How to Spot Generalized Anxiety Disorder in Kids & Teens

Young boy with generalized anxiety disorder
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Generalized anxiety disorder (GAD) and two other anxiety disorders—separation anxiety and social anxiety—are among the most commonly experienced psychiatric problems in youngsters. Similar to adult estimates, girls are about twice as likely as boys to have GAD.

GAD symptoms are distressing and can be impairing not just for the child or teen; the family as a whole (parents and siblings) can be impacted as well.

Studies have shown that early-onset anxiety disorders put children and teens at risk for problems in adulthood (including anxiety, mood, and substance use disorders). The good news in all this is that if detected early, many children and teens will experience a big, if not full, improvement in their symptoms. Early treatment may also prevent the development of other psychiatric problems later.

Signs and Symptoms

GAD presents similarly in children, adolescents, and adults. The main diagnostic differences (i.e., the threshold necessary to meet to receive a formal diagnosis) are (1) that children and teens may worry more about their abilities or the quality of their performance (in school or extracurricular activities, for example) than about a wide range of topics and (2) their anxiety need only be associated with one physical problem.

Additional signs of notable generalized anxiety are:

  • Exaggerated, anxious, difficult-to-control thoughts about real-life issues and persistent worry about catastrophic, unlikely events.
  • Worry that is more about doing things perfectly for its own sake, rather than what others will think. This perfectionism may drive behavior such as excessive studying or extreme practicing (e.g., sports, musical instruments), rigid punctuality.
  • Extreme, repeated reassurance seeking in an attempt to relieve fears. This reassurance, if obtained, is typically insufficient or short-lived and thus the worry persists.
  • Physical complaints such as headaches, stomachaches, tiredness (often due to trouble sleeping).
  • Anxiety can lead to irritability, tantrums, rigidity, or restlessness that is inappropriate for the child’s developmental age.
  • Anxiety can also lead to avoidance.

Just as in adults, in can be difficult to tell how much anxiety is too much. In general, youngsters with GAD experience a lot of worry, more days than not, for months on end. However, even mild symptoms can be worth working on with a child or teen to establish healthy coping strategies for stress (and perhaps even prevent future problems).

Getting Help: First Steps

If you are concerned that your child (of any age) is struggling with an anxiety disorder like GAD, then the first step will be an evaluation with a clinician. In the case of younger children and teens, it will fall on parents to voice concerns with their child’s pediatrician or to set up an appointment with mental health practitioner. This could be a psychiatrist, psychologist, social worker, or mental health counselor.

Seek out a clinician who is experienced in working with younger patients; these specialists are adept in using language your kid will understand, developing a good rapport, and evaluating the developmental (in)appropriateness of specific symptoms.  

As part of an evaluation, the clinician will want to hear from your child and from you. You can prepare for the appointment by jotting down examples of concerning behaviors (especially those that represent a change from how your child typically acts), such as: becoming undone at small or perceived failures (for example, getting a B+ on a quiz), over-studying or over-practicing, avoiding school, and repeatedly seeking reassurance. If your child has verbalized worries, make note of them. Bring your notes with you when you meet with the clinician.

To learn more about specific kid- and teen-friendly treatment options for anxiety, read here

To find a qualified clinician, check out referral resources including Psychology TodayThe Association for Behavioral and Cognitive Therapies, The American Academy of Child and Adolescent Psychiatry, or The Anxiety and Depression Association. Or, speak with your current physician about seeking a psychiatric evaluation with a recommended mental health provider. 

Sources:

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (Fifth edition). Washington, D.C.: American Psychiatric Association; 2013.

Mohatt J, Bennett SM, Walkup JT. Treatment of separation, generalized, and social anxiety disorders in youths. Am J Psychiatry. 2014;171:741-748.

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