Generalized anxiety disorder

Generalized anxiety disorder (GAD) is a common condition defined as at least 6 months of excessive worry about everyday issues that is disproportionate to any inherent risk and causes distress or impairment and is hard to control.

The presence of at least three symptoms, out of a possible six key symptoms, is required to make a diagnosis of GAD in adults, according to the Diagnostic and Statistical Manual of mental disorders, fifth edition, text revision (DSM-5-TR) criteria. These key symptoms include restlessness or nervousness, being easily fatigued, poor concentration, irritability, muscle tension, and/or sleep disturbance. Only one key symptom is required to make the diagnosis of GAD in children.

It is in part a diagnosis of exclusion: physical health conditions, other mental health disorders, and medications or other substances should be ruled out as a primary cause.

Physical examination and laboratory studies are generally normal, if no coexisting physical or mental health conditions or substance misuse issues exist.

Treatment is primarily with psychotherapy (usually cognitive behavioral therapy) or serotonergic antidepressants, or a combination of these approaches.

GAD is defined as at least 6 months of excessive worry about everyday issues that is disproportionate to any inherent risk and causes distress or impairment. The worry is not confined to features of another mental health disorder, a result of substance misuse, or related only to a physical health condition. The worry is hard to control.

At least three of the following key symptoms are present most of the time: restlessness or nervousness, being easily fatigued, poor concentration, irritability, muscle tension, or sleep disturbance.[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022. In children, at least one key symptom should be present most of the time.

Other common complaints are autonomic in nature, such as sweating, lightheadedness, palpitations, dizziness, and epigastric discomfort.[2]World Health Organization. WHO releases 2025 update to the International Classification of Diseases (ICD-11). Feb 2025 [internet publication]. https://www.who.int/news/item/14-02-2025-who-releases-2025-update-to-the-international-classification-of-diseases-(icd-11) Anxiety may be "free-floating" (i.e., not restricted to, or even strongly predominating in, any particular environmental circumstances).[2]World Health Organization. WHO releases 2025 update to the International Classification of Diseases (ICD-11). Feb 2025 [internet publication]. https://www.who.int/news/item/14-02-2025-who-releases-2025-update-to-the-international-classification-of-diseases-(icd-11) Examples of worries include fears that the patient or a relative will shortly become ill or have an accident.