Generalized anxiety disorder (GAD)

Generalized anxiety disorder (GAD) is defined as chronic, excessive worry and fear that seems to have no real cause. Children or adolescents with generalized anxiety disorder often worry a lot about things such as future events, past behaviors, social acceptance, family matters, their personal abilities, and school performance.

Causes

Anxiety disorders are believed to have biological, family, and environmental factors that contribute to the cause. A chemical imbalance involving two chemicals in the brain (norepinephrine and serotonin) most likely contributes to the development of anxiety disorders. While a child or adolescent may have inherited a biological tendency to be anxious, anxiety, and fear can also be learned from family members and others who frequently display increased anxiety around the child. For example, a child with a parent who is afraid of thunderstorms may learn to fear thunderstorms. A traumatic experience may also trigger anxiety.

Who is affected

All children and adolescents experience some anxiety. It is a normal part of growing up. However, when worries and fears do not go away and interfere with a child or adolescent's usual activities, an anxiety disorder may be present. Children of parents with an anxiety disorder are more likely to have an anxiety disorder.

Symptoms

Unlike adults with this disorder, children and adolescents usually do not realize that their anxiety is more intense than the situation warrants. Children and adolescents with GAD often require frequent reassurance from the adults in their lives.

The following are the most common symptoms of GAD in children and adolescents. However, each child may experience symptoms differently. Symptoms may include:

• Many worries about things before they happen
• Many worries about friends, school, or activities
• Constant thoughts and fears about safety of self or safety of parents
• Refusing to go to school
• Frequent stomach aches, headaches, or other physical complaints
• Muscle aches or tension
• Sleep disturbance
• Excessive worry about sleeping away from home
• Clingy behavior with family members
• Feeling as though there is a lump in the throat
• Fatigue
• Lack of concentration
• Being easily startled
• Irritability
• Inability to relax

The symptoms of generalized anxiety disorder (GAD) in children or adolescents may resemble other medical conditions or psychiatric problems. Always consult your child's physician for a diagnosis.

Diagnosis

A psychological assessment is usually recommended to diagnose anxiety disorders in children or adolescent, with therapy generally being the first line of treatment. If the patient is in danger due to suicidal thoughts or attempts and/or severe impairment in functioning, then they might need medication first to stabilize them. Parents who note symptoms of severe anxiety in their child or teen can help by seeking an evaluation and treatment early. Early treatment may help prevent future problems.

Treatment:

Specific treatment for generalized anxiety disorder will be determined by your child's physician based on:

• Your child's age, overall health, and medical history
• Extent of your child's symptoms
• Your child's tolerance for specific medications or therapies
• Expectations for the course of the condition
• Your opinion or preference

Anxiety disorders can be effectively treated. Treatment should always be based on a comprehensive evaluation of the child and family. Treatment recommendations may include cognitive behavioral therapy for the child, with the focus being to help the child or adolescent learn skills to manage anxiety and to help master the situations that contribute to the anxiety. Some children may also benefit from treatment with antidepressant or anti-anxiety medication to help them feel calmer. Parents play a vital, supportive role in any treatment process. Family therapy and consultation with the child's school may also be recommended.

Prevention of generalized anxiety disorder:

Preventive measures to reduce the incidence of generalized anxiety disorders in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with anxiety disorders.