Generalized Anxiety Disorder in Children and Teens

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KEY POINTS

• Generalized anxiety disorder is fears and uncontrollable worries that make your child feel tense and nervous much of the time.
• Treatment may include medicines, therapy, and learning ways to manage stress.

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What is generalized anxiety disorder?

Generalized anxiety disorder (GAD) is a condition in which your child has fears and uncontrollable worries that last for at least 6 months. If your child has GAD, he worries a lot about everyday problems. Your child is tense and nervous much of the time. He worries that something bad is going to happen even when there is little reason to think that way.

GAD can last many years and sometimes an entire lifetime.

What is the cause?

The exact cause of this disorder is not known.

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. Children with this disorder may have too little or too much of some of these chemicals. Anxiety disorders can happen because of brain chemicals, certain genetic factors your child inherits from parents, and life events.
• Generalized anxiety disorder tends to run in families. It is not known if this is caused by genes passed from parent to child. It may also be that parents fear and worry a lot, and children learn this behavior from the parents. A timid or shy child may have a greater chance of developing GAD.
• Stressful life events and situations, such as family conflict, divorce, or serious illness, also play a major part.
• Some medicines can cause anxiety or make it worse. These include asthma medicines, stimulant medicines, and steroids such as prednisone.
• Anxiety is more common if your child has few friends, family, and activities. Poor food choices, lack of daily physical activity, and poor sleep may also make anxiety disorders more likely.

What are the symptoms?

Symptoms include worrying too much about things that your child can’t control. Your child may be short-tempered and unable to focus or concentrate because of the worrying. Physical symptoms may include:

• Muscle tension
• Sleep problems
• Nausea, sweating or shaking
• Having a very fast heartbeat
• Feeling out of breath or like fainting
• Needing to go to the bathroom often

How is it diagnosed?

Your child's healthcare provider or a mental health therapist will ask about the child's symptoms, medical and family history, and any medicines the child is taking. Your child’s provider will check for a medical illness or drug or alcohol problem that could cause the symptoms.

How is it treated?

Cognitive behavior therapy (CBT) is a good way to help your child identify and change views your child has of self, the world, and the future. CBT can make your child aware of unhealthy ways of thinking. It can also help your child learn new thought and behavior patterns even after your child stops going to therapy. It can help your child learn to manage stress and improve self-esteem.

Family therapy may also be helpful. Family therapy treats the whole family rather than just your child. Children often feel supported when parents and siblings attend therapy with them and work as a group.

If your child has severe symptoms, both behavioral therapy and medicine may be best. Several types of medicines can help treat anxiety. Your child’s healthcare provider will work with you and your child to select the best medicine. Your child may need to take more than one type of medicine.

Claims have been made that certain herbal and dietary products help control anxiety symptoms. Supplements are not tested or standardized and may vary in strength and effects. They may have side effects and are not always safe. Talk with your provider before your child tries herbs or dietary supplements.

Learning ways to relax may help. Yoga and meditation may also be helpful. You may want to talk with your child’s healthcare provider about using these methods along with medicines and psychotherapy.

What can I do to help my child?

• Support your child. Let your child talk about the scary feelings if he feels ready. Do not force the issue if your child does not feel like sharing his thoughts. Do not criticize your child for his fears or for acting younger than his age. Let your child know that he is safe and protected. The support and understanding that you provide can help children deal with scary emotions.

  Stay in touch with teachers, babysitters, and other people who care for your child to share information about symptoms your child may be having.

• Help your child learn to manage stress. Teach children and teens to practice deep breathing or other relaxation techniques when feeling stressed. Help your child find ways to relax, for example take up a hobby, play, listen to music, watch movies, or take walks.
• Take care of your child’s health. Make sure your child eats a variety of healthy foods and gets enough sleep and physical activity every day. Teach children and teens to avoid alcohol, caffeine, nicotine, and drugs.
• Check your child’s medicines. To help prevent problems, tell your child’s healthcare provider and pharmacist about all the prescription and nonprescription medicines, natural remedies, vitamins, and supplements your child takes.
• Contact your healthcare provider or therapist if you have any questions or your child’s symptoms seem to be getting worse.

Get emergency care if your child or teen has thoughts of suicide or self-harm, violence, or harming others.

For more information, contact:

• National Institute of Mental Health
  866-615- 6464
  https://www.nimh.nih.gov/index.shtml
• Mental Health America
  800-969-6642
  https://www.mhanational.org