Merck Manual

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Generalized Anxiety Disorder in Children


Josephine Elia

, MD,

  • Professor of Psychiatry and Human Behavior, Professor of Pediatrics
  • Sidney Kimmel Medical College of Thomas Jefferson University
  • Division Chief, Child and Adolescent Psychiatry
  • Nemours/A.I. duPont Hospital for Children

Last full review/revision Mar 2019| Content last modified Mar 2019
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Generalized anxiety disorder involves excessive, persistent nervousness, worry, and dread about many activities or events.

  • Because of their worries, children with generalized anxiety disorder have problems paying attention and may be restless and irritable.

  • Doctors diagnose generalized anxiety disorder based on characteristic symptoms that have lasted 6 months or more.

  • Training children how to relax is often the best treatment, but sometimes a drug to reduce the anxiety is needed.


In children with generalized anxiety disorder, worries are general and encompass many things and activities rather than one specific thing such as being away from their mother (as in separation anxiety disorder). Controlling the worries is difficult. Stress worsens the anxiety.

These children often have difficulty paying attention and may be hyperactive, restless, and irritable. They may feel keyed up, tense, or on edge. They may also sleep poorly, sweat excessively, feel exhausted, and complain of physical symptoms, such as stomachache, muscle aches, and headache.


  • Symptoms

The diagnosis of generalized anxiety disorder is based on symptoms: excessive worries that do not focus on a particular activity or situation or that include many activities and situations.

General anxiety disorder is diagnosed when symptoms last for 6 months or more.


  • Relaxation training

  • Sometimes drugs

If anxiety is mild, relaxation training is often the most appropriate treatment. Other types of counseling may also be tried.

If anxiety is severe or counseling is not effective, drugs that can reduce anxiety, usually selective serotonin reuptake inhibitors (SSRIs) or sometimes buspirone (an antianxiety drug), may be needed.

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