Anxiety and COVID

Generalized Anxiety Disorder in Children and Teens

What is Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is defined as chronic, excessive worry and fear that seems to have no real cause. Children or teens 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 teens 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 in Children?

Anxiety disorders are believed to be caused by biological, family and environmental factors. 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 generalized anxiety disorder in children and teens; 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.

Generalized anxiety symptoms 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.

Generalized Anxiety Disorder Treatment?

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.

Generalized anxiety 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.

Intensive Outpatient Therapy Program for Teens

Three teens looking seriousCHOC offers teenagers experiencing symptoms of a mental health condition a new source of hope in a validating, supportive environment staffed by experts in adolescent mental health. The Intensive Outpatient Therapy Program for teens at CHOC brings solutions to teens and their families who show moderate to severe symptoms of anxiety, depression or other mental health problems.

High-school aged teens attend after-school programming for three hours a day, four days a week in sessions that span eight weeks total. Get more information about the CHOC mental health Intensive Outpatient Program.

What to do if your child experiences depression or anxiety during COVID-19

These past months have been challenging for so many children, adolescents and their families. The pressures of a pandemic, economic disruptions and many other uncertainties have increased feelings of anxiety and depression in many people.

Below are activities and other strategies to help lift the mood of children and adolescents – and may work for parents, too. Continue to follow CHOC for more ways to manage feelings of depression, including a wide variety of suggestions as different activities may work for different children.

While these can be helpful for milder feelings of depression, if your child has persistent feelings of depression for most days over two weeks, and is having trouble with sleep, eating, ongoing fatigue or loss of interest in fun activities, please seek out the assistance of a mental health provider or your pediatrician. If your child (or you) have ongoing thoughts of hurting themselves, please seek help immediately by calling the mobile CAT team (1-866-830-6011), call 911 or proceed to the nearest emergency department. You can also contact the California Youth Crisis Hotline (1-800-843-5200) or Suicide Prevention Center (1-800-784-2433).

What is Performance Anxiety?

Performance anxiety is related to what we know as “stage fright” and is a type of general anxiety disorder that tends to appear once a young athlete is old enough to begin comparing their skills to others. This is often used to describe the anxiety or fear caused by performing in front of a crowd. In sports, the worry is directly related to being evaluated. The fear of failure becomes so overwhelming that the skill level of the athlete appears to diminish because they feel nervous or insecure. It can be overwhelming for kids and their parents to know how to manage performance anxiety.

Boy bouncing soccer ball on his knee