Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is a chronic psychiatric condition characterized by pervasive and excessive worry about multiple life domains. Etiologies include genetic predisposition, dysregulation of the hypothalamic-pituitary-adrenal axis, neurotransmitter imbalances (notably GABA and serotonin), and environmental stressors. Patients often present with restlessness, fatigue, irritability, muscle tension, and sleep disturbances, which can significantly impair occupational and social functioning. Diagnosis is based on DSM-5 criteria, requiring excessive anxiety and worry occurring more days than not for at least six months, with difficulty controlling the worry. Management involves cognitive-behavioral therapy (CBT), pharmacotherapy including selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), and adjunctive lifestyle modifications such as stress reduction, exercise, and sleep hygiene. Prognosis is favorable with early diagnosis and adherence to treatment, though symptoms may wax and wane over time.