Generalized anxiety disorder (GAD) is more than just getting butterflies before a big test
Anxiety is a normal human emotion. And while everyone feels anxious occasionally, GAD involves a persistent worry that attaches itself to many topics — school, health, family safety, or even future events.
For kids and teens, this often feels like being caught in a worry loop that can't be turned off, even when they are logically aware that the fears aren’t rooted in reality.
Three core symptoms in kids and teens
Anxiety tells the brain to worry about something that doesn’t need concern. (That’s part of why it’s hard for people who don’t have anxiety to understand it.) Learning to recognize that mindset helps. Here are three symptoms of generalized anxiety
1. Mind games
Perfectionism: You might see your child freeze up with fear over the thought of making a single mistake or getting a less-than-perfect grade on an assignment
Negative thinking: When your child jumps to the absolute worst-case scenario for every situation (catastrophizing) and constantly seeing reassurance to combat the “what ifs”
Worries about things nobody can control: Your child can’t seem to stop worrying about things like their or your family’s health, natural disasters, world events, and family relationships or situations
2. Physical manifestations
Frequent stomachaches or headaches (which may often lead to trips to the school nurse)
Muscle tension (feeling tight or on edge)
Sleep disturbances (difficulty falling asleep because the brain won't shut off)
Fatigue (from the sheer exhaustion of constant worrying)
3. Behavioral changes
Avoidance: Dodging situations that take them out of what they consider to be their “safe” bubble
Adherence: Trying to avoid making mistakes or doing anything not expected of them by going to school, doing their homework, attending activities, etc.
Irritability: Lashing out or getting angry when their nervous system is overloaded with anxiety
Why are kids and teens diagnosed with GAD?
When the worry becomes uncontrollable and sustained over time (lasting for at least six months), and it significantly interferes with a child’s daily life, it may be considered GAD. Several factors contribute to why a young person might develop GAD:
Genetics
A family history of anxiety or depression can increase the likelihood of a child developing a similar disorder
Brain chemistry
Imbalances in neurotransmitters (like serotonin and dopamine) that regulate mood and the fight-or-flight response
Environmental stress
Things like high-pressure academic environments or family instability can create unseen pressure to perform well
Temperament
Some kids are naturally more inclined to worry and overthink things from birth; they may also not do well with change because uncertainty feels hard
How GAD differs from typical stress
It’s helpful to think of the difference in terms of intensity and duration:
Typical stress comes at the onset of an event and dissipates: For example, your child might be nervous about their soccer game, but they don’t refuse to go and the stress goes away once the game starts.
Generalized anxiety disorder may take that stress further into other worries beyond the soccer game and into the avoidance and what-if zones: “I can’t go, I don’t want to play today — what if I get hurt, what if we lose, what if I fail my math test tomorrow, what if my parents get in a car accident on the way there?” The stress is constant and shifts from one topic to the next.
If your child is struggling, and you see their thoughts or behaviors disrupting their day-to-day life, talk about why and consider getting support. GAD is highly treatable through cognitive behavioral therapy (CBT), which helps kids “talk back” to their worries. And parent-centered care can be particularly helpful when it comes to kids who resist therapy directly and for parents to learn different ways to support a child experiencing this level of anxiety at home, school, and in the community.