GENERALIZED ANXIETY DISORDER (GAD)


WHAT IS GENERALIZED ANXIETY DISORDER (GAD)?

All children suffer from fears at one time or another, this is normal. But when a fear creates feelings of overwhelming danger that are disproportionate to the actual situation, the child is most likely suffering from an anxiety disorder.  

GAD is excessive fear related to various things, such as school or sports performances and catastrophes. Children with this disorder find it difficult to control their anxiety and stay focused. Sufferers try to avoid activities they believe they will not perform perfectly. If the situation can’t be avoided, the child becomes distressed.
 

SYMPTOMS

Emotional symptoms of a child with GAD may include:  
·     ongoing worry or fear over school or sports performance  
·     fear for family’s safety
·     worrying about being on time 
·     fear of making mistakes 
·     need to do things perfectly
·     fear of catastrophic events and natural disasters
·     lack of confidence
·     difficulty concentrating
·     a sense of panic

Physiological symptoms may include:
·     a racing heart
·     headaches
·     stomachaches
·     trembling
·     difficulty breathing
·     feeling weak
·     sweating
·     fatigue
·     difficulty sleeping

When GAD interferes with the child’s sleep, concentration, ability to have fun or function normally, intervention from a mental health professional is needed. 


CAUSES

Predisposition - Some children are prone to being more anxious than others and are less capable of handling stress. 

Genes - If the child comes from a long line of anxious people, chances are that the child will develop an anxiety disorder.

Environment - Situations that may be a factor in developing GAD in a child include: 
·      parents going through a divorce
·      losing a family member or friend
·      living with an ill or disabled family member
·     living in a volatile home
·     living with an anxious parent – the parent’s anxieties can be passed on
·     moving
·     attending a new school
·     going through a traumatic experience or event 


TREATMENT 

Cognitive Behavioral Therapy (CBT) 

CBT helps children recognize their thought patterns and identify where and when those patterns help and where they hurt. In other words, how we think and act affects how we feel. By incorporating Graded Exposure into CBT, the child slowly and systematically faces his fears and learns to better manage the symptoms of his anxiety. With practice the child gains mastery over fear and experiences reduced symptoms.

Dr. Madeleine Vieira's Anxiety Disorder Series, I’M AFRAID, introduces CBT techniques to help children overcome their anxiety disorders. 

 Priscilla Puppy Is Afraid of Everything! focuses on GAD. In this book, Priscilla Puppy wants to play her violin in the school talent show, but she’s afraid something will go wrong. To overcome her fear, she uses a stepladder process (i.e., Graded Exposure) to gradually expose herself to situations in which mistakes do happen. She starts with small steps and gradually builds up to more fearful situations.    

In treatment, mental health professionals help children to control their GAD and uncomfortable feelings using specific techniques such as:
·     Understanding that the imagined outcome associated with the anxiety isn’t realistic. 
·     Using self-talk to ‘fight’ the fear. The child might tell himself that what he thinks will happen won’t actually happen.
·     Using relaxation techniques. The child is taught to use controlled breathing exercises to help lessen anxious feelings.
·     Using role-playing techniques, such as practicing worst-case outcomes. The mental health professional will help the child realize that the outcomes are not possible or highly unlikely.  
·      Teaching the child that he can manage his uncomfortable feelings successfully without avoidance. This takes time, repetition, and practice!

 Anti-Anxiety Medication

When a child’s GAD doesn’t fully respond to CBT, anti-anxiety medication prescribed by a child & adolescent psychiatrist may be beneficial.

Additional Help

Based on the therapeutic technique of Graded Exposure, a component of Cognitive Behavioral Therapy (CBT), Priscilla Puppy Is Afraid of Everything! demonstrates that it is possible for children to manage their anxiety. The story guides children through steps that research shows help them overcome the harmful habits and patterns they’ve developed while struggling with their fears. Along with the story, there is an About Anxiety page, a Coping Strategies page, and a Stepladder page. These additional tools can help alleviate anxiety symptoms. 


REFERENCES

  1. https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803 

  2. http://www.childrenshospital.org/conditions-and-treatments/conditions/g/generalized-anxiety-disorder-gad/symptoms-and-causes