Generalized Anxiety Disorder (GAD) is a highly prevalent and disabling anxiety disorder that is characterized by excessive, overwhelming and irrational worry (i.e., anxiety-provoking anticipation about everyday things, events, or activities). Individuals with GAD typically anticipate disaster or expect the worst to happen, even when there is no apparent reason for concern.

Prevalence: Generalized Anxiety Disorder affects about 6.8 million American adults, typically affecting about twice as many women as men. GAD affects about 3.1% of American adults age 18 years and older (about 18%) in a given year.

GAD typically develops gradually and can start at any point in one’s life; however, the span between childhood and middle age holds the highest risk. The average age of onset is 31 years old. Although individuals with GAD don’t generally avoid specific situations due to the disorder, GAD can be very debilitating, creating immense difficultly for individuals to engage in and complete activities of everyday living. When GAD develops, it can become chronic. With proper treatment, however, GAD can be managed.


GAD involves exaggerated worry relating to everyday matters such as health, money, family, friendships, interpersonal relationships, and work, often interfering significantly with daily functioning. Individuals who suffer from GAD experience excessive worry about an assortment of everyday issues for at least 6 months. In addition to anxiety about everyday internal and external events, those with GAD also experience several somatic complaints.

Individuals may exhibit a variety of symptoms, including:

  • restlessness, feeling “on edge”

  • inability to fully control the anxiety

  • difficulty concentrating or mind going blank

  • sleep disturbance

  • fatigue

  • headaches

  • nausea

  • numbness in hands and feet

  • muscle tension and/or muscle aches

  • difficulty swallowing

  • breathing difficulty

  • trembling, twitching

  • irritability, agitation

  • sweating

  • hot flashes

  • rashes


Everyone occasionally worries about things such as money, health, or family issues—however, individuals with generalized anxiety disorder are immensely worried about these and other things, despite there being little or no reason to worry about them. They can feel highly tense and anxious about just making it through the day. Often, individuals with GAD worry that things will always go badly or that the worst will happen, frequently keeping them from doing everyday tasks.

Fortunately, several types of psychological treatments have been developed and supported through research in recent decades, most of which utilize cognitive behavioral-based therapies (CBT). This typically entails a mixture of one or more specific techniques, (e.g., cognitive restructuring, biofeedback, exposure, applied relaxation, and problem-solving). Current CBT treatments for GAD often involve metacognitive therapy or acceptance-based behavior therapy, which emphasize the function of worry as a method of avoiding unpleasant internal experiences.

At Spectrum, we integrate traditional cognitive-behavior therapy (CBT) with somatic approaches including biofeedback, breathing exercises, guided imagery training and progressive muscle relaxation. Through CBT, we target the underlying belief and thought patterns that cause GAD and work towards adapting these patterns to be more realistic and useful.  An emerging new CBT approach is Acceptance and Commitment Therapy (ACT) and at Spectrum we use ACT extensively to address strategies to deal with fear-triggering thoughts. Extensive research exists demonstrating the effectiveness of traditional CBT and ACT in the treatment of GAD. The somatic training provides alternative coping skills for managing worry and anxiety.