Generalized anxiety disorder (GAD) is a mental health condition that causes people to have excessive worry or fear about everyday issues and events. Children and teens with GAD tend to stress over the same problems as their peers, but the feelings are more intense and lasting than the situation might call for.
For example, most teens will worry about their social status, physical appearance, parental expectations, or academic performance at some point. But for those with GAD, the distress is so consuming that it can actually affect their ability to perform day-to-day tasks. In short, it feels like you’re constantly worrying about something but you can’t control the stress.
Generalized anxiety disorder tends to first present between childhood and age 30 and can have serious consequences for youth and young adults if not addressed early on. In fact, that’s one of the reasons that the United States Preventive Services Task Force now encourages screening for anxiety in all children and adolescents ages 8 to 18 years. Fortunately, GAD is a highly treatable mental health condition. Below, we’ve outlined everything you need to know about its signs and symptoms, causes, and ways to cope.
Generalized anxiety disorder: signs and symptoms
The tricky thing about experiencing generalized anxiety disorder as a teen is that you might not realize that your feelings and reactions are any different than someone else’s. Here are a few clues to help you understand if your distress over daily interactions is something to look into.
- Do you often worry about things before they happen? In this situation, “What if...” thoughts are common for you.
- Do you often seek reassurance or repeatedly ask the same questions in order to feel less anxious?
- Do you tend to procrastinate or do whatever you can to avoid anxiety related to school work, chores, or socializing?
- Has anyone commented that you tend to show severe distress over “things that shouldn’t be a big deal”?
- Do you spend too much time on a task in order to complete it perfectly?
Other common signs and symptoms of GAD in teens include:
- Trembling, twitching, or tensing muscles
- Being easily fatigued
- Headaches, muscle aches, stomachaches, or unexplained pains
- Difficulty falling or staying asleep
- Difficulty controlling feelings of worry
- Confidence and self-esteem issues
Generalized anxiety disorder: causes and risk factors
Like other anxiety conditions, generalized anxiety disorder is likely caused by a combination of genetic, neurobiological, behavioral, and environmental factors.
Before we dive deeper into potential causes, we want to clarify what we mean by risk factors. A health risk is a likelihood that something will harm or affect your health. While you can change factors like diet and exercise, many health risks are out of your control—including family history, race, and age.
Most researchers will agree that genetics play a key role in the development of generalized anxiety disorder. This means that if someone in your family has GAD, there’s a chance that you will too. Some research points to a heritability rate of 30 percent, meaning that more than one-fourth of your risk of developing anxiety is based on genetics.
Other studies have even focused on the specific genes responsible for the condition. For example, a 2015 study researching mental illness in twins found that the RBFOX1 gene may be responsible for increasing a person’s chances of developing generalized anxiety disorder.
Another factor to consider is a person’s environment. A study from a few years ago followed nearly 50,000 twins for 25 years and found that as their age increased, their heritability risk decreased. Instead, their risk for anxiety became linked to their environment more so than their genes.
We know that traumatic experiences, such as the loss of a loved one, can trigger the onset of an anxiety disorder, but it seems like every day there is something new to worry about. Between global issues like the Covid-19 pandemic and climate change to the looming threat of mass violence at school, it’s normal to be a bit jumpy. However, these issues may have a greater effect on those who are prone to anxiety.
Other risk factors
Research points to several other risk factors which may increase a teenager’s chance of developing generalized anxiety disorder. For example, anxiety is often co-occurring with major depressive disorder or other anxiety disorders, and girls are twice as likely as males to have the condition.
Generalized anxiety disorder: diagnosis and treatment
Generalized anxiety disorder is defined as excessive worry about everyday events that are out of a person’s control on most days for at least six months; typically, this worry causes difficulty in performing day-to-day tasks.
If you suspect that your stress and anxiety fall in line with a GAD diagnosis, then you might want to consider speaking with a healthcare professional. Typically, your provider will use a standardized set of questions to assess your symptoms and help make an accurate diagnosis. They’ll also collect information about your family, medical, and social histories.
Looking for answers right away? You can use this screening tool from the Anxiety & Depression Association of America, but we strongly suggest reviewing these results with a healthcare professional.
If reading this article has you feeling overwhelmed, know that there are several options to help you effectively manage generalized anxiety disorder. Many teens and young adults will explore therapy, medication, or a combination of both to treat their symptoms.
Therapy for GAD
Research suggests that cognitive behavioral therapy (CBT) is an effective treatment for generalized anxiety disorder in children and teens. CBT is designed to help a person develop the skills to manage their anxiety and the circumstances that cause it. According to the American Psychological Association, CBT focuses on the connection between thoughts, emotions, and behaviors in three main ways:
- Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
- Psychological problems are based, in part, on learned patterns of unhelpful behaviors.
- People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.
CBT interventions are personalized for each individual, but the idea is that by understanding the why and how of negative thought cycles, you’ll be better prepared to interpret situations for how they truly are.
Another therapy option involves the whole family. Some research suggests that teens “learn” their anxious tendencies from parents, so family therapy may provide an opportunity to educate the entire family on the condition and ways to cope.
Medication for GAD
There are several types of medications that healthcare providers will prescribe for generalized anxiety disorder.
Some people respond well to antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Although commonly used to treat depression, they’ve also proven effective for the symptoms of GAD. That said, antidepressants can come with side effects, such as headaches, nausea, or trouble sleeping, among others.
Another common choice is an anti-anxiety medication called benzodiazepines. These medications can be very effective in reducing worry and anxiety, but they’ve also been linked to dependency.
As always, it’s best to review your symptoms with a healthcare provider to find the right medication or treatment for your specific condition.
Learn how Charlie Health can help
It’s common to experience worry or stress as a teenager—however, it’s important to recognize if your symptoms are beginning to affect your work, relationships, and overall day-to-day functioning.
Charlie Health is committed to providing teens and adolescents with a proactive approach to mental wellness—all from the comfort of their home. Our intensive outpatient program connects you with other people experiencing generalized anxiety disorder or other anxiety issues so that you feel seen, heard, and connected.
To learn more, read our page about other types of anxiety disorders in teens and young adults here. If you'd like to connect with a member of our care team about your treatment options, get started here.