Generalized Anxiety Disorder

What is Generalized Anxiety Disorder (GAD)?

Children and teens with generalized anxiety disorder (GAD) experience excessive and uncontrollable worry about future events and minor matters. This can include worry about health of self and family, money matters, the environment, state of affairs at a local, country or global level, parents’ marital satisfaction or family stability, academic or athletic performance, punctuality, and more. Worry is considered excessive and uncontrollable when your child is worrying more than his or her peers, and if he or she cannot stop worrying once it has started. This worry occurs most days and is accompanied by at least three or more physical symptoms such as fatigue, feeling amped up, 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.


  • Approximately 1% of adolescents will have GAD in any given year
  • Girls are twice as more likely to have GAD than boys
  • There are several factors that are related to the onset of GAD including children who are inhibited (or more cautious or slow to warm up to new situations), see the glass as half empty, have over protective parents, and dislike risk
  • 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

Signs & Symptoms


(Note: very young children may be unable to identify specific fear thoughts):

  • What if something bad happens to mom or dad?
  • What if there was an earthquake and the house got destroyed?
  • What if grandma doesn't pick me up after school?
  • What if the ozone layer keeps getting thinner?
  • What if I get cancer?
  • What if I don’t get into university?
  • What if someone breaks into our house while we are out?

Physical feelings:

  • Fidgety, amped up, unable to sit still
  • Irritable
  • Tired
  • Muscle pains (often in the neck and shoulders)
  • Headaches
  • Stomachaches


  • Anxiety/worry
  • Sadness
  • Anger
  • Shame
  • Guilt


  • Tantrums
  • Snapping at others
  • Difficulty paying attention or concentrating
  • Difficulty falling or staying asleep, or disturbed/interrupted sleep
  • Excessive studying
  • Reassurance seeking
  • Excessive or unreasonable list making
  • Procrastinating
  • School refusal

AREAS Common situations or affected areas

  • School absenteeism
  • Refusing to attend school field trips
  • Inability to make and maintain friendships due to fears
  • General decline in quality of life
  • Less involved in activities and limited interests
  • Unusual or overly focused interests often related to areas of worry
  • Frequent checking about current affairs, becoming an expert on identifying diseases, etc.

Be sure to watch our video below for more the play button to start.


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. In addition, they are more likely to complain about physical symptoms instead of specific worries: sore muscles, sleep problems, stomach or head aches. For example, the day before a school project your child might complain of stomachache 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 exhausted, or refuses to participate in recreational activities or hang out with friends because of fears of academic failure or a limited future at a second tier university.

Click here for My Anxiety Plan (MAP)


Jasmine is nine going on fifty-nine. Everyone comments on her “old soul” and how kind, caring, and wise she seems to be at such a young age. Although her parents are grateful for Jasmine’s compassion, they worry it comes at too great a cost. For example, her mother says that Jasmine worries about bringing the perfect gift to a friend's birthday party or whether the cat has enough drinking water for the day. She worries about the safety of the homeless, global warming, and a possible tsunami. When her little brother catches a cold, Jasmine is convinced these are symptoms of something far worse, and nothing seems to convince her otherwise.

It is as if worry is a moving target and Jasmine is always able to seek it out. Over the past several months, she has been having terrible stomachaches in the morning, and sometimes vomits before going to school. When Jasmine’s mum suggests she stay home and rest, Jasmine panics about missing too much work and falling behind, but if her mum encourages her to go to school, Jasmine worries she’ll get others sick. Jasmine’s mom says that although Jasmine has a  few friends, she has overheard them teasing Jasmine for worrying too much, which hurts Jasmine’s feelings.


Mitchell is 17 and in his final year of high school and plans to attend university next year. Mitchell desperately wants to attend an Ivy League university and is working non-stop to achieve this goal.  He has loaded up his course work this year with several Advance Placement classes, has a part-time job at a doctor’s office, volunteers at the animal shelter, is president of the student council, and is a peer tutor. By the time he sits down to start his homework it is often after 9pm and many nights he does not stop until after 2am. There have even been a few nights when he has fallen asleep at his desk trying to get his essay perfect, and he has even nodded off a few times in class. His friends have noticed that Mitchell is irritable and angry most of the time, but when they try to distract him or ask him to hang out he blows them off. Mitchell knows he cannot stop now. He thinks constantly about his future, and is terrified what will happen if he does not get in to his top choice. He does not want to be seen as a failure, but this is his deepest fear. As a result, he tries hard to hide this from others, appearing as a hardworking, bright, polite young man to his employers, teachers, and even his parents, none of whom know just how afraid and unhappy he is.


Mrs. Martin is raising her teenage daughter alone after the sudden death of her husband three years ago. Although it has been a struggle for both her and her daughter, Mrs. Martin was just starting to feel as though things were improving until she recently discovered her daughter has been drinking heavily on weekends. Mrs. Martin was shocked and devastated, but her daughter agreed to go to counseling. Over the course of several joint sessions, Mrs. Martin has learned how anxious her husband’s death has made her daughter, who has been worrying about illness, death, and loss of her mother, other relatives, and friends. In addition, her daughter has been highly concerned about their financial wellbeing, as well as what will happen to Mrs. Martin once her daughter leaves for college. It has been these fears that her daughter said were near constant and uncontrollable that lead her to start drinking as a means to quiet the worry.