What Is Generalized Anxiety Disorder? 10 Criteria To Look For

PUBLISHED Oct 22nd, 2021 & UPDATED ON Nov 14th, 2022

Anxiety sucks. There, we said it. We were all thinking it so we said (wrote?) it. So what IS generalized anxiety disorder (or GAD to its close friends)?

You might be reading this because you’ve been feeling extra shitty lately and are starting to wonder if it’s more than just *gestures vaguely at the world*. Maybe you’ve known for a long time that you might be coping with anxiety or maybe this is all very new. Maybe you don’t have an anxiety disorder, but your friend, partner, or family member does and you’re looking for ways to support them (props to you, that’s so amazing).

Whatever reason you’re here — welcome. You’re among friends at DiveThru. Let’s start answering some of the questions that brought you here.

What Is Generalized Anxiety Disorder?

Generalized anxiety disorder, or GAD, is excessive and difficult-to-control worrying on more days than not over a six-month period. It needs to cause “clinically significant distress” — that is to say, it causes serious problems in your day-to-day life. The anxiety also cannot be attributable to any other medical condition, mental disorder, or medication/substance use.

The feelings of anxiety can be about pretty much anything. It could be job responsibilities, household chores, finances, health of family members, and other routine circumstances. The focus of the anxiety can also shift from subject to subject, but the feelings of worry persist.

Generalized Anxiety Disorder Symptoms

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists six symptoms of GAD. At least three of these must be present over a six-month stretch in order for a physician to diagnose adults.

Restlessness or feeling keyed up or on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)

These symptoms are felt more severely by younger adults compared to seniors. But there are ways to reduce the impact and intensity of anxiety! Psychotherapy and medication can both be very helpful, as well as other practices like mindfulness.

It may also be helpful to check out Dr. Justin Puder’s course “Thriving With Generalized Anxiety Disorder (GAD)” in the DiveThru app. He goes through where anxiety comes from, the different ways it affects the body and mind, and most importantly, gives tools to manage anxiety so it doesn’t get in the way of leading a happy and fulfilling life!

What Causes Anxiety Disorders?

As with many mental disorders, there are several different factors that can each play a role in GAD. Genetics, personality, development, and brain chemistry can all have an effect. In 2017, researchers looked back at a bunch of past studies and came to the conclusion that GAD has a heritability rate of about 30 percent. However, environmental factors also play a role, so it’s possible to have GAD without a family history, or have a family history and not have GAD.

There are also socioeconomic and cultural factors that can play a role. Women are twice as likely as men to experience GAD symptoms at some point in their lives. People of colour generally experience GAD more than white people.

People from developed countries are more likely to report symptoms; the worldwide prevalence of GAD is somewhere around three percent, but a 2017 report found that so-called “high-income” countries like Australia and New Zealand have the highest rate at around eight percent…versus less than one percent in Nigeria and China, both defined by the report as “low-income countries.”

That’s not to say that people in the wealthier countries are more anxious — just that they’re more likely to report having symptoms. The DSM-5 offers a recommendation to doctors to consider cultural-specific factors when assessing patients for GAD.

10 Other Ways GAD Might Show Up for You

In addition to those symptoms listed above, there are way more ways that GAD can make its presence felt in your life. Here are some physical and psychological signs of anxiety to look out for:

1. Body Aches

Anxiety is ultimately your body reacting to something psychological that it perceives as a physical threat. When your body prepares to deal with this threat, it goes into fight, flight, or freeze… which means your body tenses up. That can cause you to tremble or twitch, feel shaky, and have muscle aches or soreness. It can also lead to an accelerated heart rate and shortness of breath, as your body begins breathing quickly to prepare for either a fight or flight. You may also feel dizzy as a result of these physiological changes.

2. Sweat

Another super fun physical sign of anxiety is the Stress Sweats™. You may find yourself sweating, even if you’re sitting down in a climate-controlled room. Your internal body temperature is going up as your body reacts to this threat… and how does your body regulate its temperature? That’s right, sweat!

Stress Sweat™ has a unique (ahem, not great) smell to it. That’s because it comes from a different (apocrine) gland in your body than regular sweat (eccrine glands). Apocrine glands are found in body parts with more hair follicles, like your underarms or genital region. They produce thicker sweat, rich in proteins and fats that combine with bacteria to cause that special version of B.O. And if that’s not fun enough, your underarms can actually produce UP TO 30 TIMES MORE sweat when under stress. Thanks a lot, body.

3. Frequent Bathroom Breaks

As your body is flooding its system with chemicals during the stress response, some of those chemicals find their way into your stomach. Your gut bacteria is very sensitive… so it doesn’t take much to throw it off. Ever drank milk that was a day or two past expiry?

Nausea, IBS, and diarrhea can all result from your gut bacteria being thrown off balance. So in addition to all the other stuff you’re feeling worried about, you might also be feeling sick to your stomach, passing more gas, pooping more, and feeling bloated. Suuuuuper fun, love that so much.

4. Headaches

As if there wasn’t enough going on in your head already, there’s a correlation between GAD and headaches/migraines. Headaches are a very common symptom of anxiety, and are usually one of the first things a doctor will ask you about when potentially diagnosing GAD.

If you find yourself getting headaches more often than you used to, it could be a sign of anxiety (of course, in concert with other symptoms). Talk to your doctor if you’re having frequent headaches—they’re the medical experts!

5. Health Anxiety

It’s totally normal to feel concerned if you have a sore throat, especially these days… but health anxiety (formerly known as hypochondria) goes beyond that. It’s when these feelings of worry disrupt your life, making it hard to concentrate or get anything done. This can also be caused or amplified by past experiences with illness, either your own or a loved one’s.

Health anxiety becomes more common as people approach middle age. If you find that a headache or stomach-ache sends you into a spiral of worries, and you end up convincing yourself that it means you have cancer, that can be a sign of GAD.

6. Excessive Perfectionism

There’s nothing wrong with having high standards. But here, we’re talking about perfectionism to the point of disruption. You may be feeling an overwhelming need to do things perfectly — even if you’re not actually being evaluated. It’s the idea that “anything less than perfection means I failed.” That can lead to spending way too much time on simple tasks while you agonize over every small detail and end up redoing everything because it “wasn’t good enough” the first time.

It can also present through an excessive fear of being late or procrastination. It sounds contradictory, right? But they’re actually related. Do you arrive everywhere early because “arriving on time means you’re 10 minutes late?” Or perhaps you find yourself often putting off projects or tasks because you figure “future you” will have more knowledge and therefore do a better job? Yeah totally, us neither…

7. Constantly Searching for Validation

For those of you who remember your Psychology 101, this is basically just needing constant rewards. You get a compliment from someone, so you repeat the behaviour that got you the compliment. That’s not a sign of anxiety in and of itself. It becomes a problem when everything you do is in search of validation. This can also coincide with a lack of confidence — if you struggle to have good feelings about yourself, you might be extra motivated by others saying nice things about you.

8. Catastrophic Fears

In addition to everyday life stuff, you could also find yourself thinking and worrying about catastrophic events like natural disasters or nuclear war. This goes beyond a feeling of concern during an event, like seeing a hurricane hit a different country; this is feeling worried and like you need to be actively preparing for when it happens to your home.

This particular symptom is more common in teenagers and children, but climate change-related anxiety is also becoming more prevalent.

9. Coping With Substances

If you feel like you need to alter your mind with alcohol or drugs in order to stop feeling worried, it’s probably a good indicator that there’s something else going on beyond just regular worries. A drink or two when out with friends isn’t problematic behaviour, but when it begins to happen daily and for the explicit reason of making yourself feel better, that’s an issue.

Approximately one-fifth of Americans with an anxiety or mood disorder also have a substance abuse disorder.

10. Your History

Many people with GAD have had feelings of anxiety and nervousness all their life. Think back on your past experiences and consider whether these feelings of worry are new, or if you’ve experienced them in the past. Anxiety in children can often be explained away, like social anxiety as shyness. This conversation could also be had with a therapist, to help you get a fresh perspective.

This is by no means an all-encompassing list. Everybody’s different, and if you have a symptom that’s not on the list, that does not mean your experience is any less valid. If you read this article and thought to yourself “oh shit, they’re describing me” — it’s probably best to make an appointment and chat with your doctor.

It can be rough to be diagnosed with anxiety, but it can also be empowering. If you feel like you have a special ability to be very sad and you don’t know why, it can make you feel all sorts of extra down on yourself. But once you know there’s a reason, you can reassure yourself that it’s not your fault and that it’s something you can take tangible action to manage.