The Difference Between GAD and Social Anxiety Disorder

Generalized Anxiety Disorder (GAD)	Social Anxiety Disorder (SAD)
Excessive, pervasive worry about various aspects of life	Fear of social scrutiny and embarrassment in social situations
Uncertain future events, daily responsibilities	Social interactions, public speaking, performance situations
Restlessness, muscle tension, fatigue, sleep disturbances	Blushing, trembling, sweating, rapid heartbeat in social situations
Persistent worry, difficulty controlling worry, overthinking	Excessive self-consciousness, fear of being judged or humiliated
Procrastination, avoiding decision-making	Avoiding social situations, social isolation
Multiple areas of life and future events	Social interactions and scrutiny
Persistent worry throughout the day	Situation-specific worry and anticipation
Impairs daily functioning, affects productivity, and relationships	Interferes with forming relationships, academic/work performance

It’s important to note that while there are similarities and differences between SAD and GAD, a comprehensive evaluation by a mental health professional is necessary to accurately diagnose and determine appropriate management strategies based on an individual’s specific signs and experiences.

GAD and SAD at the same time

Commonly, people who have anxiety disorders are likely to present with features of more than one disorder. GAD and SAD may occur together, with many people starting out with GAD and going on to develop social anxiety.

Likewise, someone with SAD may go on to expand their worries to other areas of life and eventually develop signs of GAD.

Having either of these anxiety disorders is also thought to increase the likelihood that someone may experience a depressive episode or other types of anxiety disorders, such as obsessive-compulsive disorder (OCD) or agoraphobia.

If someone has both GAD and SAD, management, such as medications and CBT, can effectively treat both disorders.

Similarities

Shared traits

Both GAD and SAD are anxiety disorders and are characterized by persistent worry that is disproportionate to any actual threat. Those with GAD and SAD experience physical sensations associated with their anxiety.

Their anxiety triggers the fight-or-flight response. It produces many of the same physical sensations associated with being faced with actual danger (e.g., sweating and a fast heartbeat).

Catastrophizing, a cognitive distortion, is central to both GAD and SAD. Catastrophizing is the belief that disaster is imminent when this is highly unlikely.

Those with GAD may catastrophize about their family’s safety, believing that something bad will happen to them. Those with SAD may catastrophize about how bad a presentation will go – believing that they will stumble over their words, forget what to say, and everyone will be negatively judging them.

A study also found that people with GAD and those with SAD are similar in relation to negative feedback. They found that both disorders are associated with high sensitivity to negative feedback and the perspective of negative consequences being a core feature of both (Khdour et al., 2016).

Keeping anxiety going

Those with GAD or SAD may often use avoidance as a coping mechanism meaning they will try to avoid a feared situation as much as possible to reduce their anxiety.

Avoidance can rapidly decrease anxiety but worsen anxiety in the long run. Long-term effects of avoidance can result in an increase in physical sensations, a loss of confidence about coping, and increased use of safety behaviors.

Safety behaviors are another way that people with GAD or SAD can cope with their anxiety. These behaviors include relying on medication, having an exit plan, excessive phone use, or having a person go with them to fearful settings.

Although safety behaviors can help reduce feelings of anxiety, people can become too dependent on them. These behaviors prevent people from challenging themselves to see that the perceived threat is not that threatening.

Avoiding anxiety-provoking situations and using safety behaviors can keep the anxiety going and worsen it, resulting in more avoidance and safety behaviors.

Hence, this is known as the vicious cycle of anxiety, as it will continue for people with GAD or SAD until they take steps to break the cycle.

Similar complications

Mostly due to wanting to avoid situations, people with GAD or SAD may isolate themselves for fear of either social situations or their generalized worries.

Isolating themselves could result in unhappiness with life and potentially lead to other issues, such as depressed feelings.

Those with GAD or SAD may also find it difficult to maintain going to school or work due to their worries. This can negatively impact their academic and occupational outcomes if not treated.

Likewise, those with GAD or SAD may find making and keeping friends hard. Their disorders may also put a strain on their already-established relationships.

Similar causes

There can be some similarities in the possible causes of GAD and SAD. For instance, genetics may play a role in both developments since individuals with immediate family members with an anxiety disorder may be more likely to develop GAD or SAD.

Personality traits can also play a role in developing GAD and SAD. Someone with a timid temperament, pessimistic outlook, or someone who tends to avoid anything dangerous may be more prone to GAD or SAD.

Moreover, those high in the personality trait neuroticism may be more likely to develop an anxiety disorder than those low in neuroticism (Zhang, 2020).

A brain region named the amygdala seems to be a key area in anxiety. The amygdala is a part of the limbic system involved in the processing and regulating of emotions, including fear.

It is thought that people with exaggerated anxiety and fear in certain situations may be caused by a hyperactive amygdala or an issue with the fear network of the brain.

Finally, those with GAD and SAD may have similarities in their past experiences, which may have been a cause for their anxiety disorder. They may have experienced a significant life change or traumatic or negative experiences such as bullying, which could have contributed to their current fears and worries.

Similar management strategies

Both GAD and SAD can be managed similarly. Medications such as antidepressants, beta-blockers, and benzodiazepines have been shown to be effective for both anxiety disorders.

Likewise, therapeutic treatments, especially cognitive behavioral therapy (CBT), may be used for both disorders.

CBT is commonly used to tackle the worrying thoughts and behaviors that accompany these thoughts.

CBT can help challenge people with anxiety and break the vicious cycle which keeps anxiety going.

Differences

Below are some of the main differences between GAD and SAD:

Different thoughts

Although the thought patterns and cognitive distortions can be similar for those with GAD and SAD, the content of the thoughts distinguishes the two conditions.

Those with GAD worry about various topics, from health and finances to relationships. Those with SAD, however, will only have intense fear about social situations such as meeting new people, speaking in front of others, or being observed.

The thoughts of those with SAD typically center around fear of negative evaluation or rejection, usually finding it challenging to begin conversations for fear of being negatively judged.

Social worries are common in those with GAD; however, their focus tends to be ongoing social relationships rather than fear of evaluation.

For instance, someone with GAD may worry uncontrollably about an argument they had with their partner.

Consider the following examples to illustrate the differences in thought content between GAD and SAD:

GAD: “I’m worried I didn’t save enough money to retire comfortably. What if I run out of money and struggle financially?”

SAD: “I’m afraid I’ll stumble over my words when I give this presentation at work. My colleagues will think I’m incompetent.”

Differences in beliefs

Whilst those with GAD and SAD will both have unhelpful beliefs, the types of beliefs they have can differ. For those with SAD, their anxious beliefs will stem from believing there is something wrong within themselves.

In contrast, the anxiety for those with GAD will often stem from the belief that there is something wrong with the world rather than something necessarily being wrong with themselves.

Consider the following examples to illustrate the differences in belief content between GAD and SAD:

GAD: “Unless I keep worrying about my finances, I won’t be adequately prepared if something bad happens.”

SAD: “I’m awkward and weird. If I talk to people, they won’t like me.”

Differences in avoidance

While both GAD and SAD are characterized by a high degree of avoidance, the reason for the avoidance is likely to differ for both.

For example, someone with GAD may avoid attending a work meeting due to worries of not preparing enough and thinking they won’t be able to finish everything in time.

Whereas someone with SAD may avoid work meetings out of fear of being judged by their colleagues and worrying about having nothing to say at the meeting.

Consider the following examples to illustrate the differences in avoidant between GAD and SAD:

GAD: Jane avoided making any major purchases or financial commitments because she worried extensively about debt and managing her money.

SAD: Mark declined invitations to attend office happy hours because he feared embarrassing himself socially around coworkers.

Difference in age of onset

There is a difference in the average age of GAD and SAD development. The average age of onset for SAD is 13 years old, while it is 31 for those with GAD.

That being said, many people with GAD report they experience signs long before they seek treatment so the actual average age of onset may be a lot lower.

Differences in management

Although the therapeutic options for those with GAD and SAD are similar, the focus of the therapy is often different.

Therapy for SAD will often involve challenging the individual’s feelings of being judged and fear of embarrassment in social situations. However, therapy for GAD will focus on controlling an individual’s multiple worries.

What is Generalized Anxiety?

Generalized anxiety disorder (GAD) is a mental health disorder that is characterized by uncontrollable and excessive worries about many different occurrences and situations.

Individuals with GAD may worry about issues such as finances, health, and safety, which is more exaggerated than normal levels of worry.

Those with GAD may often report feeling as if something bad is going to happen and tend to expect disaster. They may not be able to pinpoint the exact reason why they feel tense and find it difficult to calm themselves down when anxious.

“The thoughts and generalized anxiety disorder really shut out other kinds of thoughts and they kind of hijack or take over your brain, and if it gets bad enough, it’s hard to function – it’s hard to work, it’s hard to be with people it’s hard to get out of the house.”

Dr Jennie Byrne, Psychiatrist

GAD Signs

Those who experience GAD often report a combination of psychological and physical traits. These can include, but are not limited to, the following:

• Persistent worry or anxiety surrounding a number of areas.

• Worries are out of proportion to the impact of the events.

• Tendency to overthink plans and solutions to all possible worst-case outcomes.

• Inability to control worries.

• Perceiving a lot of situations as threatening.

• Being unable to relax.

• General feelings of being on edge.

• Avoiding situations where anxiety can worsen.

• Sweating

• Tiredness

• Trouble sleeping

• Nausea

• Stomach aches

• Headaches

• Muscle tension

• Light-headedness

How is GAD diagnosed?

For a diagnosis of GAD to be made, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that worries and anxieties must occur more often than not over a period of at least six months.

The worries must be difficult to control and may easily shift from one topic to another.

There should be at least three physical or cognitive signs to meet a diagnosis, and the anxiety must be severe enough that it may interfere with areas of normal functioning.

What is Social Anxiety?

While it is normal to experience some anxious feelings in certain social situations, for some, these anxious feelings can occur in most or all social situations. They can be so intense that they can affect their lives significantly.

Social anxiety disorder (SAD) is an intense, long-standing, and debilitating fear of social situations.

Those with SAD often fear that they will embarrass themselves or be judged negatively and criticized by others in social situations.

“When people are socially anxious, they feel unsafe and afraid that they’re going to be criticized and make a fool of themselves.”

Dr Ramani, Clinical Psychologist

The anxiety in response to a social situation can occur before, during, or after a social situation, with many experiencing this in all three instances.

SAD can differ in range, with some fearing most social situations, whilst others may experience anxiety in one or two social settings.

Some of the anxiety-provoking settings can include public speaking, one-on-one conversations, parties, phone calls, giving presentations, and initiating and maintaining conversations.

SAD Signs

Those who experience SAD often have a combination of psychological and physical traits. These can include but are not limited to the following:

• Intense anxiety during social situations.

• Worrying about being embarrassed.

• Fear of situations where there is the possibility of being negatively judged.

• Fear of physical sensations such as blushing or sweating.

• Fear of talking to strangers.

• Feeling as if the mind has gone blank.

• Avoiding situations where social anxiety can worsen.

• Sweating

• Rapid heartbeat

• Blushing

• Nausea

• Muscle tension

• Feeling breathless.

How is SAD diagnosed?

The DSM states that SAD is a marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny from others.

The social situations must almost always provoke fear or anxiety, which is out of proportion to the actual threat. Thus, the social situations are either avoided or endured with intense fear or anxiety.

The fear, anxiety, or avoidance must be persistent, typically have lasted for at least six months, and causes clinically significant distress or impairments in social, occupational, or other important areas of functioning.

How to Tell GAD and SAD Apart in Yourself

Do you have trouble determining whether you may have GAD or SAD? Reflecting on the following questions can help identify key differences between the two based on your own experiences:

Ask Yourself:

Content

• What do I worry about most typically – finances, work, relationships or social embarrassment, being judged?

Triggers

• Is my anxiety more constant or tied to specific social situations like gatherings, talks, or meetings?

Physical Signs

• Do I feel general or social anxiety more in my body through symptoms like muscle tension or rapid heart beat?

Thought Patterns

• Do my anxious thoughts center more around something bad happening or around being negatively evaluated?

Avoidance Behavior

• Am I more likely to avoid commitments out of daily worry or social events for fear embarrassment?

Beliefs

• Do I believe something is fundamentally wrong with the world or with myself as the core issue?

Development Factors

• Did symptoms arise for me more in adolescence or young adulthood?

Carefully examining your thought patterns, physical symptoms, behaviors, and what situations tend to prompt anxiety or avoidance can uncover helpful clues if GAD or SAD resonates with your personal experiences more predominantly.

Noticing these distinctions can guide what specialized treatment and self-help strategies may be most effective if you do seek further support.

Recognizing whether generalized worry or social anxiety represent greater daily impairments is an important initial step for safeguarding emotional health over the long run if anxiety feels uncontrolled.

References

Khdour, H. Y., Abushalbaq, O. M., Mughrabi, I. T., Imam, A. F., Gluck, M. A., Herzallah, M. M., & Moustafa, A. A. (2016). Generalized anxiety disorder and social anxiety disorder, but not panic anxiety disorder, are associated with higher sensitivity to learning from negative feedback: behavioral and computational investigation. Frontiers in integrative neuroscience, 10, 20.

Zhang, F. (2020). Neuroticism. The Wiley Encyclopedia of Personality and Individual Differences: Models and Theories, 281-286.)