Generalized Anxiety Disorder (GAD)

What are the symptoms of GAD?

All of us are born with the instinctive “fight or flight” response that helped our ancestors escape predators and other threats. When we are afraid, concerned, or stressed, the part of our brain responsible for the fight or flight response will generate the nervous, fearful sensation we call anxiety. While everyone experiences anxiety at times, children with anxiety disorders contend with excessive worrying that does not subside the way normal anxiety does. Children with generalized anxiety disorder experience excessive and uncontrollable worry about a number of events or activities. They feel anxious in multiple settings and are often unable to “put their worries aside” no matter how hard they try.

Examples of common worries experienced by children with GAD include:

• Future events (“What’s going to happen to me when Mom and Dad die?”)

• Past behaviors and incidents (“I still feel sick when I remember tripping in front of the whole class last year and how everyone laughed at me”)

• Social acceptance (“What if my friends are only pretending to like me?”)

• Family matters ("Now that Kathy’s parents are getting divorced, what if mine do too?”)

• Personal abilities (“Why can’t I climb the rope swing in gym class like everyone else?”)

• Perceived personal shortcomings (“I’m so dumb”)

• School performance (“I’m feeling kind of confused in math class this semester. What if I fail?”)

Children with GAD often worry about the same subjects as children who do not have an anxiety disorder. The difference is that for a child with GAD, there is no “on-off” switch for the worry: it is ever-present and so extreme that it interferes with the child’s ability to relax, concentrate, and enjoy activities.

Symptoms of generalized anxiety disorder can vary. They may include:

• Restlessness or feeling keyed up or on edge

• Apprehensiveness

• Being easily fatigued, especially at the end of the school day

• Irritability

• Trouble sleeping

• Difficulty concentrating or the feeling that your mind "goes blank"

• Difficulty handling uncertainty or indecisiveness

• Expecting the worst, even when there is no apparent reason for concern

Physical signs and symptoms may include:

• Fatigue

• Muscle tension or muscle aches

• Trembling

• Twitching

• Sweating

• Nausea, diarrhea, or irritable bowel syndrome

• Headaches

How is GAD diagnosed?

Generalized anxiety disorder is diagnosed by a mental health clinician who can help determine whether the symptoms your child is experiencing is related to an anxiety disorder or another medical condition. The mental health clinician (such as a child and adolescent psychiatrist, child psychologist, psychiatric social worker, or psychiatric nurse practitioner) will make the diagnosis following a comprehensive assessment, which includes a diagnostic with you and your child. During the assessment, parents are asked to talk about their child’s anxiety symptoms and related behavior. You will also be asked to give an overview of your child’s family history, medical history, social history, and social interactions. Sometimes parent or child questionnaires are used to help clarify the diagnosis.

If my child is diagnosed with GAD, what happens next?

After the comprehensive assessment, a mental health clinician will help explain your child’s condition and answer any questions you or your child may have. The next step is developing a mutually agreed-upon treatment plan that works for you, your child, and your family.

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