what is generalised anxiety disorder (GAD)?

The term "generalized anxiety disorder" (GAD) refers to a condition characterized by excessive worry. In some ways, the term "tension disorder" is a better one - this is a condition characterized by both mental tension (e.g. worry, irritability) and physical tension (e.g. muscle tension, insomnia). People with GAD worry about everyday life circumstances (e.g. job responsibilities, finances, the health of family members) or about more minor matters (e.g. household chores, keeping appointments). The worries are experienced as difficult to control, and they are clearly distressing or interfere significantly with work or with social functioning. The worrying is accompanied by one or more of a range of physical symptoms, such as restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and disturbed sleep.

The particular, symptoms of generalized anxiety disorder may differ somewhat from person to person. For example, some people may experience primarily cognitive symptoms (i.e. worry), while in other people the bodily symptoms (e.g. aches and pains) are experienced as the main problem.

Worries are not always GAD
The worries of generalized anxiety disorder need to be distinguished from the ruminations of depression and the obsessions of obsessive- compulsive disorder (OCD). The disorder that most closely overlaps with GAD is in fact depression; many people with GAD also have depressed mood, and many people with depression also have significant worries. The obsessions of OCD tend to be relatively senseless in comparison to the more understandable worries of GAD.

Second, a number of different general medical disorders may present with symptoms of anxiety (e.g. hyperthyrodism, pheochromocytoma). It is important not to misdiagnose GAD in these cases. Certain foods (e.g. caffeine), medications (e.g. stimulants), and substances (e.g. alcohol) may also contribute to increased anxiety.

Finally, GAD should be differentiated from normal anxiety. The distinction between normal anxiety and a clinical disorder such as GAD rests on the extent of distress and dysfunction associated with symptoms. The worries of GAD are of course more pronounced, more pervasive, and more likely associated with physical symptoms than are ordinary worries.

Who gets GAD?
Around 5% or more of the general population will suffer from GAD at some point in their lives. The prevalence of the disorder is higher, however, in people who are already visiting a general practitioner. GAD is also more common in people with another psychiatric disorder, including another anxiety disorder. Finally, GAD is somewhat more common in women than in men.

Most people with GAD say that they have suffered from excessive worrying all their lives; the condition may have an early onset and may continue for many years. Symptoms often worsen during stressful times.