Generalized Anxiety Disorder (GAD) is an anxiety disorder. Children and teens with GAD worry excessively and uncontrollably about daily life events.
- Although younger children can show signs of excessive worry, children usually develop GAD at about 12 years old.
- Girls are more likely to have GAD than boys. In fact, 2 out of every 3 children with GAD are girls.
- Almost half of children with an anxiety disorder will continue to suffer from an anxiety problem when they are adults.
- Many children with GAD also have other anxiety problems. The most common problems are social anxiety, depression, separation anxiety, and attention-deficit hyperactivity disorder (ADHD).
The Story of 9-year-old Jasmine
Jasmine is a 9-year-old girl who has always been sensitive and caring, and who worries about the health and happiness of everyone around her. For example, her mother says that Jasmine worries about bringing the perfect gift to a friend's birthday party or whether the cat has enough drinking water for the day. Over the past several months, Jasmine has been having terrible stomachaches in the morning, and sometimes vomits before going to school. She begs her mom not to send her to school because she says she is afraid something badwill happen. Her mom says that although Jasmine is very friendly, she has few friends. Jasmine refuses to go to sleepovers at other kids' houses, and won't even visit or play with other children unless her mom is there. She doesn't like leaving the house alone because she worries that she might get into an accident on her bike, get hit by a car, or be attacked by a stranger.
The Story of 17-year-old Mitchell
Mitchell is a 17-year-old boy. His school counsellor says he used to be a good student, but over the past year his grades have dropped and he often skips classes. Mitchell is very withdrawn. He avoids friends and family, and tends to stay home alone in his room. He states he is very anxious whenever he is at school, and he worries a lot about what others think of him - whether he is wearing the right clothes, or if he will give the correct answers in class. Mitchell also worries a lot at home, especially when he watches the news and hears about crime in the city. He worries about his own and his family's safety, and tries to deal with his anxiety by avoiding the news and newspapers. He also tries to avoid being around others, including his friends at school. Mitchell often has muscle cramps in his neck and shoulders, and he has difficulty paying attention in class. He also doesn't sleep well, usually just 'tossing and turning' throughout the. He worries a lot about his future - whether he will ever have a girlfriend or a job.
What does "Worry" Look Like?
Worry involves thoughts about negative events that might happen in the future, and usually begins as a "what if" question:
- What if I fail my exam? I might have to repeat my grade; all of my friends will make fun of me; I'll have to get new friends. I might not get into university because I repeated a school year; I'll be a failure!
- What if I make a mistake on my homework? The teacher might be upset and tell me I did a bad job. What if she talks about my mistake in class? What if the other kids laugh at me?
What is "Excessive and Uncontrollable" Worry?
Obviously, everybody worries from time to time. This is normal. Worry becomes a problem when it is "excessive" and "uncontrollable". That is, your child might have GAD if he or she is worrying more than others would, and if he or she cannot stop worrying once it has started. The following questions can help to determine whether worry has become a problem:
- Is my child worrying more than most children the same age?
- Does my child worry even when everything is OK? (for example, worrying about mom and dad getting sick when everyone is healthy)
What are the Worries About?
For the most part, children and teens with GAD worry about the same things that their peers worry about - they just worry more and more often. Some common GAD worries include:
Worries about health
- "What if I catch cold and get sick?"
- "What if my mom gets cancer?"
Worries about school
- "What if I failed my test?"
- "What if I forget what I'm supposed to say during my presentation today?"
- "What if I don't get into university after high school?"
Worries about personal harm
- "What if a bad man breaks into the house and hurts everyone?
- "What if I get kidnapped when I leave school?"
Worries about disasters
- "What if there was an earthquake and the house got destroyed?
- "What if the ozone layer keeps getting thinner?"
Worries about minor matters
- "What if my pants don't match with my shoes?"
- "What if my book is past due at the library and I'm not allowed to borrow any more books?"
Physical Symptoms of GAD
Because of their worries, children and teens with GAD can experience many of the physical symptoms associated with anxiety, such as:
- fidgety, restlessness, unable to sit still
- irritable; getting easily upset, snapping at people, having frequent temper tantrums
- sleep problems: your child might either have difficulty falling asleep or staying asleep (child might wake up several times every night)
- difficulty paying attention or concentrating
- muscle pains (often in the neck and shoulders)
- headaches, stomach aches
How Else can I Determine if my Child might have GAD?
Another way to recognize GAD in your child is to consider how long your child has been anxious and worrying excessively:
- It is normal for children to have times in their lives when they worry, especially when there has been a major change or stressor, such as moving, changing schools, the death of a loved one, or parental divorce.
- For a child to have GAD, he or she needs to be worrying excessively almost every day for at least 6 months.
Tip For Parents:
Before deciding there is a problem, consider the stressors in your child's life. Is he or she having a normal reaction to a difficult situation, or is your child worrying even when nothing is really wrong? The answers to these questions can help you ascertain whether your child might be suffering from GAD.
Behaviours of Children and Teens with GAD
They are often described as "little adults", since they sometimes spend hours worrying about adult concerns (for example, the family budget, or whether grandma is taking her medication).
They are very perfectionistic, and, at the same time, they are also very unsure of themselves. They will redo activities to make sure they are perfect. For example, they might rewrite their homework assignments if there is even a tiny error or if they crossed out something on the page.
They try to relieve their worry by doing some of the following behaviors:
- Seeking excessive reassurance (e.g., asking a parent to review homework several times, to make sure that it is perfect).
- Checking (e.g., calling parents' cell phone several times, to ensure they are okay).
- Information-seeking or list-making (e.g., reading every book on a subject before completing homework or making a decision).
- Withdrawal from groups (e.g., in an attempt to avoid worrying about their friends, a child with GAD might just avoid having close friends; "what if my friend got angry with me?")
- Avoidance/procrastination (avoid going to school because of worries about parents being harmed while they are away; procrastinating homework so that they don't have a lot of time to worry about whether it was well done)
Does GAD look Different in Young Children vs. Teens?
GAD in young children:
- Worries tend to be about more concrete concerns ("What if I get an answer wrong on my test at school?" or "What if my mom and dad get into a car accident?")
- They mostly complain about physical symptoms instead of worries: sore muscles, sleep problems, stomach or head aches
You are the best source of information regarding these feelings in your child. Younger children will usually not tell other people (other than mom and dad) about these feelings.
GAD in older children and teens:
- As children get older, their thinking becomes more complex, so their worries might become more abstract or further into the future ("what if global warming affects my family when I grow up and have children?")
- Older children are more likely to complain about all their worries instead of only the physical symptoms
Click here for Home Management Strategies for Generalized Anxiety Disorder