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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-5). The symptoms of GAD must be present for at least 6 months and cause impairment in your ability to function.

Initial Assessment

After 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 Disorders

Before 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:

Your doctor should also ask what medications, herbal supplements , and vitamins you take. You may be asked to stop taking certain medications or supplements so that your doctor can more accurately pinpoint the cause of your symptoms. Medications that can contribute to or worsen anxiety include:

  • Steroids
  • Over-the-counter cold remedies and diet pills
  • Antidepressants
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Digoxin
  • Thyroxine
  • Theophylline

Evaluation for Substance Abuse

Use 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 Disorders

You may be tested for:

Revision Information

  • 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 Suppl 11:53-58.

  • Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013.

  • Flint AJ. Generalised anxiety disorder in elderly patients: epidemiology, diagnosis and treatment options. Drugs Aging. 2005;2(1)2:101-114.

  • Generalized anxiety disorder. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/generalized-anxiety-disorder.html. Updated March 2014. Accessed June 13, 2016.

  • Generalized anxiety disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 1, 2016. Accessed June 13, 2016.