Anxiety in Teens

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The number of teens that are anxious are increasing every day.  6.3 million teens ages 13 to 18 have had an anxiety disorder. That number represented 25% of the population in that age group in 2015.  Schrobsdorf, S. (2016). 

It's important to keep in mind that all anxiety isn't an anxiety disorder. Feeling anxious in general isn't necessary bad, it's only when it rises to the level of a disorder that it becomes a problem. This page will explain some general issues that can become problematic for teens and some things you can do as a parent to spot when anxiety in teens rises to the level of a disorder. 

A good rule of thumb is that if your child is exhibiting behavior that is interfering with their ability to function in specific expected domains in their lives, such as school, family, or friendships, then you want to get them checked out to see if they may be suffering from anxiety that may be more serious. 

Behavior can mask the symptoms

Anxiety in teens may often be expressed through defiance and avoidance, especially in boys but also in girls. Anxiety in teens can  appear to be bad behavior. In my office this behavior is often truancy, mild drug use, and oppositional or argumentative behavior at home. Parents often unknowingly will reinforce a child’s anxiety if their symptoms are primarily behavioral because they avoid doing things that upset the child, thus feeding their anxiety.

If parents are not tip toeing around the teen anxiety than they are engaging in conflict over the teens behavior, thus leading to a stressful and uncomfortable home life. This can contribute to a teens anxiety  and depression as well.

Both of these approaches fail to address the real issue, the teens anxiety.

Take the case below of Adam.

Case Study: Adam

Adam was a fourteen year old boy who had recently been resistant to engaging in the same activities he had been in the past. He had a peer group who he had withdrawn from, and had recently been caught smoking pot. His parents were drug testing him regularly. His dad was convinced that he needed more discipline, and that the primary problem was he was lazy. He mother was convinced he was depressed and something else was wrong.

After exploring with Adam some more of what was going on it was obvious that he had some intense social anxiety. As was the case here, teen anxiety can lead to some maladaptive behaviors and also some depression. Adam's social anxiety was so debilitating that it became a cause for depression.

In Adam’s case, we worked on treatment of the social anxiety and education regarding where his feelings and behaviors were coming from. After working on those issues, were able to implement a plan to improve his coping skills. Specifically we replaced his substance abuse with better coping mechanisms. He began to confront his anxiety and face it.


Anxiety in Teens: Common Stressors

Dating

Anxiety in teens can be caused by life stressors, especially if the teenager is already prone to stress. Girls in particular are very vulnerable to anxiety over dating issues. Girls are often at a loss for how to behave and what to expect when dating.  Half of the time I spend with my teenage clients’ amounts to dating advice. Teen anxiety around dating is particularly likely if there haven’t been explicit discussions in the house about dating and an open attitude that cultivates and exchange between the teenagers parents around sex and dating. If  kids are left to fend for themselves they will make a mess of figuring it out. Without the skill to pick good dating partners, to know how to make good choices within that relationship, and how to stand up for themselves, they are overwhelmed. Dating is a huge source of teen anxiety. This is the case with teenage boys as well. Click here for more information about teen dating.

Body Image

Body image issues are another source of anxiety in teens. Girls are under a tremendous amount of pressure to be thin and beautiful. As far as women have come over the past few decades, this remains and issue we have not been able to escape from. Teenage girls are judged by their appearance and are surrounded by media images of perfectly gorgeous and thin women who don’t exist in reality. I have noticed, in particular, that girls who present with anxiety over body images are more likely to have mother’s who have body image issues.

Poor Communication Skills

Difficulty communicating and problem solving is often a source of anxiety for teens. These are rarely issues that are mastered  in adolescents ( or adults). Teens who have not mastered the skill of assertiveness and who have trouble verbalizing their thoughts and feelings are particularly vulnerable  to anxiety. This is an issue of constant focus in my therapy practice. I will hear stories in therapy about how hurt teens were feeling when someone criticized them or ignored them or stepped on their feelings. When I ask “what did you say?”, the response is "nothing". Walking around with your feelings stuffed inside all day long will cause you anxiety and depression! Click here for more information about assertiveness .

Although it may not be apparent, teen boys can have very complex emotional lives. They are often taught not to verbalize their feelings, to be strong, and are sometimes not even able to recognize their feelings. They me be avoidant and more hesitant to let you know what is happening. Inside they are feeling  anxious, but outside they may appear  depressed and angry.

Please Get Help Early

Specifically social anxietypanic attacks and panic disorder, and generalized anxiety disorder are the diagnoses I see most commonly with teen anxiety. Some teens also have separation anxiety disorder. It is very important if you have a teenager suffering from anxiety to get help for your teen. Studies show there is a strong likelihood that a teen who has depression and anxiety will become an adult with depression and anxiety. The earlier you learn the tools to conquer these struggles the better! Most retrospective studies of adults with these disorders indicate that the illness began in adolescence or earlier.

In addition to the anxiety disorder diagnoses, many kids who have anxiety also suffer from depression, physical problems, school problems, and eating disorders. If you have an anxious teen, please get them some help immediately.

Anxiety in Teens: What to do

So what should you do if you are a parent of a teen who is experiencing anxiety?

Keep Communication Lines  Open

Creating a safe environment for teens is tough to do. As a parent we want to ensure we are doing the right thing. That often transfers into lecturing, managing, and controlling behavior on parts of the parents especially when we start to get concerned about how are kids are doing. This is the last thing we should do. This shuts our kids down, makes them feel criticized, and often more anxious. Good parenting doesn't come naturally to most of us. Listening to and respecting our teen should be a big part of what we strive to do while encouraging them to explore their feelings and seek us out when they are stuck. 

2.  Model Emotional Regulation

Resist the urge to yell, punish or act out when you are angry at your teens or anxious about what is happening. Instead, ask them calmly about what is going on. Share your observations, and your own thoughts. Let them know you are a resource for them, and encourage them to think about what might be going on with them, and how you might help them solve their problem. 

3. Encourage them to identify their anxiety, and not use it as a reason to avoid doing things 

4.Protecting your child from ordinary disappointing and feelings or working through their own difficulties will deprive them of opportunities to acquire coping skills and learn how to regular their emotions. Don't constantly step in to help your child as it will make their anxiety worse. 

 4. On the flip side,  ease up on parental pressure. In my practice I see many adolescents who suffer from anxiety because of too many expectations from parents. Try to examine whether your expectations might be contributing to your  teens anxiety. 

5. Err on the side of getting help. It's never a bad idea to get therapy for yourself or for your teen. Meet with a therapist if you think your teen is having a diffiuclt time. It's never a bad idea to meet with a therapist and get an assessment to check in. There may be things you can do to help yourself or your teen through this diffiuclt time, and a professional can give you an objective opinion about these issues. 


EJ, Garland. (2001). Rages and Refusals: Managing the Many Faces of Adolescent Anxiety. Can Fam Physician , 1023-1030. 

Schrobsdorf, S. (2016). The Kids Are Not All Right. Time International (South Pacific Edition)188(19), 44. Retrieved from http://search.ebscohost.com.proxy141.nclive.org/login.aspx?direct=true&db=f5h&AN=119170445&site=ehost-live

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