Generalized Anxiety Disorder
What is generalized anxiety disorder in children and teens?
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,
All children and teens have some anxiety. It's a normal part of growing up. But sometimes
worries and fears don’t go away. They may interfere with a child’s normal activities.
In these cases, an anxiety disorder may be present.
What causes GAD in a child or teen?
Experts believe GAD is caused by both biological and environmental factors. A child
may inherit a tendency to be anxious. An imbalance of 2 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.
Which children and teens are at risk for GAD?
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.
What are the symptoms of GAD in a child or teen?
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
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
Refusing to go to school
Frequent stomachaches, headaches, or other physical complaints
Muscle aches or tension
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
his or her healthcare provider for a diagnosis.
How is GAD diagnosed in a child or teen?
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.
How is GAD treated in a child or teen?
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.
How can I help prevent GAD in my child or teen?
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.
How can I help my child or teen live with GAD?
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
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, non-stressful 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
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 should I call my child’s healthcare provider?
Call the healthcare provider right away if your child:
Feels extreme depression, fear, anxiety, or anger toward him or herself 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 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the
If your child is older, make sure they have emergency numbers in their phone. These
would include parents, other trusted adults, the healthcare provider, and the National Suicide Prevention Lifeline at 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 about GAD in children and teens
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
The child may not realize his or her worry is more intense than the situation calls
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
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.
Online Medical Reviewers:
- L Renee Watson MSN RN
- Marianne Fraser MSN RN
- Paul Ballas MD