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Anxiety

Summary

Generalized Anxiety Disorder (GAD) is a common mental health condition characterized by excessive and persistent worry that lasts for at least six months. This worry is often difficult to control and can interfere with daily life.

Symptoms may include restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. While adults must experience at least three of these symptoms for a diagnosis, children only need one key symptom.

GAD is a diagnosis of exclusion, meaning other medical conditions, mental health disorders, and substance-related factors must be ruled out first. If no underlying physical or psychological causes are found, the diagnosis is confirmed based on symptoms.

Treatment typically includes therapy, such as cognitive behavioral therapy (CBT), medications like selective serotonin reuptake inhibitors (SSRIs), or a combination of both.

Diagnosis and When to Seek Help

Parents should seek medical advice if their child:

  • Worries excessively about everyday matters for months
  • Struggles to control their worry
  • Experiences symptoms such as nervousness, sleep disturbances, or physical discomfort (e.g., headaches, stomachaches)
  • Avoids social activities or school due to anxiety

A healthcare provider will evaluate the child’s symptoms, medical history, and emotional well-being to rule out other conditions before diagnosing GAD.

Management

GAD can be managed effectively through:

  • Cognitive Behavioral Therapy (CBT): A proven therapy that helps children identify and manage anxious thoughts.
  • Relaxation Techniques: Breathing exercises, mindfulness, and physical activity can reduce stress.
  • Medications: In some cases, doctors may prescribe SSRIs or other medications if therapy alone is not enough.
  • Parental Support: Encouraging open communication, providing reassurance, and modeling healthy coping skills can help children feel more secure.

Follow-Up and Monitoring

Ongoing monitoring by a healthcare provider ensures treatment remains effective. Regular check-ins with a therapist or doctor can help track progress and make necessary adjustments.

With early intervention and the right support, children with GAD can learn to manage their anxiety and thrive.

History and Exam

Key diagnostic factors

  • Presence of risk factors
  • Excessive worry for at least 6 months
  • Anxiety not confirmed to another mental health disorder
  • Anxiety not due to medication or substance

Other diagnostic factors

  • Headache
  • Sweating
  • Dizziness
  • Gastrointestinal symptoms

Risk factors

  • Family history of anxiety
  • Physical or emotional stress
  • History of physical, sexual, or emotional trauma
  • Other anxiety disorder

Diagnostic Investigations

1st investigations to order

  • Clinical diagnosis

Investigations to consider

  • Thyroid function tests
  • Urine drug screen
  • 24-hour urine for catecholamines, metanephrines, normetanephrines, and creatinine
  • Pulmonary function tests

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 ADDRESS