Generalized Anxiety Disorder in Children

ByJosephine Elia, MD, Sidney Kimmel Medical College of Thomas Jefferson University
Reviewed/Revised May 2023
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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 medication to reduce the anxiety is needed.

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(See also Overview of Anxiety Disorders in Children and Adolescents and Generalized Anxiety Disorder in adults.)

Symptoms

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 parent (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.

The COVID-19 pandemic was associated with disruptions in daily activities and environments that increased anxiety in many children. These disruptions included school closures, isolation from others (extended family, peers, teachers, cultural groups, and religious congregations), the need to live in constrained spaces with family members for weeks to months, parental job loss, and uncertainty about the future.

Diagnosis

  • A visit with a doctor or behavioral health specialist

  • Sometimes questionnaires about 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.

Treatment

  • Relaxation training

  • Sometimes medications

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, medications that can reduce anxiety, usually selective serotonin reuptake inhibitors

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