Generalized
Anxiety Disorder
Worry that runs most days, about most things, for six months or more. It's treatable — and treatable without cognitive dulling or dependence, which is a standard worth insisting on rather than a bonus.
What is generalized anxiety disorder?
Generalized anxiety disorder is excessive, hard-to-control worry about multiple areas of life, occurring more days than not for at least six months, with physical symptoms and real functional cost. Escitalopram, paroxetine, venlafaxine XR, and duloxetine carry FDA indications for GAD, and buspirone is a non-controlled option. Dr. Farkas prioritizes strategies that work without causing dependence or cognitive dulling.
GAD is not ordinary worry scaled up. The defining features are duration and breadth: anxiety about a range of everyday concerns, more days than not, for six months or longer, which the person finds difficult to control. It comes with a physical signature — restlessness, muscle tension, fatigue, irritability, poor concentration, and disrupted sleep — and it wears people down gradually enough that many describe themselves as worriers rather than as unwell.
NIMH estimates that 2.7% of U.S. adults had GAD in the past year and 5.7% meet criteria at some point in their lives, with roughly twice the rate in women as in men. Among adults with past-year GAD, about a third experience serious impairment.
The six-month threshold does real diagnostic work. A brutal stretch at work that produces the same symptoms for two months is not GAD, and treating it as though it were means missing an adjustment disorder or a straightforward stress reaction. In the other direction, GAD is routinely mistaken for a personality trait and left untreated for years.
Several conditions produce the same picture and need excluding: hyperthyroidism, arrhythmia, anemia, sleep apnea, caffeine and stimulant load, and substance withdrawal. So do other psychiatric conditions — untreated ADHD, trauma, and bipolar disorder all generate anxiety that responds poorly to anxiolytic treatment alone.
Dr. Farkas brings MD/PhD neuroscience training, NIH research center experience, and board-certified psychiatric practice to that sorting. Her 30–60 minute evaluations establish what's actually present before anything is prescribed for it.
What generalized anxiety looks like
Conditions as classified in the DSM-5-TR, which requires six months or more of symptoms. This page is educational and is not a diagnostic tool.
How Dr. Farkas treats generalized anxiety disorder
Evidence-based, neurobiologically informed, and built to avoid trading one problem for another. The plan follows your diagnosis.
Medications are named here for general educational purposes only and are not recommendations. Prescribing decisions require individual evaluation by a physician.
What to expect from your first appointment
A new patient evaluation with Dr. Farkas runs 30–60 minutes. It covers your psychiatric and medical history, how long the worry has been running and what it attaches to, sleep, caffeine and substance use, every medication tried and how each one went, and where anxiety is costing you something.
You'll leave with a specific diagnosis explained in plain terms, a treatment plan you understand and agree with, and a follow-up already scheduled. Telehealth is available throughout South Carolina and New York. In-person appointments are available at the Bluffton, SC office.
Related Conditions
Call or text 988 (Suicide & Crisis Lifeline). Text HOME to 741741 for the Crisis Text Line. Call 911 or go to your nearest emergency room if you are in immediate danger.
Medical disclaimer: This page is for educational purposes and does not constitute medical advice. No doctor–patient relationship is established through website use. Medications named here are described for general educational purposes only and are not recommendations; prescribing decisions require individual evaluation. Individual results vary; no specific outcome is guaranteed. Telehealth visits are conducted on a HIPAA-compliant platform. Gabriella I. Farkas, MD PhD, is a board-certified psychiatrist licensed in South Carolina and New York.
Ready to stop worrying
about the worrying?
30–60 minutes. A specific diagnosis. Treatment that lowers the anxiety without dulling you or creating a dependence.
Generalized anxiety disorder (GAD) is chronic, excessive worry across multiple domains for six months or more, with somatic symptoms — sleep disruption, muscle tension, restlessness, fatigue, concentration difficulty. First-line pharmacotherapy is SSRI or SNRI; buspirone is a non-sedating adjunct. Dr. Farkas measures response with the GAD-7 and avoids benzodiazepines as chronic treatment.
Key Takeaways
- GAD is excessive, hard-to-control worry about many areas of life, most days for at least six months, with physical symptoms.
- Normal worry is proportionate and situational and doesn't impair daily life.
- SSRIs and SNRIs are first-line, and buspirone is a non-controlled option.
- Benzodiazepines aren't used as first-line ongoing treatment, and the GAD-7 tracks progress at each visit.
Frequently Asked Questions
What's the difference between GAD and normal worry?
GAD worry is excessive, difficult to control, present most days for at least six months, and accompanied by physical symptoms — sleep disruption, muscle tension, restlessness, concentration difficulty — that impair functioning. Normal worry is proportionate, situational, and doesn't drive impairment.
Can I take a benzodiazepine for daily anxiety?
Benzodiazepines are effective for acute anxiety but carry dependence and cognitive risks with chronic use. For persistent GAD, SSRIs, SNRIs, and buspirone are safer long-term. Dr. Farkas uses benzodiazepines sparingly, if at all, and never as first-line chronic treatment.
How is GAD tracked over time?
The GAD-7 is a validated seven-item scale measuring symptom severity. Dr. Farkas administers it at every visit and adjusts treatment based on objective change rather than subjective impression alone.