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Your guide to Generalized Anxiety Disorder

Here's what separates generalized anxiety disorder from regular anxiety.

Everyone experiences worry from time to time. But when worry or stress is persistent and interferes with a person’s life, it may lead to a diagnosis of anxiety, Jennifer Payne, director of the Women’s Mood Disorders Center and an associate professor of psychiatry and behavioral sciences at Johns Hopkins University, tells Allure.

“We’ve all had anxiety. With all psychiatric illness, the main thing that differentiates them from normal symptoms is functional impairment,” says Payne. “Anxiety that causes significant impairment or distress is what separates generalized anxiety disorder from regular anxiety."

Symptoms, treatment options, and personal experiences for various physical, mental, and health conditions and concerns.

To learn more about anxiety, how it affects people, and how it’s treated, we spoke with two mental health experts.

What is generalized anxiety disorder?

According to the U.S. Department of Health and Human Services, there are five major types of anxiety disorders: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder.

Sarah E. Valentine, a psychologist at Boston Medical Center and an assistant professor in psychiatry at Boston University School of Medicine, says when a patient presents with anxiety, therapists will assess for the type of anxiety disorder they’re facing. People with uncontrolled, general worry that causes impairment in their ability to function may be diagnosed with GAD. “With GAD, the anxiety is attached to many different domains, where other disorders might be linked to more specific scenarios,” Valentine says.

According to the National Institute of Mental Health, GAD often causes feelings of restlessness or being “on-edge,” being easily fatigued, and difficulty concentrating.

In addition to persistent worry, people with GAD can also experience physical symptoms, like headaches, stomach aches, and other kinds of pain, according to Payne. “Many people [with GAD] complain of tight muscles or feeling short of breath, or like they can’t swallow,” she says.

Since some level of worrying is a normal part of life for many people, it can be confusing to differentiate between anxiety and generalized anxiety disorder. Payne says worry that interferes with someone’s everyday life is what makes GAD distinct.

How is generalized anxiety disorder diagnosed?

When diagnosing a patient who might have anxiety, Valentine says mental health providers consider how much it’s affecting a person’s ability to function. “You’re looking not just at the worry behavior, but how it’s causing impairment in the person's life,” she explains.

To diagnose GAD, a health care provider would do a clinical interview to see if a patient meets criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a diagnostic tool from the American Psychiatric Association. The number of anxiety symptoms — and the persistence of those symptoms — can help a provider diagnose a patient.

“You base the diagnosis on the person having enough symptoms most of the time that they meet criteria for GAD, and that they are having significant impairment or distress from the symptoms,” Payne says.

Once diagnosed, how is GAD treated?

While GAD can be overwhelming, with the support of a health care provider, people can find relief from their anxiety symptoms. One way providers help their patients is psychotherapy.

Payne says the ideal type of psychotherapy is cognitive-behavioral therapy, which works by challenging thought patterns. “Many people with GAD catastrophize a lot of things. CBT helps people challenge those thoughts and change them to a more positive pattern,” she says.

Some people with anxiety might receive a prescription for an antidepressant, which Payne says often helps reduce symptoms of anxiety over time. “It’s not an overnight fix, but over the course of a number of weeks, patients will usually recognize that their anxiety seems to be less frequent, severe, and incapacitating,” she says.

Payne notes providers may avoid prescribing anti-anxiety medications because many of them can be addictive and could even increase anxiety over time. “Antidepressants are much more commonly and appropriately used for anxiety disorders,” she says.

Lifestyle factors can help people manage their anxiety, too. According to Valentine, doctors often help their patients reduce anxiety with factors like diet, sleep, and exercise, alongside other kinds of treatments for patients with anxiety. “A good therapist will integrate all those types of coping that help people manage their emotions,” she says.

Mindfulness skills can also be helpful to help people gain control of their worrisome thoughts. “When people have GAD, they often feel like their thoughts and emotions are out of control, and meditation teaches you how to control your mind and relax,” Payne says. “I think that’s a really important skill for everyone, particularly for people with GAD.”

Valentine recommends people with anxiety learn more about how to choose a therapist through resources like the Association for Behavioral and Cognitive Therapies. Additionally, to find the best treatment option for each person's specific kind of anxiety, she encourages people to try and ask for what they need. “The average person who shows up in a clinic might not get a therapist who’s trained in CBT, so patients need to know what to ask for,” she says.

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