Generalized Anxiety Disorder in People with Down Syndrome

Nearly all of us have experienced anxiety during our lives. We may feel anxious about a school exam, a new job, a dentist appointment, a disagreement with a friend, or other similar situations. This is typical. However, if anxiety interferes with our day-to-day lives on a long-term basis, an anxiety disorder may have developed. Generalized anxiety disorder is characterized by excessive worry about multiple areas of life. The anxiety is difficult for the individual to control and can interfere in school, work, and other settings.

Symptoms

Generalized anxiety disorder can impact our physical, mental, and social health and well-being. Individuals with Down syndrome (DS) may experience one or more of the following symptoms:

• Feeling worried or anxious most days
• Mild self-injurious behavior such as hand rubbing, nail biting, and picking at sores or parts of the body
• Being easily fatigued
• Difficulty sleeping
• Restlessness
• Difficulty concentrating
• Muscle tension
• Irritability

Assessment and Diagnosis

Every thorough mental health assessment should include an assessment of physical health to ensure that physical health problems are not affecting mental well-being. Some physical health problems that can contribute to anxiety include hyperthyroidism (overactive thyroid), sleep apnea, conditions that cause hypoxemia (low oxygen), and consumption of too much caffeine.

A diagnosis of generalized anxiety disorder is made after speaking with an individual, obtaining their medical history, and reviewing their symptoms. Mental health conditions such as generalized anxiety disorder can be challenging to diagnose in some individuals with DS who may have difficulty communicating their symptoms and the frequency and severity of their symptoms. Information shared by family members or care providers who observe and spend time with the individual with DS may be used to make the diagnosis. While some individuals with DS will describe feeling anxious, others may not be able to verbalize those feelings. Changes in behavior may indicate that the person is anxious or worried.

Treatment

Treatment may include one or more of the following:

• Treating underlying physical problems
• Counseling
• Calming strategies/relaxation techniques
• Sensory approaches
• Medications
  • Benzodiazepines
  • Nonbenzodiazepine anxiolytics
  • Antidepressants

Where to Find Additional Information

• Anxiety Disorders (Chapter 18) in the 2nd edition of Mental Wellness in Adults with Down Syndrome: A Guide to Emotional and Behavioral Strengths and Challenges [available as a free PDF]
• Finding a Mental Health Professional article in our Resource Library
• All Mental Health Resources in our Resource Library