Generalized Anxiety Disorder and Chronic Worry

Generalized anxiety disorder, or GAD, is characterized by excessive worry and chronic, ongoing stress.

The worry in GAD is usually about multiple topics: work, health, the welfare of others, the news, one’s own mental state, finances - almost anything. People often say that if their mind is put to rest about one topic, it will quickly look about to find something new to worry about.

In order to count as full GAD, the worry must occur more days than not, must be experienced as difficult to control, must be accompanied by other symptoms such as irritability, difficulty concentrating, or physical manifestations of stress, and must cause significant life impairment.

Most people with GAD spent a great deal of time trying to eliminate their worry or talk themselves out of it - to the point that the constant coping with worry becomes almost as much of a problem as the worry itself.


Cognitive behavioural treatment of generalized anxiety has taken significant strides in recent years and has been found to be an effective way of reducing worry and other signs of stress.

Most therapy involves cognitive work: an examination of the content, timing, and process of worry, with techniques to talk back to the catastrophic thinking. Learning to tolerate the ambiguity of life (Will my flight be safe? Will my marriage work out? What if I get cancer?) is central.

Behavioural elements include overcoming any avoidance that has taken hold (for example, of reminders of prominent worry topics), reducing "safety behaviours", and in some cases relaxation training. Exposure-based work can involve deliberately bringing on thoughts of feared outcomes and permitting those thoughts to be present without struggling to eliminate them. Because the thoughts are no longer so fearful, they subsequently recur less frequently.

Chronic worry can be a decades-long problem, but the evidence is clear: It CAN be treated.

Note: Information on these pages is provided for educational purposes only. It should not be taken as a substitute for care from a qualified healthcare provider.