Where is the dividing line between someone who seems anxious and someone who has generalized anxiety disorder (GAD)? It is part of the human condition to worry about things. But some people are more anxious than others and might be referred to as a “worry wart.” Others seem consumed by their worry — for instance, spending their time worrying about worry. How do you know how much worry is too much?
What is generalized anxiety disorder?
People with GAD experience persistent, excessive, and unrealistic worry every day. They feel that it is beyond their control to stop the worry, according to the [Anxiety and Depression Association of America (ADAA)](https://adaa.org/sites/default/files/July 15 GAD_adaa.pdf). They find it impossible to put their worry aside, even for a short time, or let go of it. People with GAD find it difficult or impossible to relax. They almost always feel restless, edgy, or keyed up. About 6.8 million people in the United States, or 3.1 percent of the population, have GAD, but only 43 percent of those people are receiving treatment, according to the ADAA.
GAD versus normal worry
People living with GAD have more negative beliefs about worry, a greater range of worry topics and more frequent and severe negative thought intrusions and higher levels of anxiety than those who were “high worriers,” according to a study completed in 2013. They are more anxious, and less able to control worry.
One of the clues to knowing whether you have normal worry or GAD comes from the people around you. They might tell you that you worry too much or you worry about trivial or silly things. They might say, “Just stop thinking about it,” or “Just take a breath and calm down.” But for someone with GAD, this is the same as saying, “Go to the moon.” With GAD you can’t stop worrying. You worry constantly and excessively.
Most people with GAD have concerns that prioritize around themselves and their immediate family or their work. "What if …?" questions are a real feature of the disorder. These questions nearly always cluster around issues of health, family, money, and work. In that regard they may appear to be no different than normal concerns, yet it is the duration and depth of concerns that are most obvious. Fear and concerns also extend beyond the typical concerns of everyday life and can embrace issues of a global nature.
People who suffer with GAD are also particularly sensitive to real or supposed feedback. For example, if someone at work is more efficient, or if there is even the slightest hint they might have done something better, alarm bells ring and thought processes spin out of control to a point where the GAD sufferer truly believes she is about to be fired.
GAD also causes disproportionate worry. Situations that might cause a short-term concern, for example being in a fender-bender, are blown out of proportion. People with GAD might worry about the damage, the financial burden, the people in the other car, their spouse’s reaction. These thoughts continue to churn and when one concern is resolved, a different worry takes its place.
Worry and anxiety is hardwired into our brains. It is part of the body's fight-or-flight response, which prepares us to act quickly in the face of danger. It is a normal response to uncertainty, trouble, or feeling unprepared, according to the University of Texas Counseling and Mental Health Center. It usually subsides once a situation is resolved. But with an anxiety disorder comes constant, chronic, and unsubstantiated worry that causes significant distress, disturbs your social life, and interferes with school or work.
Diagnosing and treating GAD
By the time you approach a doctor about your anxiety you likely have been dealing with anxiety symptoms for months. Besides chronic worry, you probably have difficulty sleeping and live with a constant sense of dread. You may have a list of physical symptoms that you attribute to some horrible or life-threatening disease. You might complain of frequently feeling irritable. You may notice a hyper-arousal, over-reacting to a sudden noise or always feeling like something terrible is going to happen.
Your doctor might want to rule out all physical health conditions that can mimic the symptoms of anxiety, such as heart murmurs, diabetes, high blood pressure, and thyroid problems. Once diagnosed, your doctor will discuss treatment options, including cognitive behavioral therapy and medication. Self-help options, such as meditation, yoga, relaxation, physical exercise, and eating a balanced diet are also important to reduce symptoms of anxiety.