Generalized Anxiety Disorder and Treatment Options

Authors

DOI:

https://doi.org/10.64420/ijcp.v3i1.478

Keywords:

Anxiety, Generalized Anxiety Disorder, Treatment

Abstract

Background: Generalised Anxiety Disorder (GAD) is a chronic mental health condition characterised by persistent and excessive worry that lasts for at least six months and interferes with daily functioning. The disorder affects adolescents and adults worldwide and is frequently accompanied by psychological and somatic symptoms such as restlessness, fatigue, sleep disturbance, irritability, and impaired concentration. Because these symptoms often appear in primary health settings, accurate diagnosis remains challenging. Objective: This article reviews the aetiology, clinical characteristics, and current treatment options for GAD, highlighting emerging therapeutic approaches. Method: The study employs a narrative literature review of recent psychological and psychiatric publications on diagnostic criteria, epidemiology, pharmacological management, and cognitive-behavioural interventions. Results: Findings indicate that GAD presents with diverse symptom trajectories across the lifespan and disproportionately affects certain populations, including women and older adults. Evidence also shows that combined pharmacotherapy and cognitive behavioural therapy remains the most effective treatment, while mindfulness-based and integrative therapies demonstrate promising complementary outcomes. Conclusion: Comprehensive and individualised treatment is essential for improving long-term symptom management and quality of life. Contribution: This review synthesizes evidence supporting clinical practice.

References

merican Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders (5th ed., TR). Arlington, VA. https://www.psychiatry.org/psychiatrists/practice/dsm

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., TR). Washington, DC: Author. https://doi.org/10.1176/appi.books.9780890423349

Andreescu, C., & Lee, S. (2020). Anxiety disorders in the elderly. Anxiety disorders: Rethinking and understanding recent discoveries, 561-576. https://doi.org/10.1007/978-981-32-9705-0_28

Ansara, E. D. (2020). Management of treatment-resistant generalized anxiety disorder. The Mental Health Clinician, 10(6), 326–334. https://doi.org/10.9740/mhc.2020.11.326

Ask, H., Cheesman, R., Jami, E. S., Levey, D. F., Purves, K. L., & Weber, H. (2021). Genetic contributions to anxiety disorders: where we are and where we are heading. Psychological medicine, 51(13), 2231-2246. https://doi.org/10.1017/s0033291720005486

Aucoin, M, LaChance, L., van der Wurff, I., McLaren, M., Monteiro, S., Miller, S., Jenkins, A., Sabri, E., & Cooley, K. (2025). Dietary counseling plus omega-3 supplementation in the treatment of generalized anxiety disorder: results of a randomized waitlist controlled pilot trial (the ’EASe-GAD Trial’). Nutritional Neuroscience, 28(6), 635–648. https://doi.org/10.1186/s40814-023-01414-y

Bhattacharya, S., & Hofmann, S. G. (2023). Mindfulness-based interventions for anxiety and depression. Clinics in Integrated Care, 16, 100138. https://doi.org/10.1016/j.intcar.2023.100138

Brennan, W., & Belser, A. B. (2022). Models of psychedelic-assisted psychotherapy: A contemporary assessment and an introduction to EMBARK, a transdiagnostic, trans-drug model. Frontiers in psychology, 13, 866018. https://doi.org/10.3389/fpsyg.2022.866018

Budhwani, H., Hearld, K. R., & Chavez-Yenter, D. (2015). Generalized anxiety disorder in racial and ethnic minorities: a case of nativity and contextual factors. Journal of Affective Disorders, 175, 275-280. https://psycnet.apa.org/doi/10.1016/j.jad.2015.01.035

Cardoner, N., Gutiérrez-Rojas, L., Saiz, P., Lahera, G., Álvarez-Mon, M. Á., Alonso Ortega, P., & Pérez-Páramo, M. (2025). Does pregabalin offer potential as a first-line therapy for generalized anxiety disorder? A meta-analysis of efficacy, safety, and cost-effectiveness. Frontiers in Pharmacology, 16. https://doi.org/10.3389/fphar.2025.1483770

Carl, E., Witcraft, S. M., Kauffman, B. Y., Gillespie, E. M., Becker, E. S., Cuijpers, P., ... & Powers, M. B. (2020). Psychological and pharmacological treatments for generalized anxiety disorder (GAD): a meta-analysis of randomized controlled trials. Cognitive Behaviour Therapy, 49(1), 1-21. https://doi.org/10.1080/16506073.2018.1560358

Chambers, R., Stoliker, D., & Simonsson, O. (2023). Psychedelic-assisted psychotherapy and mindfulness-based cognitive therapy: Potential synergies. Mindfulness, 14(9), 2111-2123. https://doi.org/10.1007/s12671-023-02206-4

Cooper, R. (2026). The conceptual evolution of exclusion rules in the DSM: Problems with determining when one diagnosis should rule out another. Studies in History and Philosophy of Science, 116, 102107. https://doi.org/10.1016/j.shpsa.2025.102107

Curtiss, J., & Klemanski, D. H. (2016). Taxonicity and network structure of Generalized Anxiety Disorder and major depressive disorder: An admixture analysis and complex network analysis. Journal of Affective Disorders, 199, 99–105. https://doi.org/10.1016/j.jad.2016.04.007

de Quevedo J.L, (April 1, 2024). FDA grants breakthrough status to LSD formula and opens a new frontier in the generalized anxiety disorder (GAD) treatment. McGovern Medical School. https://med.uth.edu/psychiatry/2024/04/01/fda-grants-breakthrough-status-to-lsd- formula-and-opens-a-new-frontier-in-the-generalized-anxiety-disorder-gad-treatment/

DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized anxiety disorder. Annals of Internal Medicine, 170(7), ITC49-ITC64. https://doi.org/10.7326/aitc201904020

Dewane, C. (2008). The ABCs of ACT—Acceptance and commitment therapy. Social Work Today, 8(5), 34. https://www.socialworktoday.com/archive/090208p36.shtml

Dong, J., Xiao, T., Xu, Q., Liang, F., Gu, S., Wang, F., & Huang, J. H. (2022). Anxious personality traits: Perspectives from basic emotions and neurotransmitters. Brain Sciences, 12(9), 1141. https://doi.org/10.3390/brainsci12091141

Farhane-Medina, N. Z., Luque, B., Tabernero, C., & Castillo-Mayén, R. (2022). Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review. Science Progress, 105(4), 00368504221135469. https://doi.org/10.1177/00368504221135469

Feske, U., and Shear, M. (1999). Progress in psychosocial assessment and treatment. Depression and Anxiety, 9(1), 32-43. https://pubmed.ncbi.nlm.nih.gov/9989348/

Frala, J., Leen-Feldner, E., Blumenthal, H., and Barreto, C. (2010). Relations among perceived control over anxiety-related events, worry, and generalized anxiety disorder in a sample of adolescents. Journal of Abnormal Child Psychology, 38(2), 237-247. https://doi.org/10.1007/s10802-009-9365-6

Gale, C., and Oakley-Browne, M. (2000). Anxiety disorder. BMJ: British Medical Journal, 321(7270), 1204-1207. Retrieved from Academic Search Premier database. https://doi.org/10.1136/bmj.321.7270.1204

Garakani, A., Freire, R. C., & Murrough, J. W. (2021). Pharmacotherapy of Anxiety Disorders: Promises and Pitfalls. Frontiers in psychiatry, 12, 662963. https://doi.org/10.3389/fpsyt.2021.662963

Graziano, T. A., Fitzgerald, H. N., Ortiz, J., Owen, C. K., & Shook, N. J. (2022). Internalized Phobia, Community Connectedness, Outness, and Mental Health Risk and Protection in LGBTQ Persons. Nursing Research, 10-1097. https://doi.org/10.1097/nnr.0000000000000759

Greifenberger, A., Hill, G., Toumeh, E., Lokuge, S., Fotinos, K., Epstein, I., ... & Katzman, M. A. (2025). Neurobiology of intolerance of uncertainty: A systematic review. Journal of Psychiatry and Psychiatric Disorders, 9(2), 140-154. https://www.doi.org/10.26502/jppd.2572-519X0244

Hantsoo, L., & Epperson, C. N. (2017). Anxiety disorders among women: a female lifespan approach. Focus, 15(2), 162-172. https://doi.org/10.1176/appi.focus.20160042

Hendriks, G. J., Janssen, N., Robertson, L., van Balkom, A. J., van Zelst, W. H., Wolfe, S., ... & Uphoff, E. (2024). Cognitive behavioural therapy and third‐wave approaches for anxiety and related disorders in older people. Cochrane Database of Systematic Reviews, (7). https://doi.org/10.1002/14651858.cd007674.pub3

Hirschtritt, M. E., Olfson, M., & Kroenke, K. (2021). Balancing the Risks and Benefits of Benzodiazepines. JAMA, 325(4), 347–348. https://doi.org/10.1001/jama.2020.22106

Holze, F., Gasser, P., Müller, F., Strebel, M., & Liechti, M. E. (2024). LSD-assisted therapy in patients with anxiety: open-label prospective 12-month follow-up. The British Journal of Psychiatry, 225(3), 362-370. https://doi.org/10.1192/bjp.2024.99

Horenstein, A., & Heimberg, R. G. (2020). Anxiety disorders and healthcare utilization: A systematic review. Clinical Psychology Review, 81 https://doi.org/10.1016/j.cpr.2020.101894

https://childmind.org/article/best-medications-for-kids-anxiety/

https://www.health.harvard.edu/a_to_z/generalized-anxiety-disorder-a-to-z

https://www.therecoveryvillage.com/mental-health/generalized-anxiety- disorder/generalized-anxiety-statistics/

Inserra, A., Piot, A., De Gregorio, D., & Gobbi, G. (2023). Lysergic acid diethylamide (LSD) for the treatment of anxiety disorders: Preclinical and clinical evidence. CNS drugs, 37(9), 733-754. https://doi.org/10.1007/s40263-023-01008-5

Johnco, C. J., Dickson, S. J., & Seaton, A. (2025). A systematic review and meta-analysis of diagnostic remission, treatment response, attrition and relapse following cognitive behavior therapy (CBT), other psychological therapies and pharmacological treatments for anxiety disorders in older adults. The American Journal of Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2025.05.010

Kalin, N. H. (2020). The critical relationship between anxiety and depression. American Journal of Psychiatry, 177(5), 365-367. https://doi.org/10.1176/appi.ajp.2020.20030305

Katzman, M. A. (2009). Current considerations in the treatment of generalized anxiety disorder. CNS Drugs, 23(2), 103-120. https://doi.org/10.2165/00023210-200923020-00002

Kavelaars, R.A., Ward, H., Mackie, D.S., Modi, K.M., & Mohandas, A. (2023). The burden of anxiety among a nationally representative US adult population, Journal of Affective Disorders, 336, 81-91, https://doi.org/10.1016/j.jad.2023.04.069

Kundakovic, M., & Rocks, D. (2022). Sex hormone fluctuation and increased female risk for depression and anxiety disorders: From clinical evidence to molecular mechanisms. Frontiers in neuroendocrinology, 66, 101010. https://doi.org/10.1016/j.yfrne.2022.101010

Lavoie, C., Dufour, M., Berbiche, D., Therriault, D., & Lane, J. (2023). The relationship between problematic internet use and anxiety disorder symptoms in youth: specificity of the type of application and gender. Computers in Human Behavior, 140, 107604. https://doi.org/10.1016/j.chb.2022.107604

LeWine, H.E. (2022). Generalized anxiety disorder. Harvard Health Publishing.

Malbos, E., Chichery, N., Borwell, B., Weindel, G., Molitor, J., Einig-Iscain, M., Seimandi, J., & Lançon, C. (2025). Virtual Reality and Relaxation for the Treatment of Generalized Anxiety Disorder: A Randomized Comparative Study with Standard Intervention. Journal of Clinical Medicine, 14(4), 1351. https://doi.org/10.3390/jcm14041351

Miller, C. (2025). Best anxiety medication for children and teens. Child Mind Institute.

Mishra, A. K., Varma, A. R., & Varma, A. (2023). A comprehensive review of the generalized anxiety disorder. Cureus, 15(9).

Munir S, & Takov V. (2022). Generalized Anxiety Disorder. StatPearls Publishing. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441870/

Newman, M. G., Basterfield, C., Erickson, T. M., Caulley, E., Przeworski, A., & Llera, S. J. (2022). Psychotherapeutic treatments for generalized anxiety disorder: Cognitive and behavioral therapies, enhancement strategies, and emerging efforts. Expert Review of Neurotherapeutics, 22(9), 751–770. https://doi.org/10.1080/14737175.2022.2125800

Newman, M. G., Jacobson, N. C., Zainal, N. H., Shin, K. E., Szkodny, L. E., & Sliwinski, M. J. (2019). The effects of worry in daily life: An ecological momentary assessment study supporting the tenets of the contrast avoidance model. Clinical Psychological Science, 7(4), 794–810. https://doi.org/10.1177/2167702619827019

Patriquin, M. A., & Mathew, S. J. (2017). The neurobiological mechanisms of generalized anxiety disorder and chronic stress. Chronic stress, 1, 2470547017703993. https://doi.org/10.1177/2470547017703993

Paulesu, E., Sambugaro, E., Torti, T., Danelli, L., Ferri, F., Scialfa, G., ... & Sassaroli, S. (2010). Neural correlates of worry in generalized anxiety disorder and in normal controls: a functional MRI study. Psychological medicine, 40(1), 117-124. https://doi.org/10.1017/s0033291709005649

Pauley, D., Cuijpers, P., Papola, D., Miguel, C., & Karyotaki, E. (2023). Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness. Psychological Medicine, 53(2), 567-579. https://doi.org/10.1017/s0033291721001999

Peng, Y. (2024). Impact factors and treatments for generalized anxiety disorder. In SHS Web of Conferences (Vol. 193, p. 03011). EDP Sciences. https://doi.org/10.1051/shsconf/202419303011

Rogers, M. P., Warshaw, M. G., Goisman, R. M., Goldenberg, I., Rodriguez‐Villa, F., Mallya, G., ... & Keller, M. B. (1999). Comparing primary and secondary generalized anxiety disorder in a long‐term naturalistic study of anxiety disorders. Depression and Anxiety, 10(1), 1-7. https://pubmed.ncbi.nlm.nih.gov/10499183/

Romanazzo, S., Mansueto, G., & Cosci, F. (2022). Anxiety in the medically ill: a systematic review of the literature. Frontiers in psychiatry, 13, 873126. https://doi.org/10.3389/fpsyt.2022.873126

Rowa, K., Waechter, S., Hood, H. K., & Antony, M. M. (2017). Generalized anxiety disorder. Psychopathology: History, Diagnosis, and Empirical Foundations, Third Edition, 149-186. https://doi.org/10.1002/9781394258949.ch4

Salcedo, B. (2018). The comorbidity of anxiety and depression. National Alliance on Mental Illness. https://www.nami.org/education/the-comorbidity-of-anxiety-and-depression/

Samaripour, H. (2025). Neurotransmitters and Mental Health: Understanding the Chemical Underpinnings of Psychological Disorders. International Journal of New Chemistry, 12(4), 825-841.

Schlinger, J. (2021). Escape from prefrontal chaos: Mindfulness and the intolerance of uncertainy-anxiety relationship (Doctoral dissertation, Alliant International University).

Schwartz, C. (2024). Generalized anxiety disorder in children. MedlinePlus, National Library of Medicine. https://medlineplus.gov/ency/article/007687.htm

Scott, E., Eng, W., and Heimberg, R. (2002). Ethnic differences in worry in a nonclinical population. Depression and Anxiety, 15(2), 79-82. https://doi.org/10.1002/da.10027

South, S., and Krueger, R. (2008). Marital quality moderates genetic and environmental influences on the internalizing spectrum. Journal of Abnormal Psychology, 117(4), 826- 837. https://doi.org/10.1037/a0013499

Stefan, S., Cristea, I. A., Szentagotai Tatar, A., & David, D. (2019). Cognitive‐behavioral therapy (CBT) for generalized anxiety disorder: Contrasting various CBT approaches in a randomized clinical trial. Journal of clinical psychology, 75(7), 1188-1202. https://doi.org/10.1002/jclp.22779

Stefánsdóttir, Í. H., Ivarsson, T., & Skarphedinsson, G. (2022). Efficacy and safety of serotonin reuptake inhibitors (SSRI) and serotonin noradrenaline reuptake inhibitors (SNRI) for children and adolescents with anxiety disorders: a systematic review and meta-analysis. Nordic Journal of Psychiatry, 77(2), 137–146. https://doi.org/10.1080/08039488.2022.2075460

Stein, D. J. (2021). Evidence-based pharmacotherapy of generalised anxiety disorder: focus on agomelatine. Advances in Therapy, 38(Suppl 2), 52-60. https://doi.org/10.1007/s12325-021-01860-1

Szuhany, K. L., & Simon, N. M. (2022). Anxiety disorders: a review. Jama, 328(24), 2431- 2445. https://doi.org/10.1001/jama.2022.22744

Taher, D., Mahmud, N., & Amin, R. (2015). The effect of stressful life events on generalized anxiety disorder. European Psychiatry, 30(S1), 1-1. https://doi.org/10.1016/S0924-9338(15)30427-2

Torales, J., Torres-Romero, A. D., Ventriglio, A., Castaldelli-Maia, J. M., Caycho-Rodríguez, T., Hualparuca-Olivera, L., ... & O’Higgins, M. (2025). From DSM-IV to the future: three decades of evolution in psychiatric classification and what lies ahead. International Review of Psychiatry, 1-10. https://psycnet.apa.org/doi/10.1080/09540261.2025.2523455

Viskovich, S., & Pakenham, K. I. (2020). Randomized controlled trial of a web‐based Acceptance and Commitment Therapy (ACT) program to promote mental health in university students. Journal of Clinical Psychology, 76(6), 929-951. https://doi.org/10.1002/jclp.22848

Wadsworth, L., Wessman, I., Beard, C., & Bjorgvinsson, T. (2019). Levels of perceived control and treatment response in a brief partial hospital setting. Neurology, Psychiatry and Brain Research, 34, 1–8. https://psycnet.apa.org/doi/10.1016/j.npbr.2019.08.001

Walczak, M., Breinholst, S., Ollendick, T., & Esbjørn, B. H. (2019). Cognitive behavior therapy and metacognitive therapy: Moderators of treatment outcomes for children with generalized anxiety disorder. Child Psychiatry & Human Development, 50(3), 449–458. https://doi.org/10.1007/s10578-018-0853-1

Walkup, J.T., Green, C.M., & Strawn, J.R. (2022) Screening for pediatric anxiety disorders. JAMA, 328(14):1399–1401. doi:10.1001/jama.2022.15224

Wandler, K. (2024). Generalized anxiety disorder statistics. The Recovery Village.

Wang J, Chen Y, Tan C, Zhao X. (2015). Family functioning, social support, and quality of life for patients with anxiety disorder. International Journal of Social Psychiatry,62(1):5- 11. https://doi.org/10.1177/0020764015584649

Weisberg, R. B., Beard, C., Moitra, E., Dyck, I., & Keller, M. B. (2014). Adequacy of treatment received by primary care patients with anxiety disorders. Depression and Anxiety, 31(5), 443-450. https://doi.org/10.1002/da.22209

Wetherell, J., Le Roux, H., and Gatz, M. (2003). DSM-IV criteria for generalized anxiety disorder in older adults: Distinguishing the worried from the well. Psychology and Aging, 18(3), 622-627. https://doi.org/10.1037/0882-7974.18.3.622

Wittchen, H. (2002). Generalized anxiety disorder: prevalence, burden, and cost to society. Depression and Anxiety 16(4), 162-171. doi:10.1002/da.10065. https://doi.org/10.1002/da.10065

Zhang, W., Du, Y., Yang, X., Wang, E., Fang, J., Liu, Z., Wu, S., Liu, Q., & Hu, Y. (2022). Comparative efficacy of face-to-face and internet-based cognitive behavior therapy for generalized anxiety disorder: A meta-analysis of randomized controlled trial. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.832167

Zoberi, K., and Pollard, C. (2010). Treating anxiety without SSRIs. Journal of Family Practice, 59(3), 148-154. https://cdn-uat.mdedge.com/files/s3fs-public/Document/September-2017/5903JFP_Article2.pdf

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2026-03-24

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Scott, D., Bebber, E., Bizoukas, K., Hudgins, T., & Scott, M. (2026). Generalized Anxiety Disorder and Treatment Options. International Journal of Counseling and Psychotherapy, 3(1), 12–25. https://doi.org/10.64420/ijcp.v3i1.478