Generalized Anxiety Disorder (GAD) in Children and Teens
Overview
Generalized anxiety disorder (GAD)
is a mental health problem. A child with GAD has a lot of worry and fear that seems
to
have no real cause. The worry may be more intense than the situation calls for. Children
or teens with GAD often worry about many things, such as:
- Physical appearance
- Future events
- Past behaviors
- Social acceptance
- Family matters
- Failing to meet parents' expectations
- Their personal abilities
- School performance
All children and teens have some
anxiety. It's a normal part of growing up. But sometimes worries and fears don’t go
away
and get worse over time. They may interfere with a child’s normal activities. In these
cases, an anxiety disorder may be present.
Causes
Experts believe GAD is caused by
both biological and environmental factors. A child may inherit a tendency to be anxious.
An imbalance of two chemicals in the brain (norepinephrine and serotonin) most likely
plays a part.
A child can also learn anxiety and
fear from family members and others. For example, a child with a parent who is afraid
of
thunderstorms may learn to fear thunderstorms. A traumatic event may also cause GAD.
This can include things such as the death of a parent, a divorce, or a serious family
accident or illness.
Risk Factors
Children who have parents with an
anxiety disorder are more likely to have GAD. Children who seem more restrained as
toddlers may be at more risk for GAD.
Symptoms
Unlike adults with GAD, children
and teens often don’t realize that their anxiety is more intense than the situation
calls for. Children and teens with GAD often need a lot of reassurance from the adults
in their life.
Symptoms may be a bit different for
each child. But the most common symptoms of GAD are:
- Many worries about things before they
happen
- Many worries about friends, school, or
activities
- Almost constant thoughts and fears
about the child’s safety or the parents’ safety
- Refusal to go to school
- Frequent stomachaches, headaches, or
other physical complaints
- Muscle aches or tension
- Sleep problems
- Lots of worry about sleeping away from
home
- Clingy behavior with family
members
- Feeling as though there is a lump in
the throat
- Extreme tiredness (fatigue)
- Lack of concentration
- Being easily startled
- Being grouchy or irritated
- Inability to relax
The symptoms of GAD may seem like
other health problems. Make sure your child sees their healthcare provider for a
diagnosis.
Diagnosis
Before a mental health referral is
made, your child's healthcare provider will want to rule out any other health problems.
Once this is done, a child psychiatrist or other mental health expert can diagnose
GAD.
They will do a mental health assessment of your child. It may include a complete
emotional and social history, interviews with you and your child, and standardized
testing.
Treatment
Children and teens with GAD can’t
just pull themselves together and get better. They don't choose to act or feel anxious.
They often need treatment. In many cases, treatment is key to recovery. Untreated,
GAD
can get worse or become a long-term problem. Treatment will depend on your child’s
symptoms, age, and general health. It will also depend on how severe the condition
is.
Treatment for GAD may include:
-
Cognitive behavioral therapy. This helps a child learn how
to better manage anxiety. The goal is also to help a child master the situations that
may lead to the anxiety.
-
Medicines. Antidepressant or anti-anxiety medicine may
help some children feel calmer.
-
Family therapy. Parents play a vital role in any
treatment.
-
School input. A child’s school may also be included in
care.
Prevention
Experts don’t know how to prevent
GAD in children. If you see signs of GAD in your child, you can help by getting an
evaluation as soon as possible. Remember that the symptoms are not attention seeking,
but a sign of a serious problem. Early treatment can ease symptoms and enhance your
child’s normal development. It can also improve their quality of life.
Living with
As a parent, you play a key role in
your child’s treatment. Here are things you can do to help:
- Keep all appointments with your
child’s healthcare provider. If medicine is prescribed, make sure it's taken as
directed. Alert your child's provider if there are any signs of side effects.
- Reassure your child. With GAD, your
child may not realize their worry is more intense than the situation calls for. Your
child will need more reassurance from you and other adults.
- Listen to your child. Find out about school, activity on social
media, and relationships. Bullying, both in person and on social media, is a serious
problem many children face. Let your child know that they can talk to you about
anything, especially if they are so anxious or sad that self-harm is being
considered.
- Spend enjoyable, nonstressful time with your child. Go for a
walk, dinner, or out to a movie.
- Talk with your child’s healthcare
provider about other providers who will be included in your child’s care. Your child
may get care from a team that may include counselors, therapists, social workers,
psychologists, teachers, and psychiatrists. Your child’s care team will depend on
their needs and how serious GAD is.
- Tell others about your child’s GAD.
Work with your child’s healthcare provider and school to create a treatment plan.
Remind teachers that your child will need extra reassurance.
-
If GAD greatly interferes with your child’s ability to succeed
in school, they may be eligible for specific protections and reasonable
accommodations under the Americans with Disabilities Act (ADA) or Section 504 of
the Civil Rights Act. Ask your school's principal or your child’s teacher for more
information.
- Reach out for support from local
community services. Being in touch with other parents who have a child with GAD may
be helpful.
When to Call a Healthcare Provider
Call the healthcare provider or
seek medical care right away if your child:
- Feels extreme depression, fear,
anxiety, or anger toward themself or others
- Feels out of control
- Hears voices that others don’t
hear
- Sees things that others don’t see
- Can’t sleep or eat for 3 days in a
row
- Shows behavior that concerns friends,
family, or teachers, and others express concern about this behavior and ask you to
get help
GAD may increase a child’s risk for
suicide. Threats of suicide are a cry for help. Always take such statements, thoughts,
behaviors, or plans very seriously. Any child who expresses thoughts of suicide should
be evaluated right away.
Call
988 in
a crisis
Call or text
988
if your child has thoughts or plans of
harming themself or others and the means to carry out the plan. You will be connected
to trained crisis counselors at the
988 Suicide &
Crisis Lifeline
. An online chat option is also available at
www.suicidepreventionlifeline.org. Lifeline is free and available
24/7.
If your child is older, make sure they have emergency numbers in
their phone. These would include parents, other trusted adults, their healthcare
provider, and the
988 Suicide & Crisis
Lifeline
at
988 or 800-273-TALK (800-273-8255). Help your child understand that reaching
out for help is the most important thing to do if self-harm is being considered.
Key Points
- Generalized anxiety disorder (GAD) is
a serious mental health problem. A child with GAD has a lot of worry and fear that
seems to have no real cause.
- A child with GAD may worry about
things such as future events, past behaviors, and family matters.
- The child may not realize their worry is more intense than the
situation calls for.
- GAD is caused by both biological and
environmental factors.
- A mental health evaluation is needed
to diagnose GAD.
- Treatment includes therapy and
medicines.
- Untreated, chronic anxiety can lead to other serious problems
such as depression, substance abuse, and self-harm.
- Treatment and family involvement can help reduce GAD symptoms
and improve your child's quality of life.
Next Steps
Tips to help you get the most from
a visit to your child’s healthcare provider:
- Know the reason for the visit and what
you want to happen.
- Before your visit, write down
questions you want answered.
- At the visit, write down the name of a
new diagnosis and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects
are.
- Ask if your child’s condition can be
treated in other ways.
- Know why a test or procedure is
recommended and what the results could mean.
- Know what to expect if your child does
not take the medicine or have the test or procedure.
- If your child has a follow-up
appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s
provider after office hours. This is important if your child becomes ill and you have
questions or need advice.