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Today, we're going to take a look at how anxiety affects teenagers and what we can do to help. When kids are young, their worries tend to be straightforward and based on their environment: a monster under the bed, maybe a big dog, or something bad happening to someone they love. As kids reach adolescence, anxieties can sometimes turn inward, morphing into deeply personal worries. Changing bodies, school or social pressure, relationships, global issues like climate change, racism or discrimination, the pandemic, and tensions with family or troubles with friends can all add to the pressure of growing up, and it can leave many teenagers wrestling with anxious thoughts. For teenagers, anxiety is not new. Many have been dealing with anxiety since childhood. Maybe they were able to manage it, maybe they've gotten some help or treatment in the past that helped them deal. As kids move into middle and high school, the stakes get higher and the work can get harder. So, what are some of the main causes of anxiety during the teenage years? One of the first causes can be performance. We see a lot of fear of not doing well. A lot of anxiety can be geared toward perfectionism or needing to do your absolute best in school, even beyond kids who might have an intense work ethic. Even when parents report that they urge kids not to stress over grades or college admissions, teenagers can say they feel intense pressure to get those grades or to get into that school. Secondly, how teenagers are perceived. Every teenager is going to have some self-consciousness about how they're being perceived. That's a completely normal part of adolescence, but for some kids, that can get really accelerated or expressed in big ways. The result can be debilitating social anxiety. Someone with social anxiety is so excessively worried about whether or not they might be seen as competent or smart, or whether they might do something embarrassing, that they might avoid many things other teens actually enjoy. A third source of stress: teens' bodies. Physical changes in adolescence can be extremely hard for many kids. Hormonal shifts bring big changes, including periods, acne, changes in height, strength, or voice, and the list goes on, and significant emotional impacts like mood swings, irritation, sadness, and for many kids, increased anxiety. Changing bodies also can create serious anxiety for trans and non-binary kids who don't identify with the gender they were assigned at birth. So, kids can also become more conscious of how they look, and factors like their weight, height, or appearance can be a big cause for stress or anxiety during this time. Some kids can develop a form of extreme anxiety called body dysmorphic disorder, becoming so obsessed with a particular physical flaw, perceived, real, or imagined, that it causes great distress, can interfere with their functioning, and in time can lead to eating disorders. A final factor is the world. Teenagers also, and very understandably, feel a lot of anxiety about the world we live in and the future. Worries for teens today can range from climate change to racism, human rights to war, LGBTQIA rights, and a future that can feel at best unstable and at worst downright scary. These are big issues, and the anxiety they cause is real. With all that's going on, it's easy to see why teenagers might be stressed. So, how can we tell the difference between normal worry and the anxiety that may need extra support or treatment? Anxiety is often overlooked because teenagers are good at hiding their thoughts and feelings. Knowing what to look for and having regular check-ins with teens in your life can help. Some signs that a teenager is experiencing more serious anxiety can be constant or often irrational-seeming fears and worries about routine parts of everyday life, being a lot more irritable than perhaps they used to be or perhaps than you'd expect, trouble concentrating or new difficulties in school, extreme self-consciousness or sensitivity to criticism, withdrawing from their family and friends, avoiding new situations, chronic complaints about stomachaches or headaches or other physical pains, needing a lot of reassurance, having sleep difficulties or problems, substance or alcohol abuse. Anxiety and depression often go hand in hand. This is in no small part because the distress and pressure of anxiety can be overwhelming and can open the door for depression. If you notice that a teenager in your life seems anxious or down, be sure to mention it, especially when seeking treatment. This kind of layering of anxiety and depression is both common and commonly missed. If a clinician just treats the presenting symptoms of depression and misses the anxiety, the result of treatment won't be as effective. So, how can we help teenagers who are struggling with anxiety? You can start by having a conversation, approaching a teen nonjudgmentally and trying not to ambush them. For example, you could say, "Hey, I've noticed you seem really stressed lately. I'm worried. Could we talk a little bit later?" When you do talk, you try to ask open-ended questions, give the teen a little bit of time to process the questions you're asking or the questions you've asked to set up the meeting, and you try to validate the teen's feelings without confirming their worries necessarily. For example, if a teenager is anxious about going to school, you could say, "Look, that sounds really hard and especially difficult for you to deal with. When did this feeling start?" You try to ask those open-ended questions to hear a bit more about what the teen's experiencing, and you try to listen more than you talk. Once you've started a dialogue, you'll have a better idea of what's going on, you'll have a better idea of what kinds of goals an adolescent might have around their anxiety, and you might have a better idea of what kind of help or treatment could be needed. Next, let's talk about how anxiety is treated. The most effective treatment for anxiety in teenagers is cognitive behavioral therapy. Cognitive behavioral therapy teaches anxious kids strategies for thinking differently about anxiety and responding to it differently when it occurs. By tolerating anxiety rather than avoiding the things that trigger it, kids can learn that it diminishes over time. By gradually increasing exposure to feared objects or activities, a type of CBT called exposure and response prevention, the anxious response itself can be reduced, eliminated, or tolerated. The most effective treatment for anxiety is CBT combined, if needed, with medication, and the good news is these treatments really work. The bottom line is that anxiety in teenagers is real, common, and treatable. If you or someone you know is struggling, don't stay quiet. Instead, reach out and speak up. Help is available, and it really does work. To learn more, visit the Child Mind Institute Family Resource Center, which has hundreds of articles and guides to help you support children who are struggling with mental health or learning disorders. You can find the link in the description below. I'm Dr. Dave Anderson, a clinical psychologist at the Child Mind Institute. Thank you for watching, and if you found this video useful, please like and subscribe to our channel below.
