Anxiety Symptoms in Teens and Effective Treatments

Later in the article we’ll list some common anxiety symptoms in teens, but let’s begin by discussing some of the reasons why your teen son or daughter may be particularly vulnerable to anxiety and developing anxiety disorders. Everyone is likely to experience anxiety at least once during his or her lifetime. We typically experience anxiety during significant life changes, in the midst of relationship issues, during periods of rapid growth or development, when the time comes for our performance to be reviewed at work, or during the holidays when  extended family comes out of the woodwork. As parents, we are likely to experience anxiety whenever we lie awake considering our aptitude as parents, or how to achieve the goal of turning our children into adults capable of functioning in a complex social world.

Why Your Teen May be Vulnerable to Anxiety

Adolescents are also very likely to experience anxiety, although they may experience it with regard to different issues. They face a variety of situations and internal factors that can cause anxiety or contribute to feelings of unease. Typically, adolescents are likely to interact with others in several domains, including at home, at school, in clubs or sporting activities, in social groups, in church groups, and on social media. These interactions create much fodder for a brain that is fraught with newfound fears and is learning to over-analyze. During their adolescent years, your son or daughter is attempting to build a cohesive formulation of their identity—of who they really are and who they want to be.
However, while trying to form this idea, they encounter a great deal of input from others. It is no longer as simple as when your daughter just knew that she loved pink, that Samantha was her best friend, and that she would never choose jeans over her sparkly, pink princess dress. Teenagers at this stage now have many others telling them who they need to become in order to fit within social norms, what personality traits make them attractive, and which aspects of their identity are going to draw attention (whether positive or negative). They need to be able to perform well at school, while coping with the immense pressure of needing to determine what their future should hold. During this time period, most adolescents will have their first relationships and must also cope with input from a newfound significant other. Social media has created further input that is almost inescapable for adolescents. Bullying, peer pressure, parental pressure, the need to perform academically and socially, and plans for the future combine cumulatively with individual factors to create soil in which it is difficult to grow and develop a cohesive identity.

The Growth of the Teenage Brain

In addition to the impact of these external factors, your teenager is attempting to create an identity with a brain that is not yet fully formed. Their developmental stage also contributes to an exaggerated perception of how others see them. They are more likely to think that a friend’s eye roll is due to the fact that this friend considers them stupid. If someone stares at an adolescent for too long, they are likely to assume that it is in regards to their own appearance, or some similar self-deprecating idea. Although it is probably the other individual’s own issues that create these scenarios, that does not mean that your son or daughter is naturally going to give this possibility the credence it deserves. This hypersensitive awareness of how others perceive them can increase feelings of anxiety.

As adolescents’ brains develop, they create beliefs or “truths” about themselves and how they interact with their environment. They are attempting to understand where they fit by means of tools such as comparison and deduction, but these are probably not the best tools with which to form accurate ideas. The beliefs they develop are built through interactions with others, their perceptions of those interactions, their level of resilience, and their understanding of where they came from and where they are going. However, sometimes these beliefs need to be nurtured into beliefs that are adaptive and accurate, and will allow the adolescent to be kind to himself or herself and offer grace. If not, further negative thoughts may create further anxiety.

Genetic Causes of Teenage Anxiety

Adolescence is also the time when the genetic and biological factors that may underlie anxiety can begin to make themselves felt. The causes of anxiety are not always simple and clear cut. While your teenager’s surroundings may be contributing to or creating anxiety, biology and genetics cannot be fully eliminated from the equation when considering its causes. Any familial history of anxiety disorders or other mental health disorders may increase the chances that your adolescent develops an anxiety disorder.
It can be a struggle to discuss mental health issues and to understand what your teen is currently dealing with, and where they are at mentally and emotionally. These are difficult topics to discuss and your son or daughter may not feel fully comfortable discussing them with you. In order to better understand adolescent anxiety, the following section discusses some of the signs and symptoms of adolescent anxiety and anxiety disorders.

What does Anxiety Look Like in Adolescents?

Anxiety in adolescents may present itself differently to anxiety in adults. Everybody experiences anxiety, which is a normal reaction to stressful situations—your son’s first driving test, your daughter’s first attempt at public speaking, or your son or daughter’s first attempt at the SAT. Anxiety can be a useful response to stress, and helps one to prepare for a present or upcoming stressor. While symptoms of anxiety are usually internal, there are some outward symptoms that you may be able to note or discuss with your son or daughter.
Anxiety can be normal, but it is important to note when it exceeds normal bounds and increases to a level that causes more distress than is typical. There are many types of anxiety disorders, and these can include a variety of symptoms that may be surprising. These symptoms are usually confusing to both the teen and the parent, as they may seem entirely unfounded or unexpected. However, these issues are not uncommon. Anxiety disorders are typically found in about 25% of the adolescent population (National Institute of Mental Health, n.d.). Anxiety can feel confusing to all involved, even the individual who has experienced it for a long time. Typical ways of coping are not likely to be helpful with all forms of anxiety. Some anxiety may be of a clinical nature, which means that it may require assistance with building coping skills and dealing with underlying issues. These symptoms are likely to feel overwhelming for the adolescent, who will feel that it is out of control. Such adolescents are not able to think or rationalize their way out of these symptoms on their own.

Anxiety Symptoms in Teens

Here are some of the most common symptoms an adolescent with an anxiety disorder may exhibit or notice:

• Consistently feeling nervous or tense, and unable to relax and let go of feelings of stress.

This may feel like a general unease. Your adolescent may appear to discuss their concerns or worries about situations more frequently. Alternatively, they may seem to be generally more on edge. This may appear as a general unease, or it may appear to be linked more specifically to certain types of concerns or situations. While worrying about life is arguably an integral part of adolescence, constant worrying is not normal and can be treated.

• Feeling nervous when there is not a specific circumstance that is likely to provoke anxiety.

Everyone feels anxious sometimes. However, when the anxiety remains consistently elevated irrespective of the external stimuli (whether situations get better or worse), an anxiety disorder may be present. This means that although nothing appears to have changed in your adolescent’s life (and they may agree that nothing has changed), they may experience newfound unease, but without knowing why. This type of generalized anxiety can be very confusing, but is likely to be indicative of an anxiety disorder.

• A preoccupation with fears that are out of proportion to what would typically be expected as a response to a specific circumstance.

If the feelings of anxiety are always present or exceed what appears to be a normal response to a stressful stimulus, you can know that your adolescent is not currently reacting well to stress. For example, if you ask them to take the trash out after dark and they appear highly upset about what may happen if they go outside, despite having done this many times in the past.

• A preoccupation with concerns or ideas that may not seem relevant or realistic.

Anxious thoughts are thoughts that are not easy to rationalize away. These fears may not seem realistic, and may even seem absurd to the observer, and even to the individual experiencing anxiety. However, they are quite real and poignant to the adolescent experiencing them. Such fears can vary greatly, but will probably seem odd or unusual to you as the parent.

• Sleep disturbance

Experiencing difficulty falling asleep, staying asleep, or restless sleep may be a sign of anxiety, although there may be many other causes that should be evaluated by a physician. Sleep disturbances may be indicated by excessive tiredness during the day or struggling to stay awake during classes. Sleep disturbances can be caused by many things, including other medical reasons, yet they can be a common symptom of anxiety. You may notice that your son or daughter is staying up excessively late, or appears to be dragging themselves around even more than usual in the morning.

• Difficulty coping with new experiences or time away from their family

If you notice that your adolescent avoids new situations or separation from their family, you may be noticing a symptom of anxiety. This may be noticeable when friends invite your adolescent somewhere and they consistently decline, preferring to stay home instead. When this type of difficulty in coping is present due to anxiety, your son or daughter may prefer to partake of familiar activities and remain in familiar settings.

• Compulsive behaviors

Anxiety can present itself through compulsive behaviors, such as hair pulling, skin picking, the need to recheck homework many times, obsessively checking locks, or other similar behaviors. You may not notice these signs as they are not always evident to an external observer. However, if these types of signs are noted, a discussion about their prevalence may be warranted.

• Obsessive, repetitive thoughts

While these may not be externally evident, your adolescent may be experiencing obsessive, repetitive thoughts. These may interrupt their normal thought patterns and be difficult to erase.

• Panic attacks

Panic attacks can appear in different forms and may be present with some types of anxiety disorders. Panic attacks vary in different individuals, and you may not know whether your son or daughter has had one in the past. They frequently cause one to feel that one’s heart is racing, and that one is breathless and lacks control over oneself and one’s surroundings. They can include a sense of terror or impending death, difficulty in breathing, and chest pain. Symptoms like these should be assessed by a medical professional, but they may be symptoms of an anxiety disorder.

• Fear of specific situations or objects

Specific phobias can be present comorbidly with generalized anxiety, or they can present themselves as an anxiety disorder on their own. These include specific, excessive fears of an object or situation.

• Physical complaints or illnesses

While physical complaints should always be assessed by a medical professional, headaches, stomachaches, and other physical symptoms can sometimes be present with an anxiety disorder or as a result of a heightened level of anxiety.

Anxiety can be an important catalyst for change or preparation. However, not everyone knows how to keep it at a manageable level. Many adolescents have yet to develop the personal coping skills that will enable them to keep anxiety to a helpful minimum. In the following section, I look at effective therapeutic treatment options for anxiety.

Types of Therapeutic Treatment for Adolescent Anxiety

You may discover that your son or daughter experiences anxiety in one of a few ways. You may notice one of the external signs of anxiety, such as the avoidance of activities outside the home. Alternatively, your son or daughter may come to you with their concerns. They may also discuss their anxious feelings with a school guidance counselor or a friend. But what do you do when adolescent anxiety comes to your attention? What is the next step? Many people choose to first seek out medical attention. This is a great first step as your doctor can rule out any physiological causes that require treatment. Your teen’s guidance counselor may also provide a resource and can aid you in determining what to do if you suspect anxiety. Eventually, you or your son or daughter may choose to start therapy.
No matter what type of treatment is ultimately chosen, it is important to know that treatment is very important. Anxiety is not a problem that is likely to work itself out, and long-term habits and behaviors can become established. In general, what does treatment look like? In this section, I look at what therapy might look like, and at the types of treatment that are generally considered effective in treating adolescent anxiety.

• Medication

Medication is one option your doctor may consider in the treatment of anxiety. While your therapist is not likely to be involved in this, medication is a common treatment option when dealing with anxiety. It is a treatment option best discussed with your general practitioner or psychiatrist.

• Family Therapy

Sometimes the family is involved in the treatment of adolescent anxiety, which can be achieved through family therapy. Family therapy may be helpful in treating adolescent anxiety when familial or parental factors are involved in the ongoing symptoms of anxiety. This type of therapy is usually conducted in an office setting with the family members involved in the adolescent’s treatment. Although it has not been shown to be more effective than individual therapy when viewing outcomes (Reynolds, Wilson, & Hooper, 2012), family therapy may still be an option worth considering, depending on your specific circumstances. Your therapist will determine whether this is a viable option in your son or daughter’s treatment.

• Cognitive Behavioral Therapy

Cognitive behavioral therapy is one of the most common treatments for adolescent anxiety. It is based on the idea that cognition impacts the individual’s feelings and behaviors. Everyone has beliefs about themselves and the world around them that underlie and influence how they think about current circumstances or ongoing issues. These beliefs create automatic thoughts, which lead to emotions and, ultimately, to behaviors. Many of these automatic thoughts go unchecked and never seeing the light of day, but they continue to live in our subconscious minds. Cognitive behavioral therapy is a pragmatic way to determine the effects of one’s beliefs, and how to alter these beliefs to more adaptive ways of thinking. This can occur through the skills gained in challenging negative thinking and ideas. Cognitive behavioral therapy is collaborative and straightforward. It can be a brief form of therapy and its effectiveness has been noted (Compton, March, Brent, Albano, Weersing, & Curry, 2004).

• Mindfulness and Relaxation

Mindfulness and relaxation techniques can be effective in reducing adolescent anxiety. These are typically introduced in addition to other modes of treatment. Mindfulness and relaxation skills can be taught in a therapeutic setting and practiced at home. These skills become effective coping strategies, and are likely to continue to be useful throughout one’s life. Mindfulness incorporates acceptance and awareness of where one is currently at, without judgment. This means fully accepting and experiencing the present moment, including the acceptance of one’s emotional states, tensions, life circumstances, etc. This type of acceptance has been shown to be effective in decreasing anxiety (Hofmann, Sawyer, Witt, & Oh, 2010). Various relaxation skills can be incorporated into mindfulness and other types of treatment.

Christian Counseling for Adolescent Anxiety

As a Christian counselor, I know that it can be extremely overwhelming to learn that your son or daughter may be dealing with anxiety, which you may or may not understand. If you feel that your son or daughter may be experiencing anxiety and you think that therapy is a good option for your family, please discuss this with your son or daughter and see if they would like to give us a call. One of our Christian counselors who works with adolescents will be happy to partner with your adolescent, and to help him or her to begin to heal and to gain effective skills that can last a lifetime.