An uncertain woman looks to the left

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD), a disorder characterized by chronic anxiety and worry, is on the surface a bit meaningless. Everyone feels anxious and worries a lot.

What makes GAD abnormal is both the frequency of anxiety, more days than not, its length – over 6 months – and that the anxiety is pretty severe.

There are many models of how GAD works. Here are three particularly useful ones:


In the avoidance model, anxious thinking is a defensive mechanism. There is a very real problem or potential consequence that could be pretty bad. To avoid thinking about the worst case scenario, sufferers barrage themselves with thoughts to distract from having to deal with “the more emotional topics.”

Treatment: A main strategy for treating the avoidance model of GAD depends on developing the cognitive skills to handle the problems directly. Desensitization, or gradually building tolerance, to the negative thoughts is key.

Another goal is to develop the ability to live in the moment and let things be.

Intolerance of Uncertainty:

In the Intolerance of Uncertainty model, the anxiety develops in response to ambiguous and uncertain situations. Those situations are “stressful and upsetting.” Because problems are over dramatized, normal life upsets can overwhelming.

The worrying becomes self-reinforcing when, anxious about problems, someone doesn’t handle them, which makes it even harder to deal with the next one.

Treatment: Similarly to above, treatment for the intolerance of uncertainty model of GAD focuses on working on internal beliefs that are leading to anxiety. Additionally, problem solving skills should be developed .


In the meta-cognitive model of GAD, anxiety provoking situations produce thoughts of worry, logically enough. Those initial thoughts, called Type 1 Worry, serve both a protective role as well as partly help deal with the problem by coming up with solutions.

In this model, however, the problem arises when the person starts to worry about their worrying. This Type 2 Worrying leads to excessive self-analysis and self-doubt. While the initial worrying was somewhat based off reality, the second wave is less so.

Treatment: Again, focusing on developing appropriate mental strategies for dealing with stress is a solid model.



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