Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is defined as chronic, excessive worry and fear that seems to have no real cause. Children or adolescents with generalized anxiety disorder often worry a lot about things such as future events, past behaviors, social acceptance, family matters, their personal abilities or school performance.

All children and adolescents experience some anxiety. It is a normal part of growing up. However, when worries and fears do not go away and interfere with a child or adolescent’s usual activities, an anxiety disorder may be present. Children of parents with an anxiety disorder are more likely to develop an anxiety disorder.

What causes generalized anxiety disorder?

Anxiety disorders are believed to have biological, family and environmental factors that contribute to the cause. A chemical imbalance involving two chemicals in the brain (norepinephrine and serotonin) may contribute to the development of anxiety disorders.

While a child or adolescent may have inherited a biological tendency to be anxious, anxiety and fear can also be learned from family members and others who frequently display increased anxiety around the child. For example, a child with a parent who is afraid of thunderstorms may learn to fear thunderstorms. A traumatic experience may also trigger anxiety.

What are the symptoms of generalized anxiety disorder?

Unlike adults with this disorder, children and adolescents usually do not realize that their anxiety is more intense than the situation warrants. Children and adolescents with GAD often require frequent reassurance from the adults in their lives. Anxiety symptoms are present for at least six months about a number of events or activities.

The following are the most common symptoms of GAD in children and adolescents. However, each child may experience symptoms differently.

  • Worrying about things before they happen
  • Worrying about performance or competence at school or in sporting events, perfectionistic and unsure of themselves
  • Constant thoughts and fears about safety of self or parents
  • Refusing to go to school
  • Frequent stomachaches, headaches or other physical complaints
  • Muscle aches or tension
  • Sleep disturbance (difficulty falling or staying asleep)
  • Excessive worry about sleeping away from home
  • Clingy behavior with family members
  • Feeling as though there is a lump in the throat
  • Fatigue
  • Difficulty concentrating or mind going blank
  • Being easily startled
  • Irritability
  • Inability to relax.

The symptoms of GAD in children or adolescents may resemble other medical conditions or psychiatric problems. Always consult your child’s doctor for a diagnosis.

How is generalized anxiety disorder diagnosed?

A child psychiatrist or other qualified mental health professional usually diagnoses anxiety disorders in children or adolescents following a comprehensive evaluation. Parents who note symptoms of severe anxiety in their child or teen can help by seeking an evaluation and treatment as soon as possible. Early treatment may help prevent future problems.

How is generalized anxiety disorder treated?

Anxiety disorders can be effectively treated. Treatment should always be based on a comprehensive evaluation of the child and family, and families play a vital, supportive role in the process.

Treatment recommendations may include cognitive behavioral therapy for the child, with the focus being to help the child or adolescent learn skills to manage his or her anxiety and to help him or her master the situations that contribute to the anxiety. Family therapy and consultation with the child’s school may also be recommended. Therapy might include social skills and relaxation training as well as exposure treatment.

Some children may also benefit from treatment with antidepressant or anti-anxiety medication to help them feel calmer.

How is generalized anxiety disorder prevented?

Measures to prevent generalized anxiety disorders in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the child’s normal growth and development, and improve their quality of life.

Reviewed by Cindy Kim, MD, Aug. 12, 2015.

How to Decrease Performance Anxiety in Young Athletes

Performance anxiety is related to what we know as “stage fright.” This is often used to describe the anxiety, fear, or persistent phobia, which may be induced in an individual by the requirement to perform in front of a crowd. In sports, the worry or fear is directly related to being evaluated about his/her performance in competitive sports. Some people describe it as that moment when the athlete freezes. The fear of failure becomes so overwhelming that the skill level of the athlete appears to diminish because they feel nervous or insecure.

Boy bouncing soccer ball on his knee