Adolescents, Anxiety, and Your Questions Answered

Everyone experiences anxious feelings at some time or another. Whether your child worries about an upcoming test at school or feels a sense of dread before presenting in front of the class, an occasional (and temporary) bout of anxiety is normal. In fact, temporary, moderate forms of anxiety are adaptive as it often provides us with the motivation and drive to complete important tasks and goals. Although mildly anxious feelings are common for most people, constant, severe, or persistent anxiety may be signs of a mental health issue.

When does anxiety stop being a normal reaction to a potentially stressful situation and instead become an issue? Anxiety that impacts your teen’s daily life (such as school, social life, or extracurricular activities), doesn’t go away on its own, or seems to get worse over time could be signs of a mental health concern.

Not all anxiety disorders are the same. The most common disorders are:

• Generalized anxiety disorder.
  Also known as GAD, generalized anxiety disorder is excessive anxiety and worry that occurs more days than not for at least 6 months, which can include a range of symptoms. Teens with GAD may feel on-edge, have difficulty concentrating, feel easily fatigued, or experience muscle tension.
• Panic disorder.
  Teens with this anxiety disorder may experience recurrent and unexpected panic attacks, which are abrupt feelings of intense fear or discomfort that peaks within minutes. During an attack, your teen may sweat, tremble, shake, have difficulty breathing, or feel like their heart is beating out of their chest.
• Phobia disorder.
  This anxiety disorder revolves around experiencing significant and persistent fear that is excessive and unreasonable around a specific situation or object. Your teen will often experience fear or develop a panic attack around this object or situation and may try to avoid the feared situation/object entirely or endure it despite experiencing intense anxiety. The situation/object could include anything from social situations to driving.
• Social anxiety disorder.
  Also known as social phobia, social anxiety disorder is persistent, intense fear or anxiety around social situations. Your teen may fear being judged, embarrassed, or negatively evaluated by certain situations to such an extent that they may try to avoid them altogether. Some common examples include avoiding school, large crowds, or frequently cancelling social outings last minute with friends.
• Obsessive-compulsive disorder.
  Teens with OCD experience obsessions, which are persistent, unwanted thoughts that they find distressing/anxiety provoking. They will try to ignore, suppress or neutralize these distressing thoughts by engaging in compulsions, which are repetitive, rigid and time consuming behaviors or mental actions that they feel compelled or driven to perform in order to relieve their anxiety/distress. Some common signs are repetitive handwashing, frequent checking of doorknobs/lights, and asking you for constant reassurance.

Ultimately, no one expects you, as the parent or caregiver, to evaluate your teen’s fears and diagnose an anxiety disorder. If you have concerns, contact a mental health provider for a professional evaluation.

How do you know when your child’s anxiety has gone from a normal case of nerves to something that requires professional help? Again, a mental health provider can look for signs of a disorder and help your teen take the next steps towards treatment. But if you’re not even sure when to call a provider, signs/behaviors that may indicate the need for professional help include:

• Excessive fear or worry.
  Does your teen worry all the time? Even though you may expect your teen to have some level of stress in their life, excessive, persistent fear may require professional attention.
• Social withdrawal.
  This type of withdrawal from friends or family members may point to one of several different disorders or issues. Sudden social changes or isolation could come from an anxiety disorder, depression, substance use, or another source entirely.
• Physical complaints.
  Even though anxiety disorders are mental health issues, psychological problems often can cause physical complaints. These could include mysterious stomach pains, headaches, excessive tiredness, muscle aches, or other types of discomfort.

Along with these symptoms, sudden or major changes in your teen’s behavior are also cause for concern. If you’re in doubt, call a mental health professional for advice and request an evaluation.

A mental health provider can do more than diagnose your teen’s anxiety — the therapist can also help your teen overcome the debilitating effects of this disorder. While there’s no one-size-fits-all cure, a mental health professional can:

• Provide therapeutic options.
  Different types of anxiety require different treatments. Evidenced-based treatments such as Cognitive Behavioral Therapy (CBT) are most supported for the treatment of anxiety disorders. Specifically, Exposure/Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT) are both evidence-based approaches that successfully treat a variety of anxiety disorders. The provider can help you and your teen explore what will work best for your child’s specific concerns.
• Discuss the use of medications.
  Some teens respond well to medications in addition to therapy. A medical doctor will need to prescribe this type of treatment.
• Offer intensive treatment programs.
  Some teens will have such a significant impairment in their life that it is helpful for them to utilize more intensive day treatment and/or on-going therapy.

The type of treatment that works best for your teen depends on his/her individual needs. This requires the provider to spend time with your teen, getting to know your teen and his or her unique needs before making specific recommendations.

Is your teen ready to get help? Contact the Anxiety Institute for more information.