Making a Generalized Anxiety Disorder Diagnosis: Distinguishing between GAD and Clinical Depression Symptoms

Generalized anxiety disorder (GAD) causes chronic and excessive anxiety and worry, but responds well to treatment. Generalized anxiety disorder diagnosis requires a thorough medical examination, including a physical examination to rule out physical causes of anxiety.

Making a Generalized Anxiety Disorder Diagnosis

The following criteria must be met before a generalized anxiety disorder diagnosis is considered:

  • excessive anxiety or worry about multiple concerns experienced most days for at least six consecutive months
  • difficulty controlling anxiety
  • symptoms of anxiety disorder cause clinically significant distress and impairment of normal functioning

In addition, at least three of the following symptoms of anxiety disorders must be present for most days during the six month period before diagnosis:

  • difficulty concentrating (sometimes described as mind “going blank”)
  • easily tired or fatigued
  • feeling restless, “on edge,” or “keyed up”
  • irritability
  • muscle tension
  • sleep disturbances (insomnia, lack or restful sleep, or difficulty staying asleep)

Adults must report at least three of the generalized anxiety disorder symptoms listed above. Children only need to report one of these symptoms for a generalized anxiety disorder diagnosis, presuming other diagnostic criteria are met.

Symptoms of Anxiety and Depression

Symptoms of anxiety and depression often overlap, and any generalized anxiety disorder diagnosis has to consider the possibility of a secondary depression diagnosis. GAD may also occur alongside substance abuse or other anxiety disorders. These conditions must be identified and treated for successful generalized anxiety disorder treatment.

Generalized anxiety disorder diagnosis is not indicated if another anxiety disorder explains all anxiety-related symptoms. For instance, if anxiety only occurs in social situations a diagnosis of social anxiety is warranted rather than GAD. If anxiety symptoms are widespread, but worsen in social situations a dual diagnosis of social and generalized anxiety disorder might be considered.

Likewise, while GAD often accompanies substance abuse, a diagnosis of anxiety disorder is not warranted when drugs or medication are the root causes of anxiety symptoms.

Physical Causes of General Anxiety

Physical conditions can cause symptoms of anxiety and depression, and must be ruled out during generalized anxiety disorder diagnosis. Doctors may order blood work or other tests to rule out possible physical causes of anxiety including:

  • cardiac disease
  • gastroesophageal reflux disease (GERD)
  • heart attack
  • hyperthyroidism
  • hypoglycemia (low blood sugar levels)
  • menopause
  • pulmonary emboli (blood clots in the lungs)
  • tachycardia (rapid heart rate)
  • temporal lobe epilepsy

Generalized anxiety disorder treatment offers relief of anxiety symptoms and helps prevent GAD complications. People experiencing excessive anxiety should discuss the possibility of generalized anxiety disorder with their doctors.