Understanding Generalized Anxiety Disorder in Children

Understanding Generalized Anxiety Disorder in Children GAD Print Understanding Generalized Anxiety Disorder in Children 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. Learn about our editorial policy Keath Low Medically reviewed by Medically reviewed by Steven Gans, MD on July 08, 2018 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on October 01, 2019 Generalized Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children In This Article Table of Contents Expand Prevalence Symptoms and Diagnosis Causes and Risk Factors Treatment Coping Skills Tips for Parents/Caregivers View All A certain amount of anxiety is a normal part of a child’s healthy development. Brief separation anxiety, 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 if they struggle with Generalized Anxiety Disorder (GAD).?? As a parent or caregiver, dont let the possibility alarm you. Once you seek help, and if appropriate receive a diagnosis, youre bringing your child one step closer to an improved quality of life. Verywell / JR Bee Prevalence Approximately 15-20% 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. 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 restlessness, difficulty concentrating, irritability, muscle tension, fatigue, difficulty swallowing, a need for frequent urination, stomach aches, and sleep difficulties.?? The tension and stress are chronic and debilitating, affecting multiple areas of the childs 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 (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 and 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 dont subside with time and, instead, escalate or begin to interfere with your childs 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: Openly sharing thoughts and feelingsIdentifying fears and worriesDeveloping positive self-talk to help reduce anxietyIncreasing coping skills like socialization, physical activity, and self-assuranceDeveloping and using relaxation techniques As a caregiver, you and your family will likely be asked to participate in your childs treatment. The counseling professional will often use this time to help educate parents about generalized anxiety disorder, suggest helpful techniques and to allow time for the family to process together some of the childs anxious thoughts and feelings in an effective, healthy way. Medication For situations when a childs 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, your provider may begin to educate you and your family about options for medication to help control symptoms.?? Selective serotonin reuptake inhibitors, also referred to as SSRIs, tend to be the more commonly prescribed medications prescribed for children and adolescents with anxiety. SSRIs include medications such as: Prozac (fluoxetine)Celexa (citalopram)Zoloft (sertraline)Lexapro (escitalopram) As with all medications, prescriptions used to treat anxiety have risks. Your childs physician or psychiatrist will prescribe them if they believe the benefits outweigh those risks. The 9 Best Online Therapy Programs 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 doesnt seem to be helping after a period of time, that is okay. Giving them the freedom to let you know what is helping and what doesnt seem to be helping can be beneficial and help to minimize stress. Slowing Down Mindfulness, prayer, relaxation, and breathing exercises are all practices that can help slow down your childs anxious thoughts and emotional responses.?? 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. Social Connection Anxiety can make children and teens want to isolate from peers and family members. Help your child feel safe to connect with others, offering opportunities to be with family and enjoy each others 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 childs 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/Caregivers A first step in helping your child manage and overcome anxiety is recognizing it and sometimes 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 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.