Generalized Anxiety Disorder (GAD)
What is GAD?
Generalized Anxiety Disorder (GAD) is a well-established anxiety condition marked by persistent and excessive worry that becomes difficult to control. The worry typically spans multiple areas of life—work, health, relationships, finances, family matters, and everyday responsibilities. Instead of appearing in short bursts, worry in GAD tends to be long-lasting, recurring, and quickly spreading from one topic to another.
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Research shows that people with GAD do not necessarily worry about more serious issues than others; rather, the frequency, duration, and intensity of their worry are elevated. Once worry begins, it is harder to stop, and the mind often shifts into a pattern of anticipating and preparing for imagined negative outcomes. This heightened sensitivity to uncertainty is one of the core features identified across decades of clinical studies.
GAD affects both mind and body. Common symptoms that have been consistently observed in research include:
• persistent tension or muscle tightness
• restlessness or feeling “on edge”
• difficulty concentrating
• sleep disturbances
• irritability
• fatigue
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These symptoms can interfere with daily functioning and may significantly impact quality of life. Many individuals describe feeling mentally overloaded, as if their worry is operating in the background all day, consuming energy and narrowing their ability to be present.
How common is GAD?
Epidemiological studies estimate that about 6–9% of the population will experience GAD at some point in their lives. The condition often follows a long-term pattern, and many people report having been prone to worry since childhood or adolescence. GAD also frequently occurs alongside other psychological difficulties, particularly depression, with some studies indicating co-occurrence rates of up to 90%.
Treatment of anxiety and GAD
In my work with GAD, I draw on two evidence-based approaches: Cognitive Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT). These therapies have been shown to reduce chronic worry, improve daily functioning, and help individuals build a healthier, more flexible relationship with anxiety.
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GAD is maintained by several interconnected processes—persistent worry, difficulty managing uncertainty, avoidance of uncomfortable thoughts or emotions, and a tendency toward self-criticism. Treatment focuses on understanding these patterns and gradually shifting how you respond to them.
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Understanding Your Worry Cycle
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Our first step is to explore how worry operates in your life. Chronic worry often begins quickly, spreads to many topics, and becomes hard to stop. By understanding the triggers and patterns that keep this cycle going, we create a foundation for meaningful change. This process also helps you see anxiety not as a personal failure but as a predictable response that can be worked with and reshaped.
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Using CBT to Break Unhelpful Patterns
CBT offers practical tools that help reduce the intensity and persistence of worry.
What this might include:
• learning ways to respond more flexibly to “what if?” thoughts
• identifying and testing beliefs that give worry its power
• reducing avoidance and behaviours that keep anxiety alive
• building greater tolerance for uncertainty
These strategies help weaken the belief that worry keeps you safe and support a calmer, clearer way of navigating daily challenges.
Using ACT to Change Your Relationship With Anxiety
ACT complements CBT by shifting the way you relate to thoughts, emotions, and bodily sensations.
Core elements include:
1. Acceptance: Making Space for Inner Experience
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People with GAD often struggle against their thoughts and emotions, trying to push them away, argue with them, or control them. ACT teaches a different stance. You learn to allow thoughts, sensations, and emotions to be present without entering a battle with them. This reduces the constant internal struggle that typically amplifies anxiety and makes it feel overwhelming. Acceptance does not mean resignation; it means dropping the fight with your inner world so you can use your energy more constructively.
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2. Cognitive Defusion: Stepping Back From Thoughts
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In chronic anxiety, thoughts can feel fused with reality—“If I think it, it must be true.”
ACT helps you create distance from your thinking so that thoughts are experienced as mental events, not instructions you must obey. This shift softens the power of intrusive worry and helps you respond according to your values, not according to fear-driven predictions. You move from looking out through your thoughts to looking at them with clarity and choice.
3. Being Present: Reconnecting With the Here and Now
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Worry pulls you into imagined futures or rehearsals of past events. Over time, this reduces your ability to notice what is actually happening in the present moment. ACT helps you anchor your attention in the “here and now” with openness and curiosity. This presence strengthens psychological flexibility, allowing you to notice opportunities, resources, and new ways of responding that chronic worry normally blocks.
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4. Self-as-Context: A Stable Perspective of Self
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When anxiety is intense, it is easy to feel defined by your thoughts and emotions. ACT introduces the idea of a broader sense of self, the part of you that observes thoughts and feelings rather than being consumed by them. This stable viewpoint creates a sense of safety and spaciousness. You begin to recognise that you have thoughts and emotions, but you are not reduced to them.
5. Clarifying Values: Identifying What Truly Matters
Chronic worry often pulls people away from the things that give their life meaning. When avoidance becomes a habit, it is easy to lose sight of your deeper priorities. ACT helps you reconnect with the values that matter most to you, your principles, hopes, and ways of living that feel deeply important. Values become a guiding compass, helping to orient your choices beyond anxiety’s demands.
6. Committed Action: Moving Toward a Meaningful Life
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With clarity about your values, therapy focuses on taking practical steps that move you toward them. This might involve setting goals, building new routines, or re-engaging with activities you have withdrawn from due to worry. Even small, steady actions begin to shift your life away from avoidance and toward growth, connection, and meaning.
Why These Processes Matter in GAD
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The six ACT components directly counter the processes that keep GAD in place, experiential avoidance, cognitive fusion, disconnection from the present, rigid self-stories, unclear values, and behavioural avoidance.
By strengthening psychological flexibility, ACT helps you:
• respond to anxiety with compassion instead of self-criticism
• allow thoughts and feelings without getting entangled in them
• reconnect with your life rather than managing threat
• build actions that reflect who you want to be
The aim is not to eliminate worry, but to change your relationship with it so it no longer restricts your life.
Taking the First Step
​Recognizing that you might have an anxiety disorder is an important first step. If anxiety is affecting your relationships, work, school, or overall quality of life, reaching out for professional help can make a real difference. You don't have to struggle alone, and you deserve support in managing these challenging feelings.
Therapy provides a safe, confidential space to understand your anxiety, develop coping strategies, and work toward lasting change. With the right support, you can learn to manage anxiety effectively and reclaim your life from worry and fear.