Most people worry. A bill comes due, a child runs a fever, a review is on the calendar, and the mind turns it over and over. That kind of worry usually has a target, and it fades once the problem is handled. Generalized anxiety disorder (GAD) feels different: the worry drifts from one subject to the next, is hard to put down and keeps going for months.
Everyday worry and GAD side by side
- Everyday worry is tied to a specific problem, roughly matches its size, can be set aside when you need to focus and eases when the problem passes.
- GAD worry jumps between topics, often feels bigger than the situation calls for, is hard to switch off even when you try and shows up on most days.
The National Institute of Mental Health (NIMH) describes people with GAD as worrying too much about ordinary matters, such as their health, money or job, and finding that worry hard to control. NIMH says this happens on most days for at least 6 months.
How GAD can feel
The signs NIMH lists reach well beyond the worry itself. A person with GAD may:
- Feel restless or find it hard to relax
- Get irritable or feel on edge
- Have a hard time concentrating
- Struggle to fall or stay asleep, or feel worn out
- Have headaches, muscle aches, stomachaches or tension
- Tremble, twitch, sweat heavily, or feel lightheaded or out of breath
Because so many of these signs are physical, people often mention them at a checkup first. That is a reasonable place to start, and part of a good evaluation is making sure something else, such as a thyroid problem or too much caffeine, is not behind them.
How a clinician decides
Generalized anxiety disorder is a DSM-5-TR diagnosis, and a qualified clinician makes it. In that manual, the American Psychiatric Association describes worry that is more than the situation warrants, happens more days than not for at least 6 months, covers a number of areas of life and feels hard to control. It comes with at least three of six symptoms: restlessness or feeling keyed up, tiring easily, trouble concentrating or the mind going blank, irritability, muscle tension and disturbed sleep. The worry also has to cause real distress or get in the way of work, home or relationships, and other explanations, such as a medical condition, have to be ruled out.
Questionnaires such as the GAD-7 help measure how strong symptoms are and track change over time; read how rating scales guide care. A score on its own is not a diagnosis.
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What helps
NIMH says treatment for GAD typically involves psychotherapy, medication or both, and that the right plan depends on the person. It calls cognitive behavioral therapy (CBT) well studied and the "gold standard" choice of psychotherapy. In CBT you learn to catch worried thoughts, weigh them against the facts and practice responding in new ways. NIMH also points to a growing body of research that acceptance and commitment therapy (ACT), which uses mindfulness and goal setting, works for GAD. Compare the two in CBT or ACT?
Medication, when indicated, is decided jointly with you. NIMH adds that habits such as enough sleep, regular exercise and less caffeine can ease anxiety, though they do not replace treatment. For more on the process, read how anxiety treatment works.
Getting started with Hope Behavioral Medicine
We see adults in person in West Ashley and by secure video anywhere in South Carolina, so a first visit can happen from home. Our psychiatric nurse practitioners and therapists can use CBT and ACT, and medication management is available when it fits your plan. If you are looking for a particular approach, ask us when you call and we will tell you what we can offer.
Learn about anxiety care in West Ashley and anxiety care by video, or request an appointment.
If worry ever comes with thoughts of suicide, call or text 988 at any hour. If anyone is in immediate danger, call 911 or go to the nearest emergency room.
Sources: NIMH, Generalized Anxiety Disorder: What You Need to Know (revised 2025); NIMH, Psychotherapies (reviewed February 2024); American Psychiatric Association, DSM-5-TR (generalized anxiety disorder).
This article is general information, not medical advice, and does not create a patient–provider relationship. Every situation is different, so see a provider who can evaluate yours and develop a plan of care. Any medication discussed here may not be right for you: the right choice depends on your diagnoses, other health conditions and current medicines, so take medication only as directed by the provider managing your care. If you are ever in doubt about an emergency, call 911 or go to the nearest emergency room.
Frequently Asked Questions
Everyday worry usually has a clear cause and eases when the problem passes. NIMH describes GAD as worry about ordinary matters that is hard to control on most days for at least 6 months, often with restlessness, poor sleep or muscle tension. A qualified clinician makes the diagnosis.
Yes. Among the possible signs of GAD, NIMH lists headaches, muscle aches and stomachaches, trembling, heavy sweating, lightheadedness and trouble sleeping.
NIMH calls cognitive behavioral therapy well studied and the gold standard choice of psychotherapy for GAD, and points to growing research support for acceptance and commitment therapy.
Yes. Hope Behavioral Medicine sees adults by secure video anywhere in South Carolina and in person in West Ashley.