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, such as:

  • Future events
  • Past behaviors
  • Social acceptance
  • Family matters
  • Their personal abilities
  • School performance

All children and teens have some anxiety. It is 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.

Which children and teens are at risk for GAD?

Children who have parents with an anxiety disorder are more likely to develop 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 usually don’t realize that their anxiety is more intense than the situation calls for. Children and teens with GAD often need frequent reassurance from the adults in their life.

Each child may have different symptoms. But the most common symptoms of GAD are:

  • Many worries about things before they happen
  • Many worries about friends, school, or activities
  • 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
  • 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
  • Irritability
  • Inability to relax

The symptoms of GAD may look 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?

A child psychiatrist or other mental health expert can diagnose GAD. He or she will do a mental health evaluation of your child.

How is GAD treated in a child or teen?

Children and teens with GAD can’t just pull themselves together and get better. 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. A child learns 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 antianxiety 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 involved 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 notice signs of GAD in your child, you can help by seeking an evaluation as soon as possible. Early treatment can ease symptoms and enhance the child’s normal development. It can also improve his or her 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.
  • Reassure your child. With GAD, your child may not realize his or her worry is more intense than the situation calls for. Your child will need more reassurance from you and other adults.
  • Talk with your child’s healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child’s care team will depend on his or her needs and how serious GAD is.
  • Tell others about your child’s GAD. Work with your child’s healthcare provider and school to develop a treatment plan. Remind teachers that your child will need extra reassurance.
  • 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 your 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 seek 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 plan.

Key points about 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.
  • A child with GAD may worry about things such as future events, past behaviors, and family matters.
  • GAD is caused by both biological and environmental factors.
  • A mental health evaluation is needed to diagnose GAD.
  • Treatment includes therapy and medicines.

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.