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  • Brittany Montes, Psy. D.

Generalized Anxiety Disorder (GAD)

Anxiety is likely one of the most common complaints I see in my clinical practice. It is an experience that is often overwhelming, all-encompassing, and difficult to manage independently. Additionally, because of the physical symptoms (i.e. headaches, nausea, increased heart rate, muscle tension, etc.), it is one of the most easily identified mental health symptoms.

General Anxiety Disorder

However, anxiety in and of itself is not necessarily problematic. This emotion gives us feedback about our environment and whether or not we need to make changes. Conversely, anxiety that is disproportionate to your situation and long-lasting in nature may represent a clinical syndrome requiring help from medical professionals.

Generalized Anxiety Disorder (GAD) typically develops slowly and over long periods of time (NIH, 2022). Additionally, the NIH (2022) notes that individuals are typically diagnosed in their 30s. However, GAD can, and is, diagnosed in children, young adults, and seniors.

While the symptoms of GAD often vary between people, there are themes that clinicians will look for when making a diagnosis. The DSM-5-TR states that in order to be considered for a GAD diagnosis, individuals must experience excessive anxiety and worry for most days of the week for at least 6 months. Further, these anxieties and worries span across a number of events, activities, and life areas (i.e. school, work, parenting, family, etc.) and individuals find it difficult to control the anxiety. Additionally, individuals must exhibit at least 3 of the following symptoms: restlessness/feeling on edge, feeling easily fatigued, poor concentration, irritability, muscle tension, and difficulties with sleep (APA, 2022).

Again, these symptoms may present different from person to person. Common symptoms include, but are not limited to: accelerated heart rate, sweating, trembling/shaking, dry mouth, difficulty breathing, feeling of choking, chest pain/discomfort, nausea, dizziness/faint/light-headedness, derealisation (feeling that objects are not real), depersonalization (social isolation/distance), fear of losing control, fear of dying, hot flushes, cold chills, numbness/tingling, inability to relax, and exaggerated startle response (Barton et al., 2014).

When it comes to treatment, Cognitive Behavior Therapy (CBT) is considered the gold standard for managing GAD. CBT works with individuals to identify maladaptive cognitive patterns contributing to their anxiety and then learn strategies to adjust these cognitive patterns, behaviors, and reactions. Acceptance and Commitment Therapy (ACT) is also commonly used in treating GAD. ACT focuses on strategies such as radical acceptance to help individuals accept and adapt to their environments and various stressors. As a final note, medications are also commonly used to assist in reducing the impact of symptoms on individuals’ ability to function independently.

As stated above, anxiety can, and often is, normal and healthy. Anxiety can motivate us to study for a test, change unhealthy habits, or finish tasks. However, anxiety should be transient in nature while also matching the nature of the stressors we are currently experiencing. Anxiety that sticks around for longer periods of time and/or is disproportionate to your current situation may indicate the presence of underlying mental health concerns. If you find yourself feeling overwhelmed and unable to independently manage your anxiety, seek professional help-you don’t have to suffer!

About the Author

Dr. Montes is a licensed clinical psychologist and co-owner of Cognitive Behavior Therapy Center in Chesapeake, VA.


Barton S., Karner C., Salih F., et al. Clinical effectiveness of interventions for

treatment-resistant anxiety in older people: a systematic review.

Southampton (UK): NIHR Journals Library; 2014 Aug. (Health Technology

Assessment, No. 18.50.) Available from:

books/NBK262338/ doi: 10.3310/hta18500

Desk reference to the diagnostic criteria from DSM-5-TR. (2022). American Psychiatric Association Publishing.

NHS. (2022, March 14). Generalised Anxiety Disorder. NHS choices.

U.S. Department of Health and Human Services. (2022). Generalized anxiety disorder: When worry gets out of Control. National Institute of Mental Health.

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