Generalized Anxiety Disorder: Causes, Symptoms & Treatment

anxiety, generalized anxiety disorder, worry
One symptom of generalized anxiety disorder is an inability to sleep because of worrying about everyday things.
Credit: Rommel Canlas | Shutterstock

People who experience generalized anxiety disorder (GAD) exhibit excessive anxiety and worry about multiple events or activities most days of the week. While it is not unusual to experience stress occasionally, GAD sufferers rarely get relief from worrying.

Although some of the symptoms and reactions may be similar to that of a phobia, generalized anxiety disorder is not connected to a specific situation or thing. There is an unease that casts a shadow over all of your activities.

While not nearly as intense as a panic attack, it lasts much longer and almost doesn’t let up. GAD sufferers describe it as a feeling of being “wired” all of the time.

Symptoms of GAD

While people who suffer from GAD worry about the same things that other people do — relationships, money, heath, work, etc. — but they have a much higher level of worry that is nearly constant. The level of concern is not in synch with reality and is greatly magnified. Most people with GAD realize that their concerns are overblown, but they cannot seem to shake their anxiety.

The symptoms typically come on slowly, typically between childhood and middle age, but they can occur at any time. In some instances, a major life event, such as a change in heath or a life transition such as a divorce, can trigger the onset of GAD.

The symptoms tend to ebb and flow, but can be exacerbated during times of stress. What sets the worry of GAD suffers apart from the normal concerns is that the worry is intrusive, excessive, debilitating and persistent and lasts for more than six months.

In terms of behavior, GAD can cause difficulty in concentrating or focusing, and an inability to relax, enjoy quiet time, or to be alone. Fatigue, nausea and headaches are some of the physical symptoms of GAD. Some experience hot flashes, trembling, sweating and frequent urges to go to the bathroom.

Sleeplessness is another sign of GAD, because those with the disorder often feel as if they can’t stop their mind from racing. People with GAD are also jumpy, fidgety and easily startled, as the disorder causes a sensation of always being on edge.

Like those with panic disorder, GAD sufferers have difficulty with everyday tasks. However, those with GAD are not gripped by an overwhelming fear, but a lower-level pervasive anxiety causing them to avoid even simple tasks during times when their symptoms are high.


GAD affects about 6.8 million American adults, striking twice as many women as men. That translates to about 3.1 percent of the population suffering with the disorder, and about one third of those cases can be classified as severe.

There is believed to be a connection to family history, although like with all mental health issues, it is typically a combination of biological and environmental factors.

An imbalance of naturally occurring brain chemicals, such as serotonin, dopamine and norepinephrine, are often seen in people with GAD and could be an indicator of a propensity to develop the disorder. An imbalance of these chemicals, called neurotransmitters, can impact emotional stability and mental well-being. [Related: Nervous System: Facts, Function & Diseases]

Enduring a trauma, especially during childhood, can have a link to GAD. Those who experienced abuse or trauma, including witnessing a traumatic event, as a child are at higher risk of developing generalized anxiety disorder.

Connection to addiction

Many GAD sufferers will use alcohol, tranquilizers or other drugs to calm their nerves and provide them some relief. The fact that so few people with GAD receive treatment suggests that many are self-medicating.

While there is a high rate of comorbidity (GAD and substance abuse occurring together) typically the GAD was present before the addiction. There is very little evidence of GAD being induced  by substance abuse.

Typically those suffering from GAD and other anxiety disorders have low self-esteem, which is a factor in substance abuse. There is a high level among GAD sufferers to abuse prescription drugs. Many build up a tolerance to some of the drugs they have been given to treat the physical symptoms, leading them to visit multiple doctors for prescriptions.

GAD sufferers are also cautioned to avoid caffeine and some over-the-counter cold medications can exacerbate the symptoms of anxiety disorders.


GAD can be difficult to diagnose, because it is the symptoms, such as sleeplessness or headache, that cause someone to seek medical attention. It is estimated that less than half of the people who live with GAD receive treatment,

As with many mental health issues, some patients respond to psychotherapy, others are helped with medication, and still others need a combination of treatments to achieve success.

Cognitive therapy, which teaches a patient new ways of reacting to situations, can help reduce the anxiety and worry. Many also find self-help and support groups beneficial in sharing their challenges and discussing coping mechanisms.

Anti-anxiety medications and antidepressants are the two most common types of medications used to treat GAD.

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