Generalized anxiety disorder, or GAD, is the most common form of anxiety, impacting 6.8 million adults a year — two-thirds of whom are women. GAD symptoms can mimic a lot of other disorders, including depression and ADHD, making it complicated to identify and treat. Pursuing an expert evaluation is the first critical step toward a productive treatment strategy.

It’s normal to feel anxious about an upcoming bill payment or a project at work. Anxiety becomes a diagnosable illness only when it takes on a life of its own — when the anxiety is disproportionate to its causes, and persists for six months or more.

Aside from general feelings of worry and fear, these symptoms may point to a diagnosis of GAD:

- Difficulty concentrating
- Difficulty sleeping
- Irritability
- Fatigue, feeling exhausted constantly
- Muscle tension
- Stomachaches
- Excessive sweating, particularly in the palms
- Rapid heartbeat

The other common anxiety disorders — namely social anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) — each has a unique set of symptoms with which your doctor should be familiar.

How is GAD Diagnosed?

To figure out if you’re suffering from anxiety, your doctor should perform an in-depth screening of your mental and physical health. Your doctor should rule out depression, ADHD, or a specific phobia, all of which can look like generalized anxiety disorder. Certain physical conditions, like thyroid disorders or heart conditions, can also mimic anxiety-like symptoms. Your doctor can rule most of these out with simple blood and urine tests — though some more complicated conditions may require x-rays or physical stress tests.

Substance abuse may also lead to anxiety-like symptoms, so don’t be surprised if your doctor questions your use of substances. Patients with a history of substance abuse are at increased risk if they mix illicit substances with the prescription medications used to treat anxiety, so it’s important for doctors to have the full picture before beginning treatment.

When drugs are involved, it’s important for your doctor to figure out which came first: the anxiety or the addiction. In many cases, an existing anxiety disorder leads to a patient “self-medicating” with substances. However, even if the substance abuse preceded the anxiety, treating an addiction will likely not eradicate all symptoms. In either scenario, doctors should devise a treatment plan that focuses on both the anxiety and the substance abuse as stand-alone problems.

Is Anxiety Underdiagnosed?

Some experts worry that GAD is underdiagnosed, since many patients don’t meet the seemingly arbitrary diagnostic cutoffs of the DSM-V. For this reason, Thomas Spencer, M.D., of Harvard Medical School, has introduced the informal “MAD” spectrum. MAD, which stands for Multiple Anxiety Disorders, allows for patients with various types of anxiety disorders (GAD, OCD, phobias, etc.) to receive an anxiety diagnosis, even if they don’t meet the full criteria for one specific condition.

Different types of anxiety require different treatment, but it’s important to address all facets of a patient’s anxiety and identify all root causes. Only by teasing out all the fears and anxieties — however they manifest — can a patient start on the road to recovery.