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Generalized Anxiety Disorder (GAD)

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C.E. Zupanick, Psy.D. and Mark Dombeck, Ph.D. Updated: Jun 4th 2019

People with Generalized Anxiety Disorder (GAD) have uncontrollable, excessive anxiety and excessive worry across several situations. This worry and anxiety happens on more days than not, and persists for six months or more. A person with GAD finds it very difficult to control or discontinue the worry, or anxiety, despite their best efforts to do so. Excessive anxiety is also referred to as anxious apprehension in the literature. This term was coined because anxiety is viewed as an emotion, focused on the future, where a person is preparing to deal with some anticipated negative circumstance. Excessive worry is referred to as apprehensive expectation because a person is always expecting some sort of terrible event will happen at any moment and that they are not safe. The feeling would be similar to walking around in a minefield while blindfolded.

woman worrying about everythingTo meet the criteria for GAD, several physical symptoms must also be present on most days. These include; restlessness; becoming easily fatigued; problems concentrating or "zoning out;' irritability; muscle tension; and sleep disturbances.

The anxiety and worries of GAD are not as specific as they are in the other anxiety disorders already discussed (e.g., Phobias and Panic Disorder). Instead, they are more "general," hence the name - Generalized Anxiety Disorder. Adults with GAD tend to worry about everyday things such as finances, job responsibilities, and tending to one's home and family. Children are apt to worry about their abilities, future events, past behaviors, making mistakes, and school performance. This chronic worrying and anxiety causes people with GAD feel "keyed up" or "on edge" much of the time.

The focus of the worry can shift throughout the course of GAD. For instance, if someone with GAD was worrying a lot about their finances, but then received a big promotion at work, their worry would simply shift to something else, such as worrying about the new job responsibilities they now have.

While everyone may tend to worry about their finances, job, and family from time-to-time (which can actually be an adaptive way of coping), individuals with GAD experience anxiety and worry that is out of proportion. They tend to overestimate risk, or to misjudge the likelihood of a negative outcome of some future event. Adults with GAD may not see their anxiety as excessive, but they usually agree that it is having a negative impact on their functioning.

Children and adolescents with GAD tend to worry about their performance, even when it is not being evaluated. As such, they may develop perfectionistic tendencies. They can become highly concerned about being on time, or worry that some unlikely event will cause them to be late. They may seek constant reassurances and approval.

Treatment for GAD is found in the Treatment Section.


Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute

Authors Statement: Established in 1979, the Bio Behavioral Institute is a psychological and psychiatric clinic dedicated to the treatment and research of anxiety and mood disorders. Based in Long Island, NY, USA, the institute serves both a local and international clientele. Our staff have over 40 years of experience treating anxiety and mood disorders and have been at the forefront of scientifically supported treatments for anxiety disorders for many years. We offer a variety of programs provided by a multidisciplinary team of professionals. For more information, please visit us online at or view Bio Behavioral Institute and author biographical information on this website.

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