Anxiety is something that everybody experiences at one time or another. Typically, anxiety works in our favor. For example, if your teen has anxiety about an upcoming test, the anxiety can motivate her to take notes in class and study for the test. The result may be a good score on the test. There are many situations where it is normal for your teen to be anxious. Between school, work, friends, and family, your teen encounters multiple opportunities to experience anxiety. This is nothing to be concerned about, and it is to be expected. However, when anxiety starts interfering in your teens ability to function in a normal way, then it is time to be concerned.
Teens and Anxiety
According to the National Alliance on Mental Illness (NAMI), 8% of teens between the age of 13 and 18 suffers from anxiety. However, only about 18% of them get proper treatment. Anxiety can start for kids as early as 6. Females are twice as likely to suffer from anxiety than males. For some people there could be a genetic proponent to anxiety, meaning if you suffer from anxiety then your child may be more likely to suffer.
The symptoms of anxiety may start gradually and eventually build up to where there is a problem. For some teens, the symptoms of anxiety will appear very quickly and suddenly. This is more likely when something happens to trigger the sudden onset of anxiety. It is common for a teen who suffers from depression to also have anxiety. There are different types of anxiety and it could have a variety of effects on your teen.
Anxiety Symptoms in Teens
Anxiety disrupts how a person’s brain identifies danger, both perceived and real danger. A person with GAD may sense that there is danger in a situation that really is’t dangerous. They worry obsessively about different things, including many things that are normal everyday occurrences. They aren’t able to control this worry and it can have many negative effects. They may experience serious emotional distress and this may cause problems in every area of their life.
They may struggle at home, at school and with relationships. A person with anxiety may have heightened responses to real or perceived fears. You may see your child avoiding social situation. Additionally, anxiety can manifest with physical symptoms, such as headaches, nausea, aches and pains, as well as shaking or trembling. Other physical symptoms can include things such as difficulty breathing or swallowing, trouble with concentrating or sleeping, easily startled and sweating or hot flashes.
Panic Attacks in Teens
The Anxiety and Depression Association of America (https://adaa.org) estimates that about half of the people that suffer from depression also have serious struggle with anxiety. Panic Disorder is a type of anxiety disorder. It is characterized by having sudden attacks of very intense fear. Many of the symptoms described above become very intense. These panic attacks can happen anywhere from seldom to as frequent as several times in an hour. If your teen suffers from panic attacks they may live in fear of when the next panic attack will occur. A panic attack may happen as a result of a trigger, such as hearing, seeing, or smelling something. It could be triggered by a specific location or they may think that they see somebody that has caused problems for them.
A person that is having a panic attack may feel frozen and can’t move. They may feel that everything is happening in slow motion, or they may have the sensation that they are watching their life happen. The panic attack may also cause your teen to flee. A panic attack can last for a few minutes or it could last for quite some time. Fearing that you could have a panic attack can make you feel that your life is out of control and add to the anxiety. Your teen may avoid going places where they have had a panic attack or places they associate with their panic attacks.
Social Anxiety in Teens
Another form of anxiety is Social Anxiety Disorder and is characterized by an extreme fear of being around other people. There are many feelings that can go along with this. Your teen may be fearful of being judged or doing something to embarrass themselves or may fear being rejected by those around them. This anxiety is typically not logical, and your teen may even know this, but is not able to control it. When a person suffers from social anxiety they will avoid going places. They may feel “safer” at home or other more familiar places. Your teen may go out of their way to avoid going somewhere. They may feel ill and the thought of going around people could cause a severe anxiety attack or even a panic attack.
Social Anxiety in School
A more rare form of anxiety, but one with potentially serious consequences, is an anxiety based school refusal. It is estimated at about 2 – 5% of children suffer from this type of anxiety. I am not talking about a child not wanting to go to school but the child whose anxiety gives them what can appear an aversion to school. This can be quite extreme. One of my daughters experiences this from an early age. Starting in 1st grade, the principal would regularly tell her that part of his job was to make sure nobody came to the school to hurt her. By the time she was in 4th grade she had a repertoire of ways to avoid being in school. At the time we didn’t understand what was going on, but in hindsight it is very clear. She would tell her teacher or the clinic aid that she threw up and that would result in a call for us to pick her up. When I made the rule that an adult had to see the vomit then this stopped. If she had to go to the restroom a teacher would have to monitor the hall because she would walk right out of the school and head home. There were times when we would carry her into the school kicking and screaming. As she got older she would get frequent headaches and migraines that would last for days. It is hard to know for certain, but I think that many of her migraines were a physiological response to the “need” to not be in school. She was very bright and the academic part of school was not a struggle for her. But the thought of being there was more than she could deal with on a daily basis.
What does this mean to you as a parent?
Treating anxiety in teens is not easy and can be very complicated. First, as always, I encourage you to take your daughter to see their pediatrician or another doctor. If they are experiencing physiological symptoms then it is best to rule out medical problems. If there are no medical problems, or if there are and they have been treated, then it is easier to treat the anxiety.
Secondly, you may have to continually remind yourself that this is something that your child cannot control. I expect that your child is probably more frustrated than you are. Feeling extreme anxiety and the physiological symptoms can be frightening. Your child needs your love, support, encouragement and understanding to help them through this difficult time. I know firsthand how frustrating it is and how difficult it can be, especially when you can see the illogical nature of the anxiety.
Flexibility and Patience is Important
You will need to be flexible with your child. Try to stick to a normal routine but understand that it is not always possible. You may need to plan for extra time to accomplish something or to get somewhere. Your child may need to sit in the car in front of the school for a bit while they are gaining the courage to go in. Don’t say or do anything that will communicate disappointment in your child.
You may need to modify your expectations. Expect that it will be difficult for your child at school, even if your child is not suffering from the school refusal anxiety. Talk to your child’s school counselor or social worker about the difficulty your child is having. They can help you to come up with a plan for your child to help them get through the school day. This may include frequent breaks or the ability to spend time in a “safe” place. This could be in a particular teacher’s classroom during lunch or maybe the counselor’s office.
Don’t punish your child when the don’t accomplish something when you believe it is related to their anxiety. If they have a hard time concentrating in class or their anxiety makes it hard for them to be at school you can expect that their grades may not be as well as they potentially can be. Praise for small accomplishments. “I know it was really hard for you to go to school today and I am very proud of how hard you tried.”
Listen to the advice of your child’s mental health provider. Get your teen involved in their treatment. Controversial as it is, medication may be the right thing for your child if using other measures doesn’t help to control your child’s anxiety. Individual therapy can be helpful. Usually, the best approach is a combination of treatments.
What Can I do to Help?
- Educate yourself – read about anxiety and talk with those who have experience
- Get help – talk to your pediatrician, school counselor or mental health provider
- Listen to your teen – be supportive and non-judgemental
- Watch for unhealthy coping mechanisms or other warning signs
- Talk to somebody about how it is effecting you