How To Recognize Anxiety In Teens

According to the Anxiety and Depression Association (ADAA), anxiety disorders may be present in over 25% of teens between the ages of 13 and 18. Common anxiety disorders include generalized anxiety disorder, social anxiety disorder, test anxiety, PTSD, separation anxiety, or specific phobias. Risk factors may include family with mental health disorders, environmental issues, medical conditions, use of alcohol or drugs, and some medications. Treatment can involve cognitive-behavioral therapy, medication, natural treatments, a healthy lifestyle, group therapy, and other options. Parents of teens with anxiety may find it helpful to speak with a licensed therapist online so that they can properly support their children.

Signs of anxiety in teenagers

The teenage years are a time of transition for young people. As they go from being younger children to nearly grown adults, teens experience several physical, emotional, and cognitive changes. According to the Child Mind Institute, “Anxious teens are different from anxious children. When they’re younger, kids worry more about things like the dark, monsters, or something bad happening to their parents. But teenagers are more likely to be worried about themselves.” 

Teenagers may experience new mental health challenges, associated with peer acceptance, academic performance, and physical health. Because of these changes, it can be hard to know the difference between an anxious response related to normal development and anxiety symptoms that require further action. Below, you’ll find brief explanations and symptoms of several anxiety-related mental health disorders.

Generalized anxiety disorder is a common mental health disorder that can cause excessive and continuous anxiety about many things. It is not typically occasional angst or worry about one or two things, but a consistent fear or worry. Some of the mental and physical symptoms of anxiety may have include:

Cognitive/emotional symptoms

• Unrealistic worry over everyday things
• Inability to let go of worrying thoughts or ideas
• Lack of concentration
• Not being able to make decisions
• Trouble dealing with everyday concerns
• Dwelling on things that might go wrong

Physical symptoms 

• Restlessness
• Sweating
• Shaking or trembling
• Irritability
• Headaches
• Fatigue
• Insomnia or sleeping too much

If your teenager is afraid to meet new people or talk to others, or if they have an unrealistic worry of being judged by others, they may be experiencing social anxiety disorder. Some other signs of social anxiety disorder can include:

• Avoiding friends and social activities
• Feeling "sick" often with no actual signs of illness
• Fear of being judged
• Refusing to go to school
• Afraid to meet new people
• Inability to speak around others
• Difficulty concentrating in social situations
• Nervousness
• Restlessness
• Irritability

A panic attack is characterized by sudden, extreme anxiety symptoms that can cause an individual to feel overwhelmed or as though they’re losing control. Those living with panic disorder experience frequent panic attacks, which can significantly impact their mental and physical well-being, social interactions, and academic success. In addition to feelings of intense fear, panic disorder symptoms may include:

• Rapid heart rate
• Shallow breathing
• Shaking
• Sweating
• Gastrointestinal distress
• Chest pain

While it can be common to worry or feel nervous before an important test, some people have such an intense fear that they are unable to perform. The cause of test anxiety may not be clear, but it could be possible that your teenager may have had a bad experience with a test in the past or is experiencing a fear of failure. The signs of test anxiety can include:

• Racing thoughts
• Blanking out
• Inability to concentrate
• Negative thoughts
• Restlessness
• Irritability
• Nervousness
• Fast heartbeat
• Dizziness or fainting
• Nausea or vomiting
• Shortness of breath

PTSD

PTSD can be a severe condition that strikes those who have experienced some kind of traumatic incident. For example, an attack or rape, child abuse*, a parent with addiction, a violent household, a car accident, or even a natural event like a tornado or hurricane may lead to the development of PTSD.

*If you or someone you know is or may be experiencing abuse, please call the National Domestic Violence Hotline, available 24/7, at 1.800.799.SAFE (7233) or text "START" to 88788. Live chat is also available on the National Domestic Violence Hotline website.

Some of the signs of PTSD may include:

• Nervousness
• Dizziness or fainting
• Irritability
• Nightmares or night terrors
• Insomnia
• Flashbacks
• Racing thoughts
• Nausea or vomiting
• Rapid heart rate
• Isolation
• Fear of loud noises
• Easily startled
• Self-medication with drugs or alcohol

Some anxious teenagers may become attached to a parent or caregiver more than usual due to a fear of being abandoned or something bad happening. Some potential symptoms of separation anxiety are:

• Refusing to go anywhere alone
• Getting anxious if parents or a loved one leave their sight
• Wanting to sleep in their parent's room
• Nightmares
• Insomnia
• Irritability
• Physical symptoms like nausea, headaches, and vomiting
• Worrying that their loved ones will never come back
• Persistent fear of being alone
• Clinginess
• Extreme distress when forced to leave home

Specific phobias

Phobias are irrational, recurring fears of situations or objects that present no real threat. The physical symptoms of a specific phobia can depend on what you are afraid of, but they usually include:

• Shaking
• Extreme fear
• Rapid heart rate
• Muscle tension
• Ringing in the ears
• Dry mouth
• Dizziness or fainting
• Nausea or vomiting
• Numbness
• Sweating
• Headache
• Tightness or pain in the chest
• Butterflies in the stomach
• Choking sensation

Causes and risk factors

Although experts are not completely certain of what causes anxiety, some things can be considered risk factors for anxiety disorders. One of these risk factors may be genes. Young people who have an immediate family with a mental health disorder such as anxiety, depression, or ADHD may be more prone to developing anxiety themselves. Other anxiety risk factors may include:

• Environmental issues such as trouble with school, relationships, or family dynamics
• Other medical conditions like heart disease, cancer, and diabetes
• Use of drugs or alcohol
• Experiencing anxiety as a side effect of some medications

Managing anxiety symptoms

Psychotherapy is a primary method of treating anxiety disorders in adolescents. Therapy can improve young people’s mental health by allowing them to develop healthy coping strategies, talk through the emotional challenges of anxiety, and better understand the sources of excessive worry. Additionally, a therapist can address symptoms of comorbid conditions that may arise alongside anxiety, such as mood disorders, eating disorders, and obsessive-compulsive disorder. 

Anxiety affects individuals differently, and symptoms of anxiety disorders can vary widely; so, a therapist may use one of several modalities when providing care. For example, teens who seek professional help for school phobia—also called school avoidance—may undergo exposure therapy, while teens with generalized anxiety disorder may participate in cognitive behavioral therapy. These different therapeutic methods can be conducted in various formats, including individual, group, and family therapy. 

Medications may also be prescribed to teenagers to alleviate severe anxiety or prevent anxiety symptoms from worsening. Selective serotonin reuptake inhibitors (SSRIs), which are typically used to treat depression, are the first-line method of pharmacological treatment for teenagers living with anxiety. Always consult with a healthcare professional prior to starting or stopping any medication. 

Cognitive behavioral therapy

CBT can be an effective treatment for most anxiety disorders. According to many studies, CBT can be as effective as medication in relieving symptoms of anxiety, depression, and other mental health disorders. The treatment plan generally consists of teaching your teen to understand that their thoughts affect their emotions, which can also affect their behaviors. Some of the common coping techniques taught in CBT may include:

• Breathing therapy
• Progressive muscle relaxation
• Filtering
• Behavioral activation
• Exposure and response prevention
• Cognitive restructuring

Other treatments

In addition to therapy, yoga, meditation, hypnosis, imagery-based exposure, mindfulness, and keeping a journal may help teens manage their anxiety symptoms. Certain lifestyle changes, such as getting plenty of sleep, maintaining a healthy diet, drinking plenty of water, and exercising regularly can also promote less anxiety and improved well-being. Group therapy, whether online or in-person, can also be beneficial for helping teens with anxiety.

Online therapy may help you support your child

It can be difficult to know the best way to help your teenager cope with anxious feelings. Speaking to a licensed therapist can be an effective way to learn how you can guide and support your child. You may even discover helpful techniques to teach your teenager so they can better manage anxiety when it arises and improve overall health. If in-person therapy isn’t convenient for you, you may prefer online therapy, as you can connect with a therapist from anywhere with an internet connection at a time that fits your availability.

According to this study, online therapy can be highly effective for a variety of mental health concerns, including anxiety, depression, and PTSD. Whether you’re experiencing mental health challenges of your own or wish to help your teenager better cope with their anxiety symptoms, please don’t hesitate to reach out for the help you deserve.