The Difference Between GAD and Social Anxiety Disorder

Table of ContentsView AllTable of ContentsShared Features of GAD and SADDifferences Between SAD and GADDevelopmental IssuesCo-Occurring Conditions

Table of ContentsView All

View All

Table of Contents

Shared Features of GAD and SAD

Differences Between SAD and GAD

Developmental Issues

Co-Occurring Conditions

Though several changes were made in the classification of anxiety disorders with the publication of the fifth edition of theDiagnostic and Statistical Manual of Mental Disorders(DSM-5for short),social anxiety disorder(SAD) andgeneralized anxiety disorder(GAD) continue to coexist within the same diagnostic category. Yet even though they share some features, GAD and SAD (sometimes called social phobia) are distinct problems.

People with SAD sometimes experiencephysical symptomsassociated with their anxiety, as do those with GAD. Biased thinking—in many casescatastrophizing(imagining worst-case scenarios)—is central to both types of anxiety disorders as well.

GAD and SAD may also occur together, and having either of these conditions increases the likelihood that a person may experience depression or other anxiety disorders such as obsessive-compulsive disorder.

Though the types of thought traps can be similar, it is thethought contentthat distinguishes GAD from SAD.

People with GAD tend to worry about a range of topics.Worries may be about major life issues—such as health or finances—but they might also be about many minor, day-to-day stresses that others would tend not to perceive as intensely.

Social worries are not uncommon in those with GAD. However, their focus tends to be about ongoing relationships rather than on fear of evaluation. For example, a person with GAD may worry uncontrollably about the implications of a fight with their girlfriend. A mother with GAD may be overly concerned with whether she made the right decision to have her child switch schools.

People with social anxiety disorder, on the other hand, tend to worry about meeting new people, being observed, and performing in front of others (for example, speaking up in class or playing an instrument in a band). Their thought content typically centers on negative evaluation and possibly rejection.

A common thread here, again, is apathological degree of worrythat is impacting the individual’s ability to develop or maintain relationships, fulfill basic obligations, and meet their personal and professional potential.

GADExperience physical symptomsWorry about major life issues as well as minor, day-to-day stressesExhibit avoidance behaviorsAverage age of onset is 31SADExperience physical symptomsWorry about meeting people, being observed, performing in front of othersExhibit avoidance behaviorsAverage age of onset is 13

GADExperience physical symptomsWorry about major life issues as well as minor, day-to-day stressesExhibit avoidance behaviorsAverage age of onset is 31

Experience physical symptoms

Worry about major life issues as well as minor, day-to-day stresses

Exhibit avoidance behaviors

Average age of onset is 31

SADExperience physical symptomsWorry about meeting people, being observed, performing in front of othersExhibit avoidance behaviorsAverage age of onset is 13

Worry about meeting people, being observed, performing in front of others

Average age of onset is 13

Let’s say that a person calls in sick on the day of a presentation at work. If this person has GAD, they might be avoiding the meeting out of fear that they have not put enough effort into preparing their talk and that they will never finish it in time. If this person has SAD, they might be avoiding the meeting out of concern that no one will like their ideas or that others might notice if they sweat while they talk.

Coping With Social Anxiety When You Have a Work Meeting

The average age of onset is later for GAD than social anxiety disorder, age 31 for the former and age 13 for the latter. That said, those with GAD often have symptoms long before they seek treatment.

The stressors of adolescence and early adulthood, when people are typically experiencing many social transitions (for example, schools, friendships, or romantic relationships), may exacerbate social anxiety symptoms. The responsibilities of adulthood (for example, finances, parenting, or career decisions) can amplify GAD symptoms.

In older individuals, the content of worry and associated behaviors may change slightly. For example, older people with social anxiety disorder may experience anxiety and embarrassment about appearance or an impairment (for example, poor hearing or tremulous movements) that leads them to avoid or severely minimize social interactions.

Understanding Anxiety Disorders

It is not uncommon for individuals with GAD to meet criteria for another psychiatric diagnosis in the course of their lifetime, or even simultaneously. The most commonly co-occurring problem isdepression.

Comorbidities in Mental Health

However, a substantial subset of people experience co-occurring GAD and social anxiety disorder.GAD and post-traumatic stress disorder (PTSD)also commonly occur together.

Fortunately, the treatments for GAD and social anxiety disorder also overlap. Manymedicationsare helpful for both problems.Cognitive behavioral psychotherapyis the first-line psychotherapy for these conditions. This type of treatment helps the individual to address biases in thinking and to eliminate as muchavoidant behavioras possible.

A Word From Verywell

6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bystritsky A, Khalsa SS, Cameron ME, Schiffman J.Current diagnosis and treatment of anxiety disorders.P T. 2013;38(1):30–57.Hirsch CR, Mathews A, Lequertier B, Perman G, Hayes S.Characteristics of worry in generalized anxiety disorder.J Behav Ther Exp Psychiatry. 2013;44(4):388–395. doi:10.1016/j.jbtep.2013.03.004Grupe DW, Nitschke JB.Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective.Nat Rev Neurosci. 2013;14(7):488–501. doi:10.1038/nrn3524Kessler RC, Ruscio AM, Shear K, Wittchen HU.Epidemiology of anxiety disorders.Curr Top Behav Neurosci.2010;2:21-35.Flint AJ.Generalised anxiety disorder in elderly patients: Epidemiology, diagnosis and treatment options.Drugs Aging.2005;22(2):101-14. doi;10.2165/00002512-200522020-00002Michopoulos V, Powers A, Gillespie CF, Ressler KJ, Jovanovic T.Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond.Neuropsychopharmacology. 2017;42(1):254–270. doi:10.1038/npp.2016.146Additional ReadingAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(Fifth Edition). American Psychiatric Association; 2013.Castonguay L, Oltmans T (eds).Generalized Anxiety Disorder. Guilford Press, 2013.Ruscio AM, Hallion LS, Lim CCW, et al.Cross-sectional comparison of the epidemiology of DSM-5 generalized anxiety disorder across the globe.JAMA Psychiatry. 2017;74(5):465-475. doi:10.1001/jamapsychiatry.2017.0056

6 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bystritsky A, Khalsa SS, Cameron ME, Schiffman J.Current diagnosis and treatment of anxiety disorders.P T. 2013;38(1):30–57.Hirsch CR, Mathews A, Lequertier B, Perman G, Hayes S.Characteristics of worry in generalized anxiety disorder.J Behav Ther Exp Psychiatry. 2013;44(4):388–395. doi:10.1016/j.jbtep.2013.03.004Grupe DW, Nitschke JB.Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective.Nat Rev Neurosci. 2013;14(7):488–501. doi:10.1038/nrn3524Kessler RC, Ruscio AM, Shear K, Wittchen HU.Epidemiology of anxiety disorders.Curr Top Behav Neurosci.2010;2:21-35.Flint AJ.Generalised anxiety disorder in elderly patients: Epidemiology, diagnosis and treatment options.Drugs Aging.2005;22(2):101-14. doi;10.2165/00002512-200522020-00002Michopoulos V, Powers A, Gillespie CF, Ressler KJ, Jovanovic T.Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond.Neuropsychopharmacology. 2017;42(1):254–270. doi:10.1038/npp.2016.146Additional ReadingAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(Fifth Edition). American Psychiatric Association; 2013.Castonguay L, Oltmans T (eds).Generalized Anxiety Disorder. Guilford Press, 2013.Ruscio AM, Hallion LS, Lim CCW, et al.Cross-sectional comparison of the epidemiology of DSM-5 generalized anxiety disorder across the globe.JAMA Psychiatry. 2017;74(5):465-475. doi:10.1001/jamapsychiatry.2017.0056

Bystritsky A, Khalsa SS, Cameron ME, Schiffman J.Current diagnosis and treatment of anxiety disorders.P T. 2013;38(1):30–57.Hirsch CR, Mathews A, Lequertier B, Perman G, Hayes S.Characteristics of worry in generalized anxiety disorder.J Behav Ther Exp Psychiatry. 2013;44(4):388–395. doi:10.1016/j.jbtep.2013.03.004Grupe DW, Nitschke JB.Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective.Nat Rev Neurosci. 2013;14(7):488–501. doi:10.1038/nrn3524Kessler RC, Ruscio AM, Shear K, Wittchen HU.Epidemiology of anxiety disorders.Curr Top Behav Neurosci.2010;2:21-35.Flint AJ.Generalised anxiety disorder in elderly patients: Epidemiology, diagnosis and treatment options.Drugs Aging.2005;22(2):101-14. doi;10.2165/00002512-200522020-00002Michopoulos V, Powers A, Gillespie CF, Ressler KJ, Jovanovic T.Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond.Neuropsychopharmacology. 2017;42(1):254–270. doi:10.1038/npp.2016.146

Bystritsky A, Khalsa SS, Cameron ME, Schiffman J.Current diagnosis and treatment of anxiety disorders.P T. 2013;38(1):30–57.

Hirsch CR, Mathews A, Lequertier B, Perman G, Hayes S.Characteristics of worry in generalized anxiety disorder.J Behav Ther Exp Psychiatry. 2013;44(4):388–395. doi:10.1016/j.jbtep.2013.03.004

Grupe DW, Nitschke JB.Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective.Nat Rev Neurosci. 2013;14(7):488–501. doi:10.1038/nrn3524

Kessler RC, Ruscio AM, Shear K, Wittchen HU.Epidemiology of anxiety disorders.Curr Top Behav Neurosci.2010;2:21-35.

Flint AJ.Generalised anxiety disorder in elderly patients: Epidemiology, diagnosis and treatment options.Drugs Aging.2005;22(2):101-14. doi;10.2165/00002512-200522020-00002

Michopoulos V, Powers A, Gillespie CF, Ressler KJ, Jovanovic T.Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond.Neuropsychopharmacology. 2017;42(1):254–270. doi:10.1038/npp.2016.146

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(Fifth Edition). American Psychiatric Association; 2013.Castonguay L, Oltmans T (eds).Generalized Anxiety Disorder. Guilford Press, 2013.Ruscio AM, Hallion LS, Lim CCW, et al.Cross-sectional comparison of the epidemiology of DSM-5 generalized anxiety disorder across the globe.JAMA Psychiatry. 2017;74(5):465-475. doi:10.1001/jamapsychiatry.2017.0056

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(Fifth Edition). American Psychiatric Association; 2013.

Castonguay L, Oltmans T (eds).Generalized Anxiety Disorder. Guilford Press, 2013.

Ruscio AM, Hallion LS, Lim CCW, et al.Cross-sectional comparison of the epidemiology of DSM-5 generalized anxiety disorder across the globe.JAMA Psychiatry. 2017;74(5):465-475. doi:10.1001/jamapsychiatry.2017.0056

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