Generalized anxiety disorder (GAD)

If you suspect your child may have generalized anxiety disorder (GAD), it is essential to speak with a qualified mental health professional as soon as possible.

Children with anxiety disorders respond well to treatment that is administered by trained clinicians. By closely working with the treatment team, you can help your child go on to enjoy an active and fulfilling life.

How is generalized anxiety disorder treated at Boston Children’s?

Our team of psychiatrists, psychologists and social workers can help you, your child and your family by:

• tailoring therapy plans according to your child’s age, specific symptoms, family and school situation and overall medical history

• using psychotherapy (which is also referred to as “talk therapy”), or a combination of medication and therapy, to help your child feel and function better

Psychotherapy

Talk therapy is always part of the treatment plan and the type of “talk” therapy that has the strongest evidence base and the one we use is cognitive behavioral therapy or CBT. CBT is designed to help children understand how their specific feelings of anxiety emerge. It will also teach them important new skills for overcoming those feelings and replacing them with healthier, more constructive behaviors.  

Your child may receive individual therapy, or may participate in group sessions with other kids who are also working to overcome GAD. We also offer family counseling, which allows parents, siblings and other family members to take part in a child's therapy sessions and learn new strategies as a team.

Coping strategies learned in therapy may include:

• identifying and talking about worries and other feelings
• stopping recurring negative thoughts as soon as they start
• relaxing the mind and body during times of stress 
• develop a “toolbox” of skills to handle anxiety wherever it occurs

Anti-anxiety medications

If your child’s GAD does not adequately respond to psychotherapy, your clinician may recommend adding an anti-anxiety medication to his treatment plan. These medications can help your child feel more relaxed and comfortable while he is working on learning and practicing coping skills in therapy.

Here at the Boston Children’s Department of Psychiatry, we never prescribe mental health medication as a standalone treatment. Instead, we always consider medication as part of a two-pronged approach, with psychotherapy as a necessary component. Our Psychopharmacology Clinic can help determine whether medication might be a useful addition to your child's talk therapy.

Commonly prescribed anti-anxiety medications that can immediately help include:

• alprazolam (Xanax)
• lorazepam (Ativan)
• clonazepam (Klonopin)
• diphenhydramine (Benadryl)
• hydroxizine (Vistaril)
• buspirone  (BuSpar)

Quite often, if medications are needed, longer-term agents may also be prescribed. These include:

• fluoxetine (Prozac)
• sertraline (Zoloft)

Learn more about psychiatric medications for children and adolescents.

Can I prevent my child from developing an anxiety disorder?

There is no way to prevent anxiety disorders like GAD, but early treatment can significantly reduce symptoms and improve your child’s quality of life. If you notice your child is showing signs of an anxiety disorder, the best thing you can do is to seek professional help as soon as possible.

Coping and support

The ups and downs experienced by a child—and family—living with an anxiety disorder can feel overwhelming. In addition to the information about the condition provided here, you may find support from the following resources:

• Boston Children’s Center for Families is dedicated to helping families locate the information and resources they need to better understand their child’s particular condition and take part in their care. All patients, families and health professionals are welcome to use the center’s services at no extra cost. The Center for Families is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.

• The Boston Children’s chaplaincy is a source of spiritual support for parents and family members. Our program includes nearly a dozen clergy members—representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions—who will listen to you, pray with you and help you observe your own faith practices during your child’s treatment.

• The Experience Journal was designed by Boston Children’s psychiatrist-in-chief, David DeMaso, MD, and members of his team. This online collection features thoughts, reflections and advice from kids and caregivers dealing not only with physical illnesses like asthma and diabetes, but also with such mental health conditions as ADHD and depression.

• Boston Children’s Center for Young Women’s Health and Center for Young Men’s Health recognize that young men and young women have certain concerns that are specific to their genders, while other concerns are shared. These Boston Children’s centers offer the latest general and gender-specific information about issues like fitness and nutrition, sexuality and reproductive health, physical development and emotional well-being.

• The Advocating Success for Kids (ASK) Program at Boston Children’s provides multidisciplinary evaluation, referral and advocacy services for children under 14 who are experiencing behavioral, emotional, learning or developmental problems, either at home or at school. ASK works with children who receive their primary care either at Boston’s Bowdoin Street Community Health Center, Martha Eliot Health Center or Joseph M. Smith Community Health Center  or at Boston Children’s Primary Care Center. For more information about ASK, please call 617-355-4690.