More than 7 percent, or 4.4 million children, between 3 and 17 years of age have a diagnosed anxiety disorder according to the Centers for Disease Control and Prevention. Many more adolescents suffer from undiagnosed anxiety disorders. Rising rates of adolescent anxiety and stress have made news in recent years and stimulated important discussions about the sources of stress that are leading to anxiety and how to successfully treat its symptoms.
Anxiety disorders can become psychologically crippling for sufferers and draining for those around him or her. Maybe you struggled with anxiety in your own formative years, perhaps you’re still struggling with anxiety as an adult, or maybe a child or other loved one is confronting that challenge right now. Teenage anxiety can be devastating for everyone it touches. And It can be heartbreaking to witness someone you love feel trapped, isolated, and debilitated by the disorder.
Teen Anxiety Disorder
Watching a loved one experience any form of anxiety can be a painful experience, regardless of how long it persists. While temporary phases of teen anxiety can pass quickly, full-blown teen anxiety disorder pervades and perpetually afflicts the young person struggling with it. Stress and anxiety are normal occurrences in life. Every teen has experienced some anxiety at one time or another. Some say that a little anxiety is a good thing; it boosts energy levels at crucial moments requiring focus and alertness. However, when that anxiety lingers, it carries the opposite effect. Long-term anxiety hinders our ability to perform work functions and other necessary tasks in our daily lives. Teens who suffer from anxiety disorder experience fear, nervousness, and shyness; they tend to avoid populated places and activities, and end up trapped in a vicious cycle where fear begets fear.
How Pervasive is Teen Anxiety?
Anxiety and depression are rising among America’s youth and—whether teenagers personally suffer from these conditions or not—a troubling 70 percent see them as a major problem among their peers, according to a 2019 Pew Research Center survey of US teens between the ages of 13 and 17. An additional 26 percent view anxiety and depression as a minor problem while only four percent believed them to be no problem at all.
Anxiety disorders are among the most common psychiatric condition in young Americans. Lifetime prevalence rates for any anxiety disorder in adolescents is around 32 percent. In a 2018 study by the National Institute of Mental Health, Greta Bushnell, Bradley Gaynes et al. found that the incidence of new anxiety diagnoses were unspecified anxiety disorder (53 percent), generalized anxiety disorder (25 percent), obsessive-compulsive disorder (5 percent), and posttraumatic stress disorder (4 percent).
How Does Teen Anxiety Affect the Family
Teen anxiety disorder touches everyone in the family. While anxiety disorders, by their very nature, isolate those who suffer from them, they are also isolating for members of the family. It is difficult to live within a community that doesn’t fully understand the challenges that you and your loved ones face; however, just as all members of the family can feel the weight and pressure of an anxiety disorder, everyone in your family can receive the benefits of learning how to handle stress effectively. Stress is, a guarantee of life, so being able to control your reactions to it is a valuable life skill.
It is important to be well-informed about anxiety in teens in order to have the understanding to know when a child needs outside support.
Anxiety is a Feeling, Not a Personality
Teen anxiety is a pervasive and consistently negative experience for those who face it; it is not a character flaw or a personality trait. Individuals braving the challenges of anxiety disorders need love, support, and comfort, the last thing they need is judgement and condescension. Seek to aid those you love who struggle with an anxiety disorder by making them feel safe and sustained. Remember to separate the person from the problem, they are not anxious they are someone with anxiety.
How Limiting is Teen Anxiety
Some of the most influential people in history suffered from anxiety. Anxiety has nothing to do with being weak or cowardly, it is a trial that can help people become even stronger. For individuals, such as President Abraham Lincoln, writer John Steinbeck, actor Marlon Brando, poet Emily Dickinson, or Dr. Sigmund Freud, the founder of psychoanalysis, their anxiety allowed them to experience and feel things few had ever encountered, which empowered them to say and accomplish things few had ever done. They found a way to succeed not despite their disorder, but hand in hand with their disorder.
That being said, there are many additional challenges your teen will have to face. Research shows that untreated teenagers with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse. Understanding these correlated obstacles will give you much of the necessary knowledge to help your teen through their more challenging times.
Teen Anxiety and School Performance
Teen anxiety can negatively influence an individual’s general well-being, social life, academic performance, and development of social skills. Anxiety symptoms are associated with impairment of memory and cognitive functions, and can contribute to poor school performance and academic failure. As poor performance in school can result from excessive anxiety, it can also lead to even greater anxiety, low self-esteem, and other affective symptoms/disorders, thus creating a self-maintaining, negative cycle.
The Correlation Between Teen Anxiety and Substance Use Disorder
Substance Use Disorders (SUD) and anxiety disorders commonly start within an individual’s teenage years. Many teens have been known to self-medicate with tobacco, alcohol, and illicit substances. While those with anxiety disorders may perceive that alcohol and other substances help their anxiety, in reality, they exacerbate their symptoms.
Teens who experience anxiety disorders are two to three times more likely to have an alcohol or other Substance Use Disorder (SUD) at some point in their lifetime than the general population. About 20 percent of Americans with an anxiety or mood disorder, such as depression, have an alcohol or other SUD, and about 20 percent of those with an alcohol or substance use disorder also have an anxiety or mood disorder; however, some studies suggest that the addiction rate may exceed 50 percent among groups who have experienced traumatic events.
Different types of anxiety disorders carry different likelihoods of a simultaneous condition. For example, the co-occurrence of substance abuse, particularly alcohol abuse, is common among people with social anxiety disorder.
Types of Anxiety Disorders
There are different types of anxiety disorders which have different symptoms. Understanding these various types helps us understand how to better help those around us who suffer from an anxiety disorder. The Anxiety and Depression Association of America categorizes these anxiety disorders in the following ways:
Generalized Anxiety Disorder (GAD):
Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry. People with GAD anticipate disaster when there is no real threat of danger. They may be overly concerned about money, health, family, work, or other issues. Individuals with GAD find it difficult to control their worry. They worry more than seems warranted about situations/events and they expect the worst even when there is no apparent reason for concern. GAD is the most common anxiety disorder among teens, and fortunately, it is very treatable.
Social Anxiety Disorder:
The defining feature of social anxiety disorder, also called social phobia, is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. People with social anxiety disorder may worry about acting or appearing visibly anxious (things like blushing or stumbling over words), or being viewed as stupid, awkward, or boring. As a result, they often avoid social or performance situations, and when a situation is unavoidable, they experience significant anxiety and distress. Many people with social anxiety disorder also experience intense physical symptoms, such as a rapid heart rate, nausea, and sweating, and may experience full-blown panic attacks when confronting a feared situation. Although they can recognize that their fear is excessive and unreasonable, people with social anxiety disorder often feel powerless against their anxiety.
Individuals with panic disorder experience frequent panic attacks that often come out-of-the-blue, which leads to the additional fear and worry of the probable reoccurrence of another attack. Panic disorder usually begins in adulthood (after age 20), but younger people also have panic disorders and many can experience panic-like symptoms (“fearful spells”).
Separation Anxiety Disorder:
Separation anxiety disorder is a condition that causes an individual extreme distress when he/she is separated from his/her parent(s) or primary caregiver(s). It is normal for a child to feel apprehensive about separation from a parent in early childhood; however, it becomes a disorder if that fear and anxiety interferes with age-appropriate behavior, whether it’s an 18-month-old who can’t bear to be out of sight of his/her mother or a 7-year-old who can’t tolerate a school day apart from his/her parent(s).
Symptoms of separation anxiety disorder commonly become noticeable in pre-school and early elementary school, but in rare cases it becomes problematic later in early adolescence. An estimated 4 percent of children have the disorder, which is very treatable with both behavioral and pharmaceutical therapies, particularly when caught early.
Obsessive-Compulsive Disorder (OCD):
OCD affects millions of people from all walks of life. Obsessions are intrusive and unwanted thoughts, images, or urges that cause distress or anxiety. Compulsions are behaviors that the person feels compelled to perform in an attempt to ease their distress or anxiety, or to suppress certain thoughts. Some of these behaviors are visible actions while others are mental behaviors. Common obsessions include concerns about contamination, cleanliness, aggressive impulses, or the need for symmetry. Common compulsions include checking, washing/cleaning, and arranging. There isn’t always a logical connection between obsessions and compulsions and often people with OCD experience a variety of both.
Post-Traumatic Stress Disorder (PTSD):
PTSD, is a serious, potentially debilitating condition we tend to associate with military personnel; however, Dr. Elizabeth Hoge, a psychiatrist at Massachusetts General Hospital, speaks on behalf of the Anxiety Disorders Association of America regarding PTSD that affects adolescents as well as men and women who are not in the military. It can occur after experiencing or witnessing a life-threatening event. Rape is the most likely trauma that can potentially cause PTSD among teenagers and adult men and women. Others include a terrorist attack such as 9/11, a natural disaster, serious accidents, personal assault or abuse, or the sudden death of a loved one. Most people who experience such events recover from them, but people with PTSD continue to be severely depressed and anxious for months or even years following the event. PTSD in teenagers can be a root cause of anxiety as traumatic memories bring on post-traumatic reactions.
Sources of Teen Anxiety
Understanding where your teenager’s anxieties originate will help you understand how to best address them. The Calm Clinic teaches that there are many potential causes of anxiety in teens, which often influence one another. Narrowing down the specific type/origin to any one cause of anxiety is oversimplifying an intricate and complex condition. Treating anxiety is made much easier as we understand how anxiety is working on the life of your teen and where it is coming from:
Existential Angst, School Violence, and Social Media:
Reporting increasingly connects real and perceived threats to safety and well-being to adolescent anxiety. Troubling themes including eco-anxiety, school shooting, technology-assisted job displacement, rising college loan debt, and a variety of other major social challenges have become commonplace. Because teenagers rely heavily upon mobile devices and social media for news and information, they may experience a significantly higher number of negative news story impressions than previous generations who relied on traditional media for their news. Teens in many areas of the country have been directly affected by ecological disasters like the wildfires in California, and school shooting incidents. School safety drills that aim to teach children how to respond in the case of school violence may be increasing stress and anxiety for some students. Increase attention to current and potential sources of stress may play a role in the development of anxiety disorders.
Hormonal Shifts and Mood Swings:
Hormonal shifts are a primary factor in most of the causes of anxiety. Hormone shifts are considered periods when the body’s hormones and brain chemistry are unbalanced. Testosterone increases in males and estrogen increases in females, causing heightened reactivity and emotional responses. Moreover, when external stressors are combined with a preexisting imbalance of hormones, the brain is likely to react by altering its physical structure, creating more receptors for stress hormones and decreasing the number of receptors for relaxation hormones, potentially causing long term anxiety problems.
Brain Development and Judgment Problems:
Brain development that occurs during the teen years is a big part of why teenagers experience mood swings and often possess poor judgment abilities. The part of the brain which oversees self-control, judgement, and thinking ahead stops growing between the ages of eleven and twelve and begins refining itself. The strong emotions produced by hormonal shifts are therefore less tempered by reason than they are in adults. Not having self-control, good judgment, or the ability to plan ahead complicates life and becomes the source of crushing stress, particularly in combination with the mood swings resulting from hormonal shifts.
Changes in bodily appearance and functionality can cause stress in many ways. No one wants pimples; vocal shifts can be awkward, and excess body hair, shifts in height, and body odors can be shocking. This goes without mentioning the pain and inconvenience of the menstrual cycle and the embarrassment of erections at inappropriate times. The list of unfamiliar, awkward, and highly stressful events that occur in a teenager’s life can continue. In addition, the development of the body’s sex organs results in overwhelming sexual urges. Repressing these sexual urges is stressful, and the consequences sometimes associated with not suppressing these desires (e.g. STDs, pregnancy, etc.) are even more stressful, requiring capabilities the teenage mind and body are often ill-equipped to handle.
Distancing from Parents or Guardians:
If a teenager has been close with his/her parents from a young age, it may be difficult for them to accept the need to branch out and form connections with others, as well as the need to form their own identity separate from their parents. Being on their own for the first time and taking on new responsibilities can cause feelings of inadequacy and fear as they learn to adjust to having less protection and guidance than they are accustomed to.
Changing Ideals and Parental Disapproval:
Adolescence is a time of changing ideals. Our ideals as children are often formed in a large part by our parents or guardians, thus when our ideals change it can be disconcerting to the adults in our lives. It may be that the religion a teen has grown up with is no longer for them, or their political ideas have become different from their parents’, or they have discovered a new intellectual or active passion, or even a sexual orientation they were previously unaware of. Any of these discoveries can cause parental disapproval and a stifling of the adolescent’s development, potentially causing them to feel unloved and even suspect that they are a bad person for not agreeing with their parents as they had always done previously.
Stressful feelings of isolation in teens can be caused by many factors. This often pertains to a combination of distancing from parents and the process of forming a new identity. When forming their identities, teenagers sometimes default to identifying with a particular group of people and rejecting others. When these divisions occur, friends can separate from friends, causing isolation. Combined with tension in the home environment, this can lead to the classic declaration that “no one understands me,” from which depression and anxiety often stem.
Peer and Social Pressures:
Peer and social pressures to look or behave a certain way or do certain things are major contributors of anxiety in adolescence. Teenagers often feel a lack of choice. They feel trapped by social expectations and the need to change who they are in order to be accepted. Being different is seen as somehow being lesser, thus the demand to give into peer pressure can be overwhelming. Often peer pressure can deviate sharply from what parents recommend and/or demand, which results in extra tension from the disconnect between parental rules and teenage social rules.
Understanding the implicit difficulties of being a teenager in today’s world, mixed with the increased predisposition of teen anxiety rates, is crucial in order to help the ones we love. We are much more fortunate than we were ten, or even five years ago, as anxiety disorders are now recognized by health professionals; we no longer need to attempt to explain something that is not “officially” an illness. The challenge now is to communicate the problem to the many people who are not, themselves, directly affected by the disorder but who do directly, or indirectly, affect the lives of teens battling anxiety disorders.
Anxiety can occupy and hijack your teenager’s life. It influences their ability to cope with fear, worry, and depression. Treatment is necessary.
It is critical that you begin treating your loved one’s anxiety as early as possible. Many hope that their teen will simply mature or grow out of these behaviors; however, this is an incorrect mentality. Anxiety can quickly become chronic anxiety and depression, which, as discussed, often leads to a decline in academic achievement, substance abuse, and other high-risk behaviors.
Below is a list of five ways to help teenagers cope with an anxiety disorder:
1. Self-care: A growing mind and body need sleep and good nutrition to feel at peace. Without these fundamental human needs, it is difficult to restore feelings of tranquility and relaxation. Ensure your teen is taking care of his/herself, help them in any way you can.
2. Connection: We all crave connection; however, teens struggling with anxiety have a fundamental need to connect with loving people in their life. Approval and support are essential to a child’s well-being. When a teen is in crisis, such love becomes even more important.
3. Nature: Anxiety in teens is often worse indoors. Help your teen get out of the house and experience the great outdoors. Turn off televisions and computers, disconnect for a while. The peace and calm provided by nature works wonders.
4. Positivity: Just because things are hard now, does not mean they have always been this way. Help teenagers with anxiety recall good times from the past and aid them to find the silver lining in their current situation. Highlight positive moments in the relationships they developed, in the choices they’ve made, and in their victories. Focus on the exciting future and the potential of realized dreams. Hope is a powerful tool, use it to promote positivity and excitement in the life of your teenager.
5. Guidance: Seek help from treatment professionals. Anxiety in teens is hard to handle alone. Many teens attempting to battle anxiety need professional guidance and/or medication. More and more teens are accessing such support.
It is difficult to realized that you may not possess the necessary skills and knowledge to completely care for your loved one, but getting help may be the best choice you can make for your teen. Proven treatment techniques and the guidance of expert clinicians will help those who experience an anxiety disorder heal. Your teenager can be taught essential tools to help him/her become self-reliant and build healthy habits and relationships.