Generalized anxiety disorder (GAD) is one of the anxiety disorders in children and adolescents. GAD is a constant state of increased anxiety and apprehension. Anxiety disorders in children and adolescents are characterized by worry, fear, or dread that significantly impair a person’s ability to function normally and are disproportionate to the situation (Iani et al., 2019). The following blog seeks to educate caregivers on GAD, including the signs and symptoms, pharmacological and non-pharmacological treatments, appropriate community resources, and referrals.
GAD Signs and Symptoms
The child with GAD will likely have multiple and diffuse worries aggravated by stress. If your child has GAD, you may notice that they have a shortened attention span and maybe hyperactive and restless, or keyed up. In addition, the child may have sleeping difficulties (difficulties initiating or maintaining sleep), sweat excessively, exhibit irritable behavior, and complain of constant fatigue (Bhatia & Goyal, 2018). GAD also presents with physical symptoms, and the child may report muscle aches, stomachaches, and headaches.
Pharmacological and Non-Pharmacological Treatments
Treatment of GAD in children and adolescents has two main approaches, pharmacological and non-pharmacological interventions. Pharmacological treatment is used for patients with severe GAD and those who fail to respond to psychotherapeutic interventions. Anxiolytic drugs include selective serotonin reuptake inhibitors (SSRIs), typically the drugs of choice in children and adolescents (Bushnell et al., 2018). Most children tolerate SSRIs without significant side effects. In addition, Benzodiazepines are prescribed for short-term treatment of anxiety but are not recommended for long-term treatment (Garakani et al., 2020).
Non-pharmacological treatment includes psychotherapy, the first-line treatment for mild to moderate GAD in children and adolescents. Psychotherapies used include behavioral therapy such as exposure-based cognitive-behavioral therapy (CBT). Exposure-based CBT involves systematically exposing the child to the anxiety-triggering situation, but in a graded fashion (Amray et al., 2019). The therapist helps the child remain in the anxiety-provoking situation, which makes them become desensitized and feel less anxious. In mild-moderate GAD cases, behavioral therapy alone is usually sufficient. Mindfulness-Based Psychotherapy is also a non-pharmacological approach used in GAD. It entails using regular mindfulness meditation practices to help the child develop mindfulness skills (Amray et al., 2019).
Community Resources and Referrals
Community resources available for children and adolescents with GAD include organizations such as the American Academy of Child & Adolescent Psychiatry, Child Mind Institute, and Anxiety and Depression Association of America – Anxiety and Depression in Children. The organizations provide information about the condition and how to help a child diagnosed with GAD. In addition, there are online communities where one can learn more about GAD, such as Parenting Anxious Kids, Turn around Anxiety Blog, and Anxiety-Free Child Blog. Children with GAD who do not improve with treatment disorder are referred to a child psychiatrist for more specialized treatment.
Conclusion
GAD in children and adolescents presents with excessive anxiety/worry and behavioral and physical symptoms. Treatment includes psychotherapy such as CBT and mindfulness-based therapy for mild to moderate exercises. Medications are prescribed for children with severe cases or those who do not respond adequately to psychotherapy.
References
Amray, A. N., Munir, K., Jahan, N., Motiwala, F. B., & Naveed, S. (2019). Psychopharmacology of Pediatric Anxiety Disorders: A Narrative Review. Cureus, 11(8), e5487. https://doi.org/10.7759/cureus.5487
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