Generalized Anxiety Disorder: Symptoms, Causes, and Effective Treatment Strategies

Michal (not her real name) came to her first session accompanied by her husband. From the moment she sat down, I could sense her discomfort. She shifted constantly in her seat, her facial expression was tense, and she whispered to her husband to sit close to her and not move away. Right at the beginning of the session, she told me she didn’t believe she could ever get out of the state she was in.

When I asked her why she had come to therapy, she began listing her fears, and even before she finished, I understood exactly what she was experiencing: Generalized Anxiety Disorder (GAD).

Throughout the session, she described not only a long list of fears but also persistent negative thoughts. She summed it up by saying: “I don’t feel alive at all.” After asking her a few more questions, I was able to identify the categories of her anxiety:

1. Financial instability

2. Illness

3. Fear of the dark

4. Anxiety over possible future disasters

5. Unexplainable, vague fears

What is Generalized Anxiety Disorder (GAD)?

Contrary to popular belief, anxiety doesn’t always stem from a specific trigger. It can be a response to a stressful thought, but it can also arise without warning, seemingly out of nowhere.

People with anxiety often worry not only about current events but also about future panic attacks. They go to great lengths to avoid repeating the overwhelming sensations they’ve experienced during an anxiety episode. However, the more they try to avoid it, the more they unintentionally tell their brain that danger is near.

For example, if someone previously experienced dizziness or weakness, their brain sends a warning: “Watch out! Don’t feel dizzy again!” This creates a thought: “If I’m afraid of getting dizzy, I probably will,” and that’s exactly what happens- the dizziness returns.

The Impact of Anxiety

People living with anxiety often experience a decline in their overall quality of life. It affects nearly every area including personal well-being, relationships, family life, work, and even social situations.

It is therefore extremely important not to ignore anxiety. The sooner it’s addressed, the better. This applies not only to GAD, but to all forms of anxiety.

Michal's Story: Living in Fear of Life Itself

Michal, who was diagnosed with GAD, saw the world as a dangerous place. Every time she watched the news or read a newspaper, she immediately internalized the negative stories.

If she read about a woman who was diagnosed with cancer, she would begin fearing that she too would develop the same illness. If she saw a film about someone suffering from chronic joint pain, she would soon feel pain in her own knees.

Over time, she started avoiding any exposure to content or situations that might trigger anxiety. She stopped watching the news, quit reading newspapers, and would interrupt anyone who began speaking about upsetting topics.

At first glance, this might seem like a workable solution, but avoidance doesn’t eliminate anxiety. In fact, it makes it worse. Without proper treatment, anxiety doesn't just linger- it grows.

Physical and Emotional Symptoms of GAD

Physical symptoms may include:

• Rapid heart rate

• Fatigue

• Hot flashes

• Shortness of breath

• Dizziness

• In severe cases: dissociation, fear of death, or a looming sense of catastrophe

Emotional symptoms often include:

• Persistent thoughts that something terrible is about to happen

• Health anxiety: “What if this pain is something serious?”

• A constant sense of danger or threat

How Do You Treat GAD?

In my work with Michal, we used Cognitive Behavioral Therapy (CBT) along with Acceptance and Commitment Therapy (ACT).

We didn’t only treat the surface-level symptoms of fear and panic, but went deeper to uncover the emotional roots of her anxiety. This is where the real transformation happened.

After about six months of therapy, Michal became a freer, more resilient version of herself. It wouldn’t be accurate to say her anxiety disappeared entirely, but the frequency and intensity of her symptoms were drastically reduced. Most importantly, Michal gained the tools to manage her anxiety and no longer fears the symptoms themselves.

Anat Doron is a psychotherapist and a therapist.