Generalized Anxiety Disorder in Children

Generalized Anxiety Disorder in Children

Generalized anxiety disorder is a mental health disorder. Children with this condition constantly worry about everyday events. Unlike normal anxiety, worry related to GAD is not triggered by a specific event. These worries also do not fade or get better with time. The condition can affect the child’s school performance and his or her ability to participate in some activities. Children with GAD may take studying or practicing to an extreme.

GAD can vary from mild to severe. Children with severe GAD can have intense waves of anxiety with physical symptoms (panic attacks). GAD affects children and teens, and it often begins in childhood.

What are the causes?

The exact cause of GAD is not known.

What increases the risk?

This condition is more likely to develop in:

  • Girls.
  • Children who have a family history of anxiety disorders.
  • Children who are shy.
  • Children who experience very stressful life events, such as the death of a parent.
  • Children who have a very stressful family environment.

What are the signs or symptoms?

Children with GAD often worry excessively about many things in their lives, such as their health and family. They may also be overly concerned about:

  • Academic performance.
  • Doing well in sports.
  • Being on time.
  • Natural disasters.
  • Friendships.

Physical symptoms of GAD include:

  • Fatigue.
  • Muscle tension or having muscle twitches.
  • Trembling or feeling shaky.
  • Being easily startled.
  • Heart pounding or racing.
  • Feeling out of breath or not being able to take a deep breath.
  • Having trouble falling asleep or staying asleep.
  • Sweating.
  • Nausea, diarrhea, or irritable bowel syndrome (IBS).
  • Headaches.
  • Trouble concentrating or remembering facts.
  • Restlessness.
  • Irritability.

How is this diagnosed?

Your child’s health care provider can diagnose GAD based on your child’s symptoms and medical history. Your child will also have a physical exam. The health care provider will ask specific questions about your child’s symptoms, including how severe they are, when they started, and if they come and go. Your child’s health care provider may refer your child to a mental health specialist for further evaluation.

To be diagnosed with GAD, children must have anxiety that:

  • Is out of their control.
  • Affects several different aspects of their life, such as school, sports, and relationships.
  • Causes distress that makes them unable to take part in normal activities.
  • Includes at least one physical symptom of GAD, such as fatigue, trouble concentrating, restlessness, irritability, muscle tension, or sleep problems.

Before your child’s health care provider can confirm a diagnosis of GAD, these symptoms must be present in your child more days than they are not, and they must last for six months or longer.

How is this treated?

Treatment may include:

  • Medicine. Antidepressant medicine is usually prescribed for long-term daily control. Antianxiety medicines may be added in severe cases, especially when panic attacks occur.
  • Talk therapy (psychotherapy). Certain types of talk therapy can be helpful in treating GAD by providing support, education, and guidance. Options include:
    • Cognitive behavioral therapy (CBT). Children learn coping skills and techniques to ease their anxiety. Children learn to identify unrealistic or negative thoughts and behaviors and to replace them with positive ones.
    • Acceptance and commitment therapy (ACT). This treatment teaches children how to be mindful as a way to cope with unwanted thoughts and feelings.
    • Biofeedback. This process trains children to manage their body’s response (physiological response) through breathing techniques and relaxation methods. Children work with a therapist while machines are used to monitor their physical symptoms.
  • Stress management techniques. These include yoga, meditation, and exercise.

A mental health specialist can help determine which treatment is best for your child. Some children see improvement with one type of therapy. However, other children require a combination of therapies.

Follow these instructions at home:

Stress management

  • Have your child practice any stress management or self-calming techniques as taught by your child’s health care provider.
  • Anticipate stressful situations and allow extra time to manage them.
  • Try to maintain a normal routine.
  • Stay calm when your child becomes anxious.

General instructions

  • Listen to your child’s feelings and acknowledge his or her anxiety.
  • Try to be a role model for coping with anxiety in a healthy way. This can help your child learn to do the same.
  • Recognize your child’s accomplishments, even if they are small.
  • Do notpunish your child for setbacks or for not making progress.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.
  • Give your child over-the-counter and prescription medicines only as told by the child’s health care provider.

Contact a health care provider if:

  • Your child’s symptoms do not get better.
  • Your child’s symptoms get worse.
  • Your child has signs of depression, such as:
    • A persistently sad, cranky, or irritable mood.
    • Loss of enjoyment in activities that used to bring him or her joy.
    • Change in weight or eating.
    • Changes in sleeping habits.
    • Avoiding friends or family members.
    • Loss of energy for normal tasks.
    • Feelings of guilt or worthlessness.

Get help right away if:

  • Your child has serious thoughts about hurting him or herself or others.

If your child has serious thoughts about hurting himself or herself or others, or has thoughts about taking his or her own life, get help right away. You can take your child to the nearest emergency department or call.

Summary

  • Generalized anxiety disorder (GAD) is a mental health disorder that involves worry that is not triggered by a specific event.
  • Children with GAD often worry excessively about many things in their lives, such as their health and family.
  • GAD may cause physical symptoms such as restlessness, trouble concentrating, sleep problems, frequent sweating, nausea, diarrhea, headaches, and trembling or muscle twitching.
  • A mental health specialist can help determine which treatment is best for your child. Some children see improvement with one type of therapy. However, other children require a combination of therapies.
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