Additional Resources

Del Mar Psychiatry