Clinical Scientist & Psychotherapist #Anxiety

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A Comprehensive Guide to Generalized Anxiety Disorder in Children

Is your child showing signs of overwhelming worry? Generalized Anxiety Disorder can affect kids too. Early recognition and intervention are essential for better outcomes.

Ann-Louise T. Lockhart, PsyD, ABPP, is a board-certified pediatric psychologist, parent coach, author, speaker, and founder of A New Day Pediatric Psychology, PLLC.

Experiencing brief separation anxiety or fears of darkness, strangers, loud sounds, and storms is typical during childhood. However, persistent anxiety across multiple environments, social groups, and situations may signal generalized anxiety disorder (GAD) in children.

As a parent or guardian, it’s important not to panic. Receiving a diagnosis connects you and your child with vital support systems and paves the way for an enhanced quality of life.

Prevalence

About 15% to 20% of young people in the general population experience anxiety disorders. This percentage is even higher among children diagnosed with ADHD.

Similar to adults, girls are diagnosed with GAD at twice the rate of boys. Consequently, experts advise regular anxiety screenings for females aged 13 and older.

Watch Now: 7 Effective Strategies to Alleviate Anxiety

Symptoms and Diagnosis

Childhood generalized anxiety disorder is characterized by excessive, unrealistic worry and fear about everyday matters. Children may constantly expect disastrous outcomes and exhibit symptoms such as:

Trouble focusing
Difficulty swallowing
Fatigue
Irritability
Muscle tightness
Frequent urination
Restlessness
Sleep disturbances
Stomach pain

Chronic stress can severely impact a child’s daily functioning, making routine tasks challenging.

Children may be aware their anxiety is disproportionate yet still struggle to control it.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), specifies that symptoms must persist for at least six months to qualify for a GAD diagnosis.

To ensure accurate diagnosis and care, consult a qualified mental health professional experienced in pediatric anxiety disorders.

Causes and Risk Factors

No single cause has been identified for generalized anxiety disorder in children or adults.

Children who have faced traumatic events or neglect may have a higher risk of developing GAD, feeling insecure and out of control in their environment.

It’s common for individuals of all ages who have experienced adversity, loss, or abandonment to feel anxious in uncertain situations; children are no exception.

Puberty introduces additional pressures and self-awareness that can heighten anxiety. Difficulties with social interactions and school performance may increase fears about disappointing parents or teachers.

While these feelings are normal, persistent interference with daily life warrants attention.

Genetics, family environment, life experiences, and neurobiology all contribute to the development of GAD.

Treatment Options

Treatment for childhood generalized anxiety disorder is individualized and may include several approaches.

Counseling and Psychotherapy

Therapeutic support plays a crucial role in managing childhood GAD. Counseling provides a safe space for children to express their concerns without judgment. Mental health professionals can assist with:

Learning relaxation techniques
Building positive self-talk to reduce anxiety
Identifying specific fears
Enhancing coping skills such as social engagement, physical activity, and confidence
Encouraging open communication of feelings

Caregivers are often involved in therapy to better understand GAD, learn supportive strategies, and help process the child’s anxious thoughts effectively.

Medication

Mild to moderate symptoms may not require medication, but moderate to severe cases might benefit from pharmacological treatment.

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for pediatric anxiety, including:

Celexa (citalopram)
Lexapro (escitalopram)
Prozac (fluoxetine)
Zoloft (sertraline)

All medications carry potential risks; healthcare providers prescribe them only when benefits outweigh concerns.

Effective Coping Strategies

Implementing proven coping methods can significantly reduce anxiety symptoms. Finding what resonates with your child is essential.

Encourage exploration of various techniques and support your child in identifying what helps them most. Some approaches include:

Mindful Slowing Down

Anxiety often fixates on future 'what if' scenarios, detracting from present moments. Mindfulness practices, meditation, progressive muscle relaxation, and deep breathing exercises can help calm anxious thoughts.

Fostering Social Connections

Anxiety may cause children to withdraw socially. Providing safe opportunities to connect with family and peers through shared activities, outdoor play, or hobbies can be beneficial.

Encouraging community volunteering aligned with their interests can also promote social engagement.

Prioritizing Self-Care

Healthy sleep routines, balanced nutrition, and regular physical activity support overall well-being. Addressing challenges in these areas can improve anxiety management.

Developing a personalized self-care plan can empower your child to handle stress more effectively.

Advice for Parents and Caregivers

Recognizing anxiety in children is the first step, though it can be challenging. Some children with GAD appear quiet, shy, and eager to please, while others may exhibit tantrums, avoidance, or defiance, which can be mistaken for behavioral problems.

Understanding the varied ways anxiety manifests will enable earlier intervention and access to appropriate support.

Early diagnosis and treatment can profoundly improve your child’s life and prevent further issues. If you suspect your child has generalized anxiety disorder, consult your pediatrician or a mental health expert.

For assistance, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information about local support and treatment resources.

Additional mental health resources are available through our National Helpline Database.

Conditions A-Z
Anxiety
Generalized Anxiety Disorder

References

Verywell Mind relies on high-quality, peer-reviewed sources to ensure accurate and trustworthy content. Read our editorial process for details.

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Wehry AM, Beesdo-Baum K, Hennelly MM, Connolly SD, Strawn JR. Assessment and treatment of anxiety disorders in children and adolescents. Curr Psychiatry Rep. 2015;17(7):52. doi:10.1007/s11920-015-0591-z
Gregory KD, Chelmow D, Nelson HD, et al. Screening for anxiety in adolescent and adult women: A recommendation from the Women’s Preventive Services Initiative. Ann Intern Med. 2020. doi:10.7326/M20-0580
Bandelow B, Boerner JR, Kasper S, Linden M, Wittchen HU, Möller HJ. The diagnosis and treatment of generalized anxiety disorder. Dtsch Arztebl Int. 2013;110(17):300–310. doi:10.3238/arztebl.2013.0300
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Bushnell GA, Compton SN, Dusetzina SB, et al. Treating pediatric anxiety: Initial use of SSRIs and other antianxiety prescription medications. J Clin Psychiatry. 2018;79(1):16m11415. doi:10.4088/JCP.16m11415
Cotton S, Kraemer KM, Sears RW, et al. Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial. Early Interv Psychiatry. 2020 Apr;14(2):211-219. doi:10.1111/eip.12848

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