What is the difference between feeling anxious and having a Generalised Anxiety

Experiencing feelings of anxiety is a common human emotion, but Generalized Anxiety Disorder (GAD) is a clinical diagnosis that signifies persistent and excessive worry about a range of different issues, significantly impacting an individual's functioning ¹. NICE recommends identifying and communicating a GAD diagnosis as early as possible to facilitate understanding and prompt effective treatment ¹. A comprehensive assessment for potential GAD should consider not only the severity and duration of symptoms but also the degree of distress and functional impairment ². For individuals presenting with anxiety or significant worry, particularly those with a chronic physical health problem, seeking reassurance for somatic symptoms, or repeatedly worrying about various issues, GAD should be considered ². The management of GAD follows a stepped-care model, starting with Step 1, which involves identification, assessment, education about GAD, and active monitoring ¹,². Step 2 interventions include low-intensity psychological approaches such as individual non-facilitated self-help, individual guided self-help, or psychoeducational groups, typically offered if symptoms haven't improved after initial assessment and monitoring ¹,². For those with GAD and marked functional impairment, or those whose symptoms haven't improved with Step 2 interventions, Step 3 offers high-intensity psychological interventions like Cognitive Behavioural Therapy (CBT) or applied relaxation, or drug treatment, usually a selective serotonin reuptake inhibitor (SSRI) as first-line ¹,². A meta-analysis supports the efficacy of psychological treatments for GAD, indicating that these interventions can lead to significant improvements [ (Cuijpers et al., 2014) ]. Step 4 is reserved for complex, treatment-refractory GAD with very marked functional impairment or a high risk of self-harm, involving specialist assessment and potentially complex treatment regimens, including combinations of psychological and drug treatments ¹,². It is important to note that while NICE guidelines suggest a structured stepped-care approach, the choice of intervention should be guided by the individual's preference, with no evidence suggesting one modality is inherently more effective than another ¹.