GAD Generalized Anxiety Disorder Guide Generalized Anxiety Disorder Guide Symptoms & Diagnosis Causes Treatment Living With In Children Understanding Generalized Anxiety Disorder in Children By Keath Low Keath Low Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD. Learn about our editorial process Updated on September 30, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Ann-Louise T. Lockhart, PsyD, ABPP Medically reviewed by Ann-Louise T. Lockhart, PsyD, ABPP Facebook LinkedIn Ann-Louise T. Lockhart, PsyD, ABPP, is a board-certified pediatric psychologist, parent coach, author, speaker, and owner of A New Day Pediatric Psychology, PLLC. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Prevalence Symptoms and Diagnosis Causes and Risk Factors Treatment Coping Skills Tips for Parents and Caregivers Next in Generalized Anxiety Disorder Guide Generalized Anxiety Disorder: Symptoms and DSM-5 Diagnosis A certain amount of anxiety is a normal part of a child’s healthy development. Brief separation anxiety and fears of the dark, strangers, loud noises, or storms are all common worries children may experience as they grow and mature. However, if your child starts to experience more consistent anxiety across a range of topics and areas of their life, such as around school, friends, family, health, and sports, it may be time to consider exploring the possibility of generalized anxiety disorder (GAD). As a parent or caregiver, don't let the possibility alarm you. Once you seek help and receive a diagnosis, you're bringing your child one step closer to an improved quality of life. Verywell / JR Bee Prevalence Approximately 15% to 20% of youth in the general population struggle with anxiety disorders. Among children with ADHD, the rate appears to be even higher. As with adults who experience generalized anxiety disorder, female children are twice as likely as their male peers to be diagnosed with GAD. Because of this, experts recommend routine anxiety screening for girls (and women) over the age of 13. 1:20 Watch Now: 7 Ways to Reduce Your Anxiety Symptoms and Diagnosis Children with generalized anxiety experience excessive, unrealistic worry and fear about everyday things. They often anticipate disaster or worst-case scenarios. They may also experience symptoms such as: Difficulty concentratingDifficulty swallowingFatigueIrritabilityMuscle tensionNeed for frequent urinationRestlessnessSleep difficultiesStomachaches The tension and stress are chronic and debilitating, affecting multiple areas of the child's life. Just getting through the day can be a struggle. A child may recognize their anxiety is exaggerated and still experience great difficulty controlling or managing it. The Diagnostic and Statistical Manual of Mental Disorders (5th edition), often referred to as the DSM-5, outlines specific criteria to be met in order to be properly diagnosed with GAD. For one, symptoms need to be experienced for at least six months in order to be appropriately diagnosed. To make sure that your child is properly diagnosed and cared for most effectively, it is best to have a trained mental health provider to assess your child. There are providers who work specifically with children and adolescents and those who are also trained in working with anxiety disorders. Causes and Risk Factors There is no singular identified cause of generalized anxiety disorder in children or adults. A variety of factors can influence the development and onset of GAD, including genetic predisposition, family dynamics, life experiences, and neurobiological factors. Children who have experienced challenging life situations or maltreatment may be at greater risk for developing GAD. These experiences can leave children feeling uncertain of people and their surroundings, unsafe, and out of control of their environment. It is common for people of all ages who have been through experiences of challenge, loss, humiliation, or abandonment to feel anxious in future situations of uncertainty—children are no different. Puberty can bring on additional stressors and feelings of self-consciousness that can add to feelings of anxiety. Frustrations and repeated difficulties in social relationships and school performance can lead to increased anxiety about being embarrassed in front of peers, as well as fears about letting down parents or teachers. Though these feelings are all normal, if they don't subside with time and, instead, escalate or begin to interfere with your child's daily activities, there may be more cause for concern. Treatment Treatment plans for GAD in children and adolescents are tailored based on their unique situation. There are a variety of options to choose from. Counseling Psychotherapy Psychotherapeutic interventions are important in the treatment of GAD in children and adolescents. Counseling offers children a place to share their worries without fear of judgment, rejection, or feeling dismissed. Through the process, a trained mental health clinician will help your child with things such as: Developing and using relaxation techniques Developing positive self-talk to help reduce anxiety Identifying fears and worries Increasing coping skills like socialization, physical activity, and self-assurance Openly sharing thoughts and feelings As a caregiver, you and your family will likely be asked to participate in your child's treatment. The counseling professional will often use this time to help educate parents about generalized anxiety disorder, suggest helpful techniques, and allow time for the family to process together some of the child's anxious thoughts and feelings in an effective, healthy way. Medication For situations when a child's anxiety is mild to moderate in terms of the severity and the impact the symptoms are having on daily living, medication may not be necessary. When the anxiety symptoms are moderate to severe, however, your provider may begin to educate you and your family about options for medication to help control symptoms. Selective serotonin reuptake inhibitors (SSRIs) tend to be the more commonly prescribed medications prescribed for children and adolescents with anxiety. SSRIs include medications such as: Celexa (citalopram)Lexapro (escitalopram)Prozac (fluoxetine)Zoloft (sertraline) As with all medications, prescriptions used to treat anxiety have risks. Your child's physician or psychiatrist will prescribe them if they believe the benefits outweigh those risks. The Best Online Therapy Programs for Kids Coping Skills There are a variety of coping techniques that children and teens can use to help ease the uncomfortable symptoms of anxiety, socially, behaviorally, and emotionally. Learning what works well for your child is key. You may want to suggest the following ideas and allow your child, depending on age, to choose which ones they would like to try first. Let them know that it is time to explore what works well for them. If a technique doesn't seem to be helping after a period of time, that is OK. Giving them the freedom to let you know what is helping and what doesn't seem to be helping can be beneficial and help to minimize stress. Slowing Down Anxiety keeps us focused on the "what ifs" of the future and can rob us of the opportunity to live in the present. Slowing the process down with intentional and peaceful action can be helpful. There are a variety of mindfulness exercises, prayers, meditations, progressive relaxation, and breathing exercises available that can help slow down your child's anxious thoughts and emotional responses. Social Connection Anxiety can make children and teens want to isolate themselves from peers and family members. Help your child feel safe to connect with others, offering opportunities to be with family and enjoy each other's company by playing games, spending time outdoors together, or finding a common interest or hobby. Volunteering in the community can be another wonderful way to help your child stay connected to others. Allow them to explore and identify something they feel passionate about and help them seek out related opportunities in the community to help. Self-Care Sleep routines, eating habits, and physical activity all contribute to your child's well-being. Your child might struggle in a certain area like sleep or physical activity, especially if they experience restlessness, muscle tension, or fatigue due to their anxiety. Helping your child create a plan of self-care can improve their ability to cope with anxiety and learn to effectively manage stress. Tips for Parents and Caregivers A first step in helping your child manage and overcome anxiety is recognizing it, but this can be difficult. Children struggling with GAD can sometimes be quiet, shy, and cautious. They may be very compliant and eager to please adults. On the other hand, an anxious child may "act out" with tantrums, crying, avoidance, and disobedience. These behaviors may be misinterpreted as oppositional and "difficult" when they are actually anxiety related. As a caregiver, it is important to be aware of some of the ways severe anxiety can show up in children. With an increased understanding of generalized anxiety disorder, you will be better able to intervene early and find the necessary help. Early intervention and treatment can make a world of difference for your child and can prevent further complications around the anxiety. If you have concerns or questions about possible symptoms of generalized anxiety disorder in your child, be sure to talk with your pediatrician or trained mental health professional. If your child is struggling with generalized anxiety disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. Psychiatr Clin North Am. 2009;32(3):483-524. doi:10.1016/j.psc.2009.06.002 Wehry AM, Beesdo-Baum K, Hennelly MM, Connolly SD, Strawn JR. Assessment and treatment of anxiety disorders in children and adolescents. Curr Psychiatry Rep. 2015;17(7):52. doi:10.1007/s11920-015-0591-z Gregory KD, Chelmow D, Nelson HD, et al. Screening for anxiety in adolescent and adult women: A recommendation from the Women's Preventive Services Initiative. Ann Intern Med. 2020. doi:10.7326/M20-0580 Bandelow B, Boerner J R, Kasper S, Linden M, Wittchen HU, Möller HJ. The diagnosis and treatment of generalized anxiety disorder. Dtsch Arztebl Int. 2013;110(17):300–310. doi:10.3238/arztebl.2013.0300 Paus T, Keshavan M, Giedd JN. Why do many psychiatric disorders emerge during adolescence?. Nat Rev Neurosci. 2008;9(12):947–957. doi:10.1038/nrn2513 Bushnell GA, Compton SN, Dusetzina SB, et al. Treating pediatric anxiety: Initial use of SSRIs and other antianxiety prescription medications. J Clin Psychiatry. 2018;79(1):16m11415. doi:10.4088/JCP.16m11415 Cotton S, Kraemer KM, Sears RW, et al. Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial. Early Interv Psychiatry. 2020 Apr;14(2):211-219. doi:10.1111/eip.12848 Additional Reading Connolly SD, Bernstein GA. Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2007 Feb;46(2):267-83. doi:10.1097/01.chi.0000246070.23695.06 Thomas E. Brown, PhD. Attention Deficit Disorder: The Unfocused Mind in Children and Adults. Yale University Press. 2005. Anxiety Disorders Association of America. Understanding Anxiety. By Keath Low Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD. 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