The Difference Between GAD and Social Anxiety Disorder

The Difference Between GAD and Social Anxiety Disorder Social Anxiety Disorder Related Conditions Print The Difference Between GAD and Social Anxiety Disorder Distinguishing Between Common Types of Anxiety Disorders By Deborah R. Glasofer, PhD twitter linkedin Deborah Glasofer, PhD is a professor of clinical psychology and practitioner of cognitive behavioral therapy. Learn about our editorial policy Deborah R. Glasofer, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on January 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on August 22, 2019 Social Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Rosanna U/Getty images In This Article Table of Contents Expand Shared Features Differences in Thinking Behavioral Differences Developmental Issues Co-occurring Conditions View All Though several changes were made in the classification of anxiety disorders with the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders  (DSM-5 for short), social anxiety disorder  (SAD) and generalized 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. Shared Features Both GAD and SAD are characterized by persistent anxiety that is excessive or disproportionate to an actual threat.?? What is meant by threat, however, differs between the two. People with social anxiety disorder sometimes experience physical symptoms associated with their anxiety, as do those with GAD. Biased thinkingâ€"in many cases catastrophizing  (imagining worst-case scenarios)â€"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 post-traumatic stress disorder or obsessive-compulsive disorder. Differences in Thinking Though the types of thought traps can be similar, it is the thought content that distinguishes GAD from social anxiety disorder. People with GAD tend to worry about a range of topics.?? Worries may be about major life issuesâ€"such as health or financesâ€"but they are also 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 young man with GAD may worry uncontrollably about the implications of a fight with his girlfriend. A mother with GAD may be overly concerned with whether or not she made the right decision to have her child switch schools and if her daughter will have a smooth transition. 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. For example, a man with social anxiety disorder may have difficulty starting a conversation at a work happy hour for fear that he will appear anxious, say something stupid, and be ridiculed by his colleagues. A single woman with social anxiety disorder may avoid dating altogether because of anxiety about humiliating or embarrassing herself on a date. A common thread here, again, is a pathological degree of worry that is impacting the individual’s ability to develop or maintain relationships, fulfill basic obligations, and meet his or her personal and professional potential.?? GAD Worry about major life issues as well as minor, day-to-day stresses The average age of onset is 31 SAD Worry about meeting people, being observed, performing in front of others The average age of onset is 13 Differences in Behavior Given that the other components of the anxiety cycleâ€"emotions and thoughtsâ€"overlap, it follows that the behavioral differences between GAD and social anxiety disorder are subtle. Both conditions are characterized by a high degree of avoidance, but the reason underlying the avoidance is likely to be different.?? Let’s say that a man calls in sick on the day of a presentation at work. If this man has GAD, he might be avoiding the meeting out of fear that he has not put enough effort into preparing his talk and he that he will never finish it in time. If this man has social anxiety disorder, he might be avoiding the meeting out of concern that no one will like his ideas or that others might notice if he sweats while he talks. Coping With Social Anxiety When You Have a Work Meeting Developmental Issues 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. The presentation of GAD in older adults (the most common of the anxiety disorders in this age group) is typified by expression of physical symptoms  more readily than psychological symptoms.?? Later in life, people with GAD are more apt to experience uncontrollable worry about the health of family members or their own well-being. How Anxiety Disorders Can Still Develop in Older Adults Do These Problems Co-Occur? 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 is  depression. The Link Between Social Anxiety Disorder and Depression However, a substantial subset of individuals struggles with 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 overlap. Many  medications  are helpful for both problems.  Cognitive behavioral psychotherapy  is the first-line psychotherapy for these conditions. This type of treatment helps the individual to address biases in thinking and to eliminate as much avoidant behavior as possible. A Word From Verywell While GAD and SAD share the symptom of anxiety, they differ in the thought content associated with that anxiety as well as the reasons underlying behaviors caused by the disorder. Both conditions can significantly reduce the quality of life, and its important for people with these conditions to seek out treatment. Both psychotherapy and medications can reduce uncomfortable symptoms and allow people to live their lives as fully as possible.