# Generalized Anxiety Disorder > GAD is worry as a full-time job: not one fear but a rotation of them (health, money, family, work) each taking its turn, none ever settled. It responds well to treatment, and most people wait far longer than they need to. **Source:** https://www.uniquembhs.com/anxiety-disorders-treatments/generalized-anxiety-disorder **Practice:** Unique Minds Behavioral Health Services, LLC. Baltimore, MD: 6810 Park Heights Ave, Suite C6, Baltimore, MD 21215 · Washington, DC: 1402 North Capitol St NW, #1, Washington, DC 20002 · Delaware, OH: 1 W Winter St, Suite 211, Delaware, OH 43015 **Phone:** (443) 538-8400 **Clinically reviewed by:** Dr. Victorine (Vicky) Ngang, DNP, APRN, PMHNP-BC, MSN, RN **Last reviewed:** 2026-08-11 ## Quick answer Generalized anxiety disorder (GAD) is persistent, hard-to-control worry across many areas of life, lasting six months or more and often carrying physical tension, poor sleep and fatigue. Unique Minds treats GAD in adults and children across Maryland, Washington, D.C. and Ohio using cognitive behavioral therapy, medication management and mindfulness-based approaches, in person or by video. ## What GAD actually is According to the [National Institute of Mental Health](https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad), generalized anxiety disorder involves excessive worry occurring most days for at least six months, about work, health, family, everyday matters, or all of them in rotation. The worry is disproportionate, difficult to control, and physical: tension, restlessness, poor sleep and fatigue are part of the diagnosis, not side notes. What makes GAD easy to miss is that each individual worry looks reasonable. It is the pattern, always another worry, never a settled mind. That is the condition. ## How GAD is diagnosed There is no blood test for worry. GAD is diagnosed clinically, in a [psychiatric evaluation](/psychiatry-practices/psychiatric-evaluation) that checks four things against the NIMH description above: - **Breadth.** Worry that rotates across several domains: health, money, work, family, the small administrative dread of ordinary life, rather than fixing on one situation. - **Duration.** More days than not, for six months or more. This is the criterion that separates GAD from a genuinely stressful season, and the one people are most surprised to have met. - **Controllability.** Not whether the worry is understandable, but whether you can set it down when you decide to. In GAD, deciding does not help. - **The physical column.** Restlessness, muscle tension, fatigue, poor concentration, irritability and disturbed sleep are part of the diagnosis rather than a separate complaint. Then the differential: an overactive thyroid, caffeine, stimulant medication, alcohol or its withdrawal, chronic sleep loss, and depression can each produce a convincing imitation, and depression co-occurs with GAD so often that both get assessed together as a matter of course. ## What raises the risk No one cause has been identified. NIMH funds research into the environmental and genetic factors behind anxiety disorders, and what an evaluation usually surfaces is a combination rather than a culprit: a family in which worry is a familiar trait, a temperament that has always run cautious and alert, and a period of stress, illness or responsibility that pushed a manageable tendency past its limit. Worth stating plainly, because people arrive believing the opposite: chronic worry is not evidence of a weak character. It is usually evidence of a threat system that has been running overtime for years without a break. ## How treatment works here Everything begins with a [psychiatric evaluation](/psychiatry-practices/psychiatric-evaluation), because persistent worry has imitators: thyroid conditions, stimulant use, depression, and plain overload. If GAD is the right name, treatment usually draws on [CBT](/therapy-services/cognitive-behavioral-therapy), which targets the worry *process* (the "what if" engine itself) rather than debating every worry, [medication management](/psychiatry-practices/medication-management) where symptoms are loud enough to need it, and [mindfulness-based skills](/therapy-services/mindfulness-based-interventions) for stepping out of the spiral in the moment. Progress in GAD tends to be quiet: you notice you slept through the night, or that a problem stayed the size it actually was. We measure as we go, so you can see it happening. ## When to reach out If worry is most days, most topics, and it is charging you sleep or peace, you do not need to be in crisis to come in. GAD rarely burns out on its own, but it responds well when treated, and the first appointment is only a conversation. ## What it can look like - Worry that jumps from topic to topic: solve one, another takes its place. - Feeling keyed up, on edge or unable to relax, most days. - Muscle tension you only notice when someone points out your shoulders. - Trouble falling asleep, or waking at 3am with the committee already in session. - Difficulty concentrating because part of your mind is always elsewhere. - Tiredness that rest does not fix. Vigilance is expensive. - Asking "but what if" about things other people seem able to set down. - Irritability, because a mind at capacity has nothing left for patience. - Seeking reassurance (from people, from search engines), and it never holding. ## How we treat it - [Cognitive Behavioral Therapy](https://www.uniquembhs.com/therapy-services/cognitive-behavioral-therapy) - [Medication Management](https://www.uniquembhs.com/psychiatry-practices/medication-management) - [Mindfulness-based Interventions](https://www.uniquembhs.com/therapy-services/mindfulness-based-interventions) - [Relaxation & Lifestyle Changes](https://www.uniquembhs.com/therapy-services/relaxation-and-life-style-changes) ## Frequently asked questions ### How is GAD different from normal worrying? Scale, control and cost. Everyone worries about real problems; GAD worries most days for months, about many things at once, in a way that is genuinely hard to switch off: and it charges for it in sleep, concentration and muscle tension. If worry feels like your default state rather than a response to events, that is the pattern worth evaluating. ### What is the best treatment for generalized anxiety? Cognitive behavioral therapy has the strongest evidence, teaching you to interrupt the worry cycle rather than argue with each worry individually. Several medications are also well supported. Many people do best with both, and the right mix for you is decided at evaluation, with you in the room. ### Can GAD be treated by telehealth? Yes. Talk therapy and medication follow-ups for GAD both work well by secure video, and we treat patients this way across Maryland, Washington, D.C. and Ohio. Many people with GAD actually find video easier to start with, and our Baltimore and Washington offices are there whenever in-person suits you better. ### How is GAD diagnosed? Through a clinical conversation, not a test. Your provider looks for excessive, hard-to-control worry across several areas of life, present more days than not for at least six months, together with physical symptoms such as restlessness, tension, poor sleep, fatigue or difficulty concentrating, and evidence that it is genuinely costing you something. They also check what else could produce it, including thyroid problems, caffeine, some medications and depression. ### What else can look like generalized anxiety disorder? Several things, which is why the evaluation is worth doing properly. An overactive thyroid, too much caffeine, stimulant medication, alcohol withdrawal and chronic sleep deprivation can all produce the keyed-up, restless, unable-to-settle picture. Depression, ADHD and trauma responses can also present as constant worry. Naming the right one is what makes treatment work rather than partly work. ## Sources - Generalized Anxiety Disorder: When Worry Gets Out of Control. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad - Anxiety Disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders ## Related pages - [Panic Disorder](https://www.uniquembhs.com/anxiety-disorders-treatments/panic-disorder) - [Insomnia](https://www.uniquembhs.com/insomnia-treatment) - [Depression](https://www.uniquembhs.com/depression-treatment) --- This page is general health information, not medical advice. In a crisis, call or text 988 (988 Suicide & Crisis Lifeline) any hour, or call 911 in an emergency.