What is Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is a psychological disorder that is characterized by persistent worrying that is difficult to control. Approximately 4-10% of the population experience symptoms of generalized anxiety disorder.

We all worry about things like money, relationships, or health. But people with generalized anxiety disorder are excessively worried about these and many other things, even when there is little or no reason to worry about them. Those who have generalized anxiety can be very anxious about just getting through the day. Chronic worriers tend to think things will always go badly. Worrying can even keep people with GAD from doing everyday tasks, procrastinating, or avoiding things that may cause additional anxiety. For people with GAD, the worry has gotten out of control and significantly reduces their quality of life.

Frequent worrying, in addition to being difficult to endure mentally, usually has physical effects. Most people who worry to an excessive degree have significantly increased muscle tension. Prolonged muscle tension can result in headaches, soreness, digestive problems, and insomnia. All of these factors make it increasingly difficult to relax. Thus, the worrying and physical tension feed off of each other, creating a difficult cycle of hyperarousal.

The cognitive-behavioral model of generalized anxiety disorder views this unfortunate cycle as a result of faulty cognitive patterns that are reinforced over time. Worry can serve a positive function for most people. By worrying about something, we do not forget about it, and we can be motivated to take action to solve problems. In this way, worry usually helps us engage in planning. Once we have a solution to a problem after worrying about it, we feel a sense of control over the situation. With generalized anxiety, however, worry no is no longer helpful. It is often over-applied to situations in which there is no way to plan or applied in such a way that otherwise simple situations are over-planned. This is partly due to discomfort with uncertainty. The more uncertain the outcome of a situation, the greater the urge to plan out every iteration of every outcome. By feeling as though one is effectively planning the situation, the sense of uncertainty can decrease, and a feeling of control can emerge. However, this process is very taxing mentally, emotionally, and physically.

Another cognitive-behavioral explanation of generalized anxiety has to do with two common cognitive distortions: fortune-telling and catastrophizing. Fortune telling, in this context, means predicting the worst-case scenario is the most likely outcome. When you predict most situations will end poorly, it can cause undue anxiety. Catastrophizing is anticipating the worst-case scenario would be unbearable and that you could not handle it. By more objectively examining the likelihood of negative outcomes and by realistically thinking about them from a less end-of-the-world perspective, it can significantly reduce anxiety.