Generalized Anxiety Disorder (GAD)

Children with GAD worry all the time, about almost everything. What they worry about may change from time to time, but the worry is always there. It  prevents the child from leading a typical life and participating in daily activities (such as brushing one’s teeth). In fact, having GAD has an effect on every aspect of the child’s life.

Children who have GAD usually have mental and physical symptoms.

The mental symptoms include:

• Worrying about big things (“Will I pass this term in school?”) and little things (“What if I can’t find the cereal I like at the supermarket?”);Difficulty concentrating and paying attention to the task at hand;
• Feeling as if one’s mind has gone “blank” (that is, not being able to think about anything, or even move);
• Feeling irritable (that is, feeling on edge);
• Feeling as if the world is going to end;
• Worrying excessively about being “on time” and what happens if one is not on time;
• Being a perfectionist (that is, wanting to do everything extremely well);
• Re-doing certain tasks because child feels that the task was not performed well the first time around (even though it was);
• Constantly asking others for reassurance that everything is ok;
• Constantly asking a lot of “what if” questions.

The physical symptoms include:

• Restlessness;
• Fatigue;
• Having muscle tension or aches;
• Trembling and getting “a bad case of the shakes;”
• Having trouble sleeping;
• Sweating (Fig. 1);
• Breathing very fast (that is, as if the child has been running for an hour);
• Feeling nauseous.

Figure 1. Sweating

Children with GAD need psychotherapy. If symptoms are severe, the therapy may need to be intensive (that is, at least once a week) in the beginning. For GAD, the most common type of psycho-therapy is cognitive-behavioral therapy. In cognitive-behavioral therapy, the therapist helps the child learn how not to worry so much by identifying negative thoughts (the cognitive part), and learning how to change the behaviors that are associated with worrying (the behavioral part).

Some children with GAD may need to take medication. Placing children under age 12 years on medication is controversial. Parents should research this issue very carefully before they decide whether or not they wish their child to take medication.

Some children with GAD may have an Individual Education Plan (IEP. In the classroom, children with GAD need the help and support of the classroom teacher:

• The teacher may have to take things slowly, as children may need extra time to process certain types of information;
• The teacher may have to give a lot of advance notice about going on field trips or outside of the school, because children with GAD usually worry a lot when they have to go to an unfamiliar place;
• The teacher may need to give extra time to submit in-class assignments or  homework assignments;
• The teacher may need to give extra time during in class tests;
• The teacher may need to make sure they are not being bullied or made fun of by other children;

The most important thing the teacher can do is offer children with GAD support and make them feel welcome and safe in the classroom. This may help the child to worry less. This will also help other students better accept  those who are different.

Children with GAD who get good therapy and lots of love and support at home move on to lead very full and healthy lives. They may not overcome GAD or be cured of it, but they do learn to live with it  successfully (Fig. 2).

Figure 2. Mother and daughter

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