Diagnosis of Generalized Anxiety Disorder (GAD)
Diagnosis of generalized anxiety disorder (GAD) can be difficult, since the distinction between normal anxiety and GAD is not always apparent. Diagnosis is based on a physical exam, psychological evaluation, and the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The symptoms of GAD must be present for at least six months and cause impairment in your ability to function.
Initial AssessmentAfter obtaining your medical history, you may be asked about worries, anxiety, “nerves,” stress, and other symptoms. Your doctor may ask whether your anxiety is acute (brief or intermittent) or chronic (persistent).Acute anxiety lasts from hours to weeks and usually occurs in response to a particular stressor. Persistent anxiety lasts from months to years and may be considered a part of your temperament. Persistent anxiety does not normally occur in response to stress. In susceptible people, though, stress may increase levels of persistent anxiety.
Evaluation of Medical DisordersBefore generalized anxiety disorder can be diagnosed, your doctor will look for and rule out other medical disorders that could cause your symptoms. Medical conditions commonly associated with anxiety include:
- Irritable bowel syndrome
- Chronic pain conditions
- Cushing’s disease
- Mitral valve prolapse
- Carcinoid syndrome
- Chronic obstructive pulmonary disease
- Heart failure
- Tourette's syndrome
- Over-the-counter cold remedies and diet pills
- Angiotensin-converting enzyme (ACE) inhibitors
Evaluation for Substance AbuseUse or withdrawal from addictive substances can cause anxiety. Your healthcare provider may ask about your use of alcohol , caffeine , nicotine , addictive medications (particularly sedatives), illegal drugs , and other substances.
Evaluation of Other Psychiatric DisordersYou may be tested for:
- Panic disorder
- Post-traumatic stress disorder
- Social phobia
- Obsessive-compulsive disorder
- Social anxiety disorder
- Other psychiatric disorders that often occur with generalized anxiety disorder
Anxiety and panic: gaining control over how you're feeling. Family Doctor.org website. Available at: http://familydoctor.org/online/famdocen/home/common/mentalhealth/anxiety/013.html . Updated September 2006. Accessed October 29, 2008.
Ballenger JC, Davidson JR, Lecrubier Y, et al. Consensus statement on generalized anxiety disorder from the International consensus Group on Depression and Anxiety. J Clin Psychiatry . 2001;62:53-58.
Flint AJ. Generalised anxiety disorder in elderly patients: epidemiology, diagnosis and treatment options. Drugs Aging . 2005;22:101-114.
Moore DP, Jefferson JW. Handbook of Medical Psychiatry . 2nd ed. Philadelphia, PA: Elsevier Mosby; 2004.
- Reviewer: Michael Woods, MD
- Review Date: 11/2013
- Update Date: 11/30/2013
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