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Generalized Anxiety Disorder or GAD is defined as an anxiety disorder marked by chronic excessive anxiety and worry that is difficult to control, causes distress or impairment in daily functioning, and is accompanied by three or more associated symptoms (Merriam-Webster).

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Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events

Overthinking plans and solutions to all possible worst-case outcomes

Perceiving situations and events as threatening, even when they aren't

Difficulty handling uncertainty

Indecisiveness and fear of making the wrong decision

Inability to set aside or let go of a worry

Inability to relax, feeling restless, and feeling keyed up or on edge

Difficulty concentrating, or the feeling that your mind "goes blank"

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Fatigue

Trouble sleeping

Muscle tension or muscle aches

Trembling, feeling twitchy

Nervousness or being easily startled

Sweating

Nausea, diarrhea or irritable bowel syndrome

Irritability

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A child or teen with excessive worry may:

Feel overly anxious to fit in

Be a perfectionist

Redo tasks because they aren't perfect the first time

Spend excessive time doing homework

Lack confidence

Strive for approval

Require a lot of reassurance about performance

Have frequent stomachaches or other physical complaints

Avoid going to school or avoid social situations

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GAD affects 6.8 million adults, or 3.1% of the U.S. population, yet only 43.2% are receiving treatment.

Women are twice as likely to be affected as men.

GAD often co-occurs with major depression.

The disorder comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age.

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Resources for Parents and Teachers (State)

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Resources for Parents and Teachers (State)

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Worry Wise Kids
http://www.worrywisekids.org/
WorryWiseKids mission is to improve the quality of life for anxious children and their families by providing parents, educators and mental health professionals with comprehensive, user-friendly information on the full range of anxiety disorders: how to identify symptoms, find effective treatments and, and prevent anxiety from taking hold in a child's life.

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From Dr. Tamar Chansky Creator of Worrywisekids.org

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Young Minds
https://www.youngminds.org.uk/parent/a-z-guide/anxiety/
This website focuses on allowing parents ways they can support them and places they can get help.

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What is anxiety?

Anxiety is a feeling of worry or fear that is experienced as a combination of physical sensations, thoughts and feelings.

All children and young people feel worried sometimes, and this is a normal part of growing up. At certain points, such as on their first day of school or before an exam, young people may become more worried, but will soon be able to calm down and feel better.

Anxiety can become a problem when a young person feels stuck in it, or when it feels like an overwhelming, distressing or unmanageable experience. If this kind of worrying goes on for a long time, it can leave a young person feeling exhausted and isolated, and limit the things they feel able to do.

If your child is struggling with anxiety, there are things you can do to help them - including providing emotional support, working on practical strategies together and finding the right professional help if they need it.

What makes young people anxious?

A young person may feel anxious for a number of different reasons, depending on the individual. If your child is feeling unmanageable amounts of worry and fear, this is often a sign that something in their life isn't right and they need support to work out what the problem is.

The following kinds of things can make some children and young people feel more anxious:

experiencing lots of change in a short space of time, such as moving house or school

having responsibilities that are beyond their age and development, for example caring for other people in their family

being around someone who is very anxious, such as a parent

struggling at school, including feeling overwhelmed by work, exams or peer groups

experiencing family stress around things like housing, money and debt

going through distressing or traumatic experiences in which they do not feel safe, such as being bullied or witnessing or experiencing abuse.

This video by Braive (2m 30s) is a useful way of understanding how stress and anxiety can build up in a person's life.

Symptoms of anxiety

Anxiety tends to affect a young person's body, thoughts and feelings. They may also behave differently, including turning to certain coping behaviours to try to avoid or manage their anxiety.
Physical symptoms:

panic attacks, which can include having a racing heart, breathing very quickly, sweating or shaking

shallow or quick breathing, or feeling unable to breathe

feeling sick

dry mouth

sweating more than usual

tense muscles

wobbly legs

irritable bowel syndrome (IBS), diarrhoea or needing to pee more than usual

getting very hot

Thoughts and feelings:

preoccupied by upsetting, scary or negative thoughts
nervous, on edge, panicky or frightened

overwhelmed or out of control

full of dread or an impending sense of doom

alert to noises, smells or sights

worrying about being unable to cope with daily things like school, friendships and being in groups or social situations

worrying so much that it is difficult to concentrate and/or sleep

Coping behaviours:

withdrawing or isolating themselves - including not wanting to go to school, be in social or group situations, be away from parents or try new things

repeating certain behaviours, actions or rituals (often called 'obsessive compulsive behaviours')

eating more or less than usual

self-harming

How to help your child in an anxious moment

When your child is in the middle of a very anxious moment, they may feel frightened, agitated or worried about having a panic attack. The important thing to do in the moment is to help them calm down and feel safe.

These strategies can help:

Remember that everyone is different, and that over time you and your child can work together to find the things that work best for them in these moments.

How to help your child manage their anxiety

Outside of moments when your child is feeling particularly anxious or panicky, there are things you can do over time to help them manage their anxiety and feel better.

A lot of these strategies are about helping your child to understand themselves and find out what works for them. The more confident they feel about helping themselves when things are hard, the more they will believe in their ability to cope - helping to reduce feelings of panic.

Some children and young people with anxiety will need professional and specialist help to feel better. They may benefit from a specific diagnosis or a treatment such as medication or talking therapy. You can find more information about this below.

Young people tell us it helps to...

find positive activities you enjoy

think about something you're looking forward to

do physical exercise

learn mindfulness and yoga

imagine your thoughts leaving your brain and floating off into the sky

keep yourself occupied

have time out

reflect on how you're feeling

talk to other people you trust

remind yourself you're not alone - odds are someone in your friendship circle has anxiety or depression too

Finding professional help

It's a good idea to seek professional support if self-help strategies are not making the situation better and anxiety is affecting your child's life - for example if they are feeling persistently anxious, often having distressing thoughts, or avoiding things like going outside or speaking to others.

There are different places where you can find help for your child. Your GP, your child's school and considering whether counselling or therapy might help are good places to start.

You can find out more about speaking to GPs, finding a counsellor or therapist, accessing Child and Adolescent Mental Health Services (CAMHS), getting help from your child's school and finding local services on our guide to getting help for your child.

You can find out more about speaking to GPs, finding a counsellor or therapist, accessing CAMHS, getting help from your child's school and finding local services on our guide to getting help for your child.

You might also find helpful...

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Supporting A Child With Anxiety | Tips & Advice

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What is anxiety? Anxiety is a feeling of worry or fear that is experienced as a combination of physical sensations, thoughts and feelings. All children and young people feel worried sometimes, and this is a normal part of growing up.

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Resources for Parents and Teachers (National)

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Resources for Parents and Teachers (National)

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Anxiety and Depression Association of America
https://adaa.org/
ADAA’s mission focuses on improving quality of life for those with these disorders through the alignment of innovative research, evidence-based treatment, education and support. ADAA's mental health professional members contribute blog posts, webinars, website content and more to help improve the quality of life for individuals and their families struggling with anxiety and depression.

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Anxiety and Depression Association of America, ADAA

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Anxiety Disorders and Depression Research & Treatment | Anxiety and Depression Association of America, ADAA

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ADAA is an international nonprofit membership organization dedicated to the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and co-occurring disorders through education, practice, and research.

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We Are Teachers
https://www.weareteachers.com/help-students-with-anxiety/
This article discusses 10 ways teachers can help their students struggling with anxiety in the classroom as well as in their regular lives as well.

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Chances are you've seen a significant increase in the number of students who struggle with mental health over the past several years. According to JAMA Pediatrics, even before the pandemic, the rate of child and adolescent anxiety increased 27% between 2016 and 2019. By 2020, more than 5.6 million youths were diagnosed with anxiety. With symptoms such as trouble concentrating, an upset stomach, or sleeplessness, anxiety can be one of the most debilitating challenges students face in classrooms today.

We know anxiety is more than just "worries." It can influence classroom performance just as much as any other learning disability. Kids who are worried and anxious aren't doing it on purpose. The nervous system acts automatically, especially when it comes to worry (which often stems from fight-or-flight reflexes). That's why phrases like "just relax" or "calm down" aren't helpful. But with practice, kids can learn to slow down their anxious brains, and we can learn to help them. Here are a few ways you can help anxious kids in the classroom.

1. Educate yourself about anxiety

The more you understand about anxiety, the more you can arm yourself with strategies to help your students. This article from district superintendent Jon Konen provides a definition of anxiety, its causes, how to recognize it, types of anxiety disorders, and, most importantly, how you can help as a teacher.

2. Create strong bonds

Building strong bonds and connecting to youth can protect their mental health. Schools and parents can create these protective relationships with students and help them grow into healthy adulthood. Try these 12 Ways To Build Strong Classroom Community.

3. Practice those deep breaths

When people slow down their breathing, they slow down their brain. When I notice that one of my kids is struggling with anxiety, I'll often lead the whole class in a breathing exercise. It helps the child who is overwhelmed and usually a few other kids too. Sometimes I'll do it just because the whole class is squirrelly and we need to focus. Slow, deep breaths are the key. This article about belly breathing describes the process I like to use with my kids. It works every single time.

4. Take a break and go outside

Being out in nature can also calm an anxious brain. Sometimes just a change of scenery is what makes the difference. Breathing the cool air or making time to notice chirping birds can also calm an overactive worrier. Asking students to carefully observe their environment can help them turn the focus away from their worries and toward something more tangible: How many different kinds of trees do you see? How many different bird songs do you hear? How many different shades of green are in the grass?

It doesn't hurt for us to take a mental break sometimes too. Check out 20 Terrific Guided Meditation for Teachers.

5. Talk openly about anxiety

Don't set anxiety up as something you want (or should) get rid of. It's part of life, and it's not realistic to think it'll go away completely. You can help students see and understand this in your own actions. Check out this great article of what you should (and shouldn't) do when working with kids dealing with anxiety.

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6. Tackle the topic with a good book

Often, when one of my kids is struggling, the school counselor will come and share a picture book about managing anxiety with the entire class. Some kids may not be receptive to direct, one-on-one intervention, but they will respond beautifully if they know the whole class is receiving the same information. Check out this list of great books for kids with anxiety.

7. Get kids moving

Exercise helps anyone who is feeling anxious. Anxiety can end up looking like anger, so if you see this, try taking a movement break. You probably already have some favorite ways to do this, but if you're looking for some ideas, check out our video above. You can also get the free set of printables for that right here.

8. Try walking and talking

Building on the moving idea, if you have a student that needs some one-on-one attention, try the " On My Walk " activity. I used to have a student who struggled a lot with anxiety, and this worked great with her. After a couple of loops around the playground with me, everything would feel a little better. Our walk served three purposes: 1. It removed her from the situation. 2. It gave her a chance to explain the issue to me. 3. It got her blood pumping, which clears out the anxiety-producing energy and brings in the positive exercise endorphins.

9. Focus on the positive by having students keep a gratitude journal

The brain is incapable of producing anxious thoughts while it is producing positive thoughts stemming from gratitude. If you can trigger a positive train of thought, you can sometimes derail the anxiety. I knew a teacher who had his fifth graders keep gratitude journals, and every day they would record at least one thing they were thankful for. When his students seemed overwhelmed by negativity or mired in anxiety, he'd encourage them to reread their journals.

Check out the video above for another inspiring teacher or these 22 videos to help kids understand gratitude.

10. Validate students' feelings

Before trying to problem-solve with students who are in the midst of racing thoughts or have completely shut down, Phyllis Fagell, a school counselor and therapist based in Maryland and Washington, D.C., recommends validating their feelings. For instance, saying, "If I was afraid I might look dumb, I'd be worried about raising my hand too," may reduce the impact of anxiety and help a student relax, develop trust, and feel understood. Fagell also reminds teachers not to shame anxious students. For more, check out the full article from WGU.

11. Remind kids to eat healthily and stay well

For the most part, teachers don't really have a lot of control over what students eat and how much they sleep, but these things do matter when it comes to managing anxiety. Not surprisingly, a healthy diet and plenty of sleep make a difference in how well a student is able to handle situations that could be overwhelming. It's one of the reasons that snack and rest time are an essential part of the day for preschoolers!

For your younger students, check out 17 tasty books that teach kids about nutrition and healthy eating habits for a list of picture books about healthy eating.

12. Encourage families to make sure their children are getting enough sleep

With all the extracurricular activities available to kids, not to mention the allure of high-stimulus technology, many kids are just not getting the amount of healthy sleep they need. According to the CDC, children ages 6-12 need as much as 9-12 hours of sleep each night. Preschoolers need even more (10-13 hours), and teens need between 8 and 10 hours. A solid night's sleep does wonders for improving mood, concentration, and outlook. Good sleep quality is also essential. Encourage healthy sleep habits in your students with these Tips for Better Sleep.

13. Create a space where kids can express their anxiety

You've probably heard of classroom safe spaces, and this is a great option to offer if you have students dealing with anxiety. A safe space is a comfy zone in the classroom where kids can go to decompress and regroup. Many teachers include glitter jars, headphones, books, or other items to help kids get back on track.

14. Use fidgets

Another helpful idea, which can stand on its own or be part of your safe space, is offering students classroom fidgets. Sometimes this can work wonders in just giving kids an outlet for their amped-up energy. Here are 39 of our favorite classroom fidgets.

15. Try aromatherapy

Aromatherapy is thought to help activate certain receptors in the brain, potentially easing anxiety. Whether in the form of essential oil, incense, or a candle, natural scents like lavender, chamomile, and sandalwood can be very soothing. Check for sensitivities among your students before introducing a scent to the whole class. An alternative could be an unlit candle, dried herbs, or a sachet treated with essential oil kept in the classroom safe space for students to use individually.

16. Teach kids to recognize their warning signs

Everyone experiences anxiety differently. For children, signs may include shortness of breath, stomachaches, or inability to settle down and concentrate, among others. Coaching students to recognize their unique triggers and warning signs can help them know when to take a step back. Integrate social-emotional strategies throughout the day to help students learn to manage their anxiety.

17. Incorporate Zones of Regulation strategies

Students with anxiety need concrete, easy-to-use strategies to help them cope. Rooted in cognitive therapy, Zones of Regulation is a curriculum developed to help kids understand and learn to manage their emotions. This informative article offers 18 helpful strategies.

18. Offer individual accommodations

For older students, accommodations can make all the difference. Many students struggle with performance anxiety, especially when it comes to tests. When a student is feeling anxious, their brain simply can't function as effectively. When we can set up our tests and assignments so anxious kids are less stressed, they'll likely perform better. Extended time and cue sheets could help kids who suffer from test anxiety. For other accommodations for kids who struggle with anxiety, check out this list from Worry Wise Kids.

The good news about anxiety is that it is one of the most manageable mental-health struggles that children face in the classroom. With the right support and strategies, most children are able to develop strategies that help them manage their anxiety.

The Child Mind Institute offers a " Symptom Checker " to help inform you about a student's possible diagnoses and information and articles to help facilitate a conversation.

19. Mind your classroom management

Schools play a critical role in helping students manage anxiety by creating environments where all students feel that they are cared for, supported, and belong. Certain classroom management approaches strengthen school connectedness. From teacher expectations and behavior management to student autonomy and empowerment, these strategies make a difference.

20. Teach inclusivity

Poor mental health is a growing problem for children and adolescents. According to a JAMA Pediatrics meta-analysis of 29 studies including 80, 879 youths, the prevalence of depression and anxiety symptoms has significantly increased, remains high, and therefore warrants attention.

And some groups are affected more than others. In a report by the CDC, feelings of anxiety and depression were found to be more common among lesbian, gay, or bisexual students and female students. Almost half of lesbian, gay, or bisexual students and nearly one-third of students not sure of their sexual identity reported they had seriously considered suicide-far more than heterosexual students. It is essential that schools put serious effort into creating safe, inclusive classrooms and invest in curricula that supports equity. Here are 50 Tips for Facilitating a More Inclusive Classroom and 5 Ways Social-Emotional Learning Can Help Your Class Become a More Inclusive Community.

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20 Ways To Help Students Who Struggle With Anxiety

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If you have students with anxiety in your classroom, words like "relax" don't help. Instead, try these ideas.

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Class Presentations
Children with extreme social anxiety may have difficulty with oral reports. Having the child present to the teacher alone, or have the child audiotape or videotape the presentation at home.
Class Participation
Fears of getting the answer wrong, saying something embarrassing, or simply having other kids look at them may be concerns for an anxious child. Determining the child's comfort with either closed ended questions or with opinion questions. Provide opportunities for the child to share knowledge on topics in which he or she is most confident.
Testing Conditions
Allowing students with anxiety to have an extended time period during testing as well as allowing students to take their test in a quiet place as hearing and seeing other students taking and turning in test could upset them and make them believe they don't know the material as well.
Time Out Passes
By allowing students a time out pass, students with GAD can take a minute away from class to refresh, calm down, or breathe as to not get too worked up or stressed out during class also allowing their brains a minute as to refocus.

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Behavior Management and Social Strategies

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Behavior Management and Social Strategies

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Talking Openly about Anxiety
Working with Parents and the Student Counselor
Implementing Mindfulness Practices
Practicing Deep Breathing
Creating a Classroom Safe Space
Get Students Up and Moving in the Classroom

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The Children's and Adult Center for OCD and Anxiety. (n.d.). Sample accommodations for anxious kids.  WorryWiseKids.org | Sample Accommodations for Anxious Kids. Retrieved February 25, 2022, from http://www.worrywisekids.org/node/40

Generalized anxiety disorder (GAD): Anxiety and depression association of america, ADAA. Generalized Anxiety Disorder (GAD) | Anxiety and Depression Association of America, ADAA. (n.d.). Retrieved February 25, 2022, from https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad

Mayo Foundation for Medical Education and Research. (2017, October 13). Generalized anxiety disorder. Mayo Clinic. Retrieved February 25, 2022, from https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803

Munir, S. (2022, January 9). Generalized anxiety disorder. StatPearls [Internet]. Retrieved February 25, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK441870/