Generalized & Social Anxiety

Generalized Anxiety Disorder (GAD) is characterized by excessive and difficult-to-control worry across multiple life domains, not tied to a single trigger. Social Anxiety Disorder (SAD) involves an intense, persistent fear of social or performance situations driven by a dread of being judged, embarrassed, or humiliated.

Diagnosis is clinical, based on a structured interview evaluating symptom pattern, duration, severity, and functional impact. For GAD, worry must occur more days than not for at least six months. SAD centers on marked fear or anxiety about social situations. Clinicians rule out medical contributors like hyperthyroidism and screen for co-occurring depression or ADHD.

Cognitive Behavioral Therapy (CBT) is the most extensively studied psychological treatment. Exposure therapy is particularly important for SAD—graduated behavioral exposure to feared social situations. Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR) also have growing evidence.

SSRIs and SNRIs are the first-line pharmacological options for both conditions. Medications typically require 4–8 weeks to show a meaningful effect and are generally continued for 12 months or longer given their chronic nature. Buspirone is an FDA-approved, non-habit-forming alternative used for GAD.