What is generalized anxiety disorder (GAD)?

Partner has generalized anxiety disorder. Facts infographic

Generalized anxiety disorder facts.

From time to time people worry and feel anxious, often when they are stressed. They worry about decisions and things they have to do, and often do so to cope with the situation in a more efficient way. People with generalized anxiety disorder (GAD), however, have excessive, uncontrollable, and unrealistic worries about normal things most of the time. The way in which people with GAD feel worried and anxious does not help them cope with situations in a more efficient way, but rather can exasperate them. People with GAD can’t control their anxiety and worry. Often this results in expecting the worst even if there is no reason for it. As a result their anxiety is out of proportion to the risk and they have difficulty concentrating on other tasks.

In the United States between 4.1% and 5.1% of people will have generalized anxiety disorder once in their lives. In the Netherlands this is 2.3%. It is likely that GAD is more common, but professionals often attribute the symptoms to a different disorder, or don’t diagnose it at all.

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At Barends Psychology Practice we offer (online) therapy for generalized anxiety disorder. Contact us to schedule a first, free of charge, online session. (Depending on your health insurance, treatment may be reimbursed).


How does it work?

Generalized anxiety disorder develops slowly: people worry a little more than usual and this gradually becomes worse to a point where people worry about something all the time. Worrying about daily things gives people with GAD the idea that they are in control of the situation. By going over every possible scenario they think they can eliminate all the risk factors. For a brief moment the worrying reduces the anxiety people experience, thus worrying seems to be rewarding. Unfortunately, this is not the case. Subconsciously people with GAD teach themselves that worrying gives them a sense of control over the situation, and that being ‘out of control’ increases anxiety. In other words, they created a vicious circle in which they get stuck.

In 2000 Ladouceur, Gosselin, and Dugas came up with the intolerance of uncertainty (IofU) theory. According to this theory people with GAD have the tendency to respond in a negative way to insecure or uncertain situations and events, regardless their likability and possible consequences. People with a high IofU scores perceive such situations and events as stressful or confusing and experience difficulty functioning normally in such situations. They need a strong sense of security and clarity and actively avoid insecurity and uncertainty. As a result people with a high IofU worry a lot.
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Generalized anxiety disorder symptoms:

Generalized anxiety disorder is a difficult disorder to diagnose, because of the great overlap with other mental disorders. People who are depressed, for instance, also worry a lot, and have difficulty concentrating. People with social phobia, just like people with GAD, may experience sweating, muscle tension, and trembling. It’s important to see a professional for a proper diagnosis if you recognize the symptoms below:

  • Excessive and persistent worrying about concerns (big or small) that are out of proportion to the impact of the event.
  • Inability to stop worrying.
  • Worrying about (excessive) worrying.
  • Fear of making the wrong decision
  • Distress about making decisions.
  • Inability to relax. Feeling restless all the time.
  • Difficulty concentrating.
  • Difficulty/inability to handle uncertainty or indecisiveness.
  • Always thinking of possible negative outcome when it comes to possible scenarios.
  • Irritability.
  • Fatigue.
  • Muscle tension.
  • Trembling.
  • Being easily startled.
  • Sleeping problems.
  • Sweating.
  • Nausea, diarrhea or irritable bowel syndrome.
  • Headaches.

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  • Ladouceur, R., Gosselin, P., & Dugas, M. J., 2000. Experimental manipulation of intolerance of uncertainty: a study of a theoretical model of worry.Behaviour Research and Therapy , 38, 933-941.
  • Bijl, R. V., van Zessen, G,m & Ravelli, A., 1997. Psychiatric morbidity among adults in The Netherlands: the NEMESIS-Study. II. Prevalence of psychiatric disorders. Netherlands Mental Health Survey and Incidence Study. Nederlands Tijdschrift Geneeskunde, 141, 2453-2460.
  • Grant B. F., et al., 2005. Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological Medicine, 35, 1747-1759.