Generalized anxiety disorder (GAD)

Children and teens with generalized anxiety disorder (GAD) experience excessive and uncontrollable worry about aspects of day to day life, future events, and minor matters.

This can include worry about the health and safety of themselves and their family, their academic or extra-curricular performance, their friendships and others’ perceptions of them, their future as an adult (e.g., career, partner), their parents’ marital satisfaction or family stability, money matters, things going on in the world (e.g., the environment, crime, government), punctuality, and more.

Youth may be struggling with GAD if they are worrying more than their peers, more days than not, and if they find it difficult to stop worrying. In addition, youth with GAD often demonstrate physical symptoms when anxious, such as fatigue, restlessness, trouble concentrating, irritability, muscle tension, and sleep difficulties. Although all youth sometimes experience worry about a range of events and activities, for youth with GAD, this worry is excessive, ongoing, uncontrollable, physically draining, and significantly negatively impacts the quality of life of the child and family.

This disorder is the most common of the anxiety disorders and we can see how children and young people may develop GAD in response to COVID conditions.

• Girls are twice as likely to have GAD than boys
• Youth may be at greater risk to develop GAD if they are inhibited and dislike risk (e.g., more cautious or slow to warm up to new situations), if they tend to view things negatively (e.g., see the glass as half empty), and if their parents are overprotective
• Left untreated, GAD is unlikely to lessen or go away, and as children mature into adulthood, GAD can create moderate to severe impairment in life functioning

How a GAD impacts the child at different ages

For younger children with GAD they typically worry about straightforward and immediate matters such as their academic performance, safety of their family, and fitting in or being liked. Youngsters are more likely to complain about physical symptoms instead of specific worries: sore muscles, sleep problems, stomach or headaches. For example, the day before a school project your child might complain of stomach-ache and wanting to stay home rather than saying, “I’m afraid to go to school because I think I will do badly on my project.”

As children get older, their thinking becomes more complex, so their worries might become more abstract or focus further into the future. For example, “What if global warming affects my family when I grow up and have children?” In addition, the negative impact of the ongoing, constant worry becomes more apparent the older the child gets. Parents, teachers, and other adults are able to see that their teen “looks” different than their same aged peers, when their child is spending hours and hours on a project, appears tense and exhausted, or refuses to participate in recreational activities or hang out with friends because of fears of academic failure.

Over time, persistent anxiety and withdrawal from friends and activities may begin to contribute to feelings of ineffectiveness and depression. In addition, teens desperate for an escape from their anxiety may turn to problematic coping strategies, such as watching excessive TV to distract themselves or using alcohol or marijuana to cope.