Once thought to be a rather uncomplicated and mild form of anxiety, generalized anxiety disorder (GAD) has been found to be a much more significant psychiatric disorder. An effective analogy to illustrate the severity uses a respiratory disease model in which GAD is akin not to the common cold, which is mild, inconveniencing and will shortly go away. Instead, generalized anxiety disorder (GAD) is more like chronic obstructive pulmonary disease, which is chronic in nature and associated with a high morbidity and mortality. In GAD, there is constant and excessive worry and anxiety for greater than six months along with marked chronic physical symptoms of anxiety. The person has no or little control of this excessive anxiety, which greatly affects a person’s capacity for work and enjoyment of life. This anxiety does not have to be rational or be associated with a known precipitating event or stressor. Generalized anxiety disorder (GAD) appears to have a genetic component. Its occurrence, which can affect up to 5%-8% of the adult population over a lifetime, can have profound effects on a person’s life. Some of these effects are listed in TABLE 3, which shows some of the findings of the Harvard/ Brown Anxiety Research Program.

Comorbidity of other anxiety disorders such as panic disorder, social phobia and obsessive compulsive disorder (OCD) is common, as well as of other psychiatric disorders such as depression and substance use disorders. Patients with untreated generalized anxiety disorder (GAD) are high users of medical services as they attempt to understand and treat their excessive anxiety.

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