Teen Anxiety

A knot in the pit of the stomach that arrives before giving a speech in class or the sweaty palms when a class crush passes a note are normal reactions to stress and anxiety for teens. However, when the stomachaches become persistent and participating in social activities with friends and family becomes difficult, these may be red flags signaling a more serious issue with anxiety.

A certain amount of anxiety is good for us, even as teens. It acts as an alarm system warning us of danger to keep us safe, and it keeps us on our toes as we strive to reach our goals. However, when stress and anxiety come in larger-than-normal doses, it can be crippling, making our ability to function in life a daily struggle. Unfortunately, anxiety is one of the most common mental health issues our teens face today.

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Teen Anxiety: Long-Term Risks

According to the Centers for Disease Control (CDC) 7.1% of kids ages 3–17 have been diagnosed with an anxiety disorder. That’s over 4.4 million people under the age of 18 known to suffer from anxiety. 1 Unfortunately, this growing trend doesn’t appear to be going anywhere anytime soon, as teen anxiety has been consistently on the rise each year over the last few decades, rising 20% between 2007 and 2012 alone.4 What’s worse, according to a Children’s Mental Health Report, 80% of kids with diagnosable anxiety are not getting the treatment they need. This is an alarming statistic, considering one in three teens will be diagnosed with an anxiety disorder by the time they reach age 18, according to the National Institute of Mental Health (NIMH). 

Untreated anxiety in childhood can lead to more serious mental health issues later on, in adulthood. This is partially due to the coping skills that teens develop during these times. If not treated, kids who suffer from anxiety will naturally seek out pain-relieving coping methods to help numb their symptoms, including turning to drugs and alcohol for relief. Other coping mechanisms include changes in eating habits, self-isolation, self-harm, engaging in risky behaviors, and addictions to technology, social media, music, exercise, shopping, and more. 

It’s also quite common for teens who suffer from anxiety to experience depression and/or behavioral problems. One in three teens diagnosed with anxiety is also diagnosed with depression, while another one out of three teens diagnosed with anxiety struggles with a behavioral problem.1 The likelihood of developing one of these conditions only increases as teens grow older. This makes the need for early intervention and treatment of the utmost importance.

Why the Increase in Teen Anxiety?

As kids and teens, we all go through ups and downs, triumphs and failures, friendships and fights, crushes, first loves, breakups, and various other phases of growing pains and conflict in relationships. Growing up can be tough, and it can be even tougher when there’s added stress in the home or conflict at school. Compounded together, it’s all likely to cause a reasonable amount of stress and anxiety for a teenager.

We also live in a society where there are various threats to our overall sense of safety, all of which can contribute to anxiety. Our schools no longer feel safe, we are bombarded with tragic events on the news, and children must engage in drills t prepare for shooters and natural disasters alike.

We’ve also witnessed a variety of terrorist attacks in recent years, and the ever-present threats to our planet due to climate change are more noticeable with each passing season. It’s easy to feel stressed out or anxious on a daily basis simply from thinking about the problems of the world we live in.

With all of the stresses we experience—within our society, our schools, our homes, and our personal lives—the ways in which our teens manage stress and anxiety can have a big impact on their overall mental health. 

Symptoms of Anxiety in Teens

In order to effectively help your teen manage anxiety, it’s important to know the symptoms. Some common symptoms to look out for that could indicate teen anxiety include:

  • Feeling tired or exhausted
  • Feeling restless 
  • Being tense or on high alert
  • Emotional outbursts
  • Excessive worry that’s inflated beyond the normal stress of a situation or without cause
  • Moodiness, irritability
  • Aches and pains
  • GI issues, stomachaches, headaches
  • Avoidance of certain people or situations that can trigger anxiety
  • An inability to focus or concentrate
  • Self-isolation or social withdrawal
  • Changes in eating habits
  • Changes in sleeping patterns

Role of Childhood Trauma

 

While the effects of anxiety can be detrimental to anyone’s sense of safety and livelihood, the root causes of anxiety are often far more upsetting. Children who experience trauma—for example, any of the adverse childhood experiences (ACEs)—are at a greater risk for developing an anxiety disorder later on in life. The most common form of anxiety which develops out of a traumatic experience is post-traumatic stress disorder (PTSD). Anything that’s perceived as traumatic during childhood can lead to anxiety or PTSD later on in life, even into adulthood. 

What Is an ACE?

Adverse childhood experiences (ACEs) are traumatic experiences that include abuse (emotional, physical, or sexual), physical or emotional neglect from a parent or guardian, abandonment, and dysfunction in the home. Trauma can also occur from being involved in a car accident or witnessing something tragic, such as the death of an animal or another person. Trauma can result from any experience that leaves a child feeling as if his or her safety and wellbeing are in danger, such as witnessing a parent being abused, using drugs, being incarcerated, or struggling with mental health. Sometimes trauma can even result from experiences that are not considered abuse but caused a traumatic reaction regardless, such as being hit with a belt or a paddle as discipline, living in poverty, or witnessing the divorce of two parents.

Trauma can also occur when we’re infants, and according to some research, even while we’re in the womb.2 This is why treating the symptoms of teen anxiety is a priority in supporting a child or teen’s healthy development, especially if it’s difficult to determine the root cause of the distress. 

Untreated, the ACEs can often lead to toxic stress, which is the result of the body’s stress responses consistently being activated. Toxic stress can wear us down, subtract years from our lives, and can quite literally be toxic to our bodies. 

How Does Trauma Manifest?

Trauma can manifest in a number of ways as we age, and the way it manifests depends largely on how each unique individual processes it. For some, it’s internalized. A child might begin to disconnect from the emotional aspects of the experience, store stress in the body, and try to overcompensate for any personal shortcomings. Internalizing trauma and storing stress in the body can cause a person to become ill, gain weight, and become more susceptible to physical diseases. For others, the trauma is externalized. A child might begin to act out and engage in mimicking behaviors—expressing the trauma outwardly through play or social interactions with peers and engaging in risky behaviors. 

When trauma becomes a pattern in a child’s life, the consequences are amplified. They may anticipate future trauma and go through life on “high alert.” This causes child to live in a state of continuous anxiety—always in survival mode—throughout their teenage years and adulthood as well. Even if there is no longer any trauma present in the life of a teen or adult, the anxiety can persist for years and impact both everyday life and the way stressful or emotional situations are dealt with in the future. 

Think of it this way: Even if a child, teen, or adult has escaped their trauma and established a calm work or home environment, that calm and safety may feel foreign after spending an extended period of time in survival mode. Especially if they have an anxiety disorder, this can cause them to create conflict in order to create an environment that requires a constant state of stress and anxiety, which is the only way they feel “normal.” In this way, trauma and toxic stress can create a vicious cycle.

Living in survival mode can make personal development a struggle, and those who experience this may find themselves repeating the same patterns and cycles over and over again throughout life without a lot of personal growth. An attitude of learned helplessness can develop out of childhood trauma, which causes teens and adults to project the helplessness they felt during traumatic experiences when they were younger onto current stressful situations, and even everyday life. This can make living life difficult at any age.

How Trauma Can Manifest as PTSD

In the case of PTSD, a traumatic event can become stuck in the brain’s hippocampus, which is the part of the brain that timestamps our memories and stores them. However, when we experience trauma, the hippocampus can become paralyzed, preventing the traumatic event from being timestamped and stored with the rest of our memories. Instead, the traumatic event can rise to the surface at inopportune times and re-play as if we’re living it again or watching it on a large movie screen. This is what happens when someone who has experienced trauma has a “flashback.” Living in fear of having a flashback in public, or ever again, can only add to a person’s anxiety and stress. It can even cause a person to fear going out in public.

Trauma can sometimes even be blocked from a person’s memory, which is the case for some ACEs. While this causes the root cause to remain unknown, the effects can manifest years later as anxiety and toxic stress. It is through intervention and therapy that such memories can be released and true healing can begin. 

This is why early intervention and treatment are essential for children and teens who suffer from anxiety, especially if there’s any suspected trauma from the past. The sooner a person is able to pinpoint the root cause of the anxiety, the sooner the healing process can begin. This is an important step, as too many children are left with untreated anxiety. The longer a kid waits to receive help and treatment, the greater his or her risk of developing more severe mental health disorders further down the line becomes.

Does All Trauma Lead to Anxiety and PTSD?

Not every case of trauma will lead to an anxiety disorder or PTSD. It depends largely on a person’s genetic makeup and unique brain chemistry. It also depends on emotional intelligence, coping skills, and how much resiliency and support a person has. This is another reason why early intervention is so important for children and teens who have experienced traumatic events, significant amounts of stress, or high-conflict environments.

Common Subtypes of Teen Anxiety

There are a variety of subtypes of anxiety disorders that vary based on the nature of the symptoms and treatment methods used. According to a 2010 article in the Journal of the American Academy of Child and Adolescent Psychiatry, 31% of U.S. teens will be diagnosed with one of the six following anxiety subtypes by age 185:

  • A specific phobia (19%)
  • Social anxiety (9%)
  • Separation anxiety (6%)
  • PTSD (5%)
  • Panic disorder (3%)
  • Generalized anxiety disorder (2%)

Treatment Options

Therapy is the first line of defense in treating the symptoms of stress, anxiety, and trauma. There may also be times when a selective serotonin reuptake inhibitor (SSRI) medication, a commonly prescribed antidepressant, will be prescribed to treat pervasive symptoms of teen anxiety. 

Some common forms of therapy used to treat teen anxiety that are offered here at Idaho Youth Ranch include:

Cognitive Behavioral Therapy (CBT)

CBT is the most widely used form of therapy for treating all types of anxiety disorders. This form of treatment focuses on challenging negative core beliefs and thought patterns while slowly facing one’s fears and forming healthy coping skills. CBT can offer the relief clients seek in fewer sessions than traditional methods of therapy.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is based on an exercise that involves eye movement desensitization. The therapist creates a safe environment for the client, who is then able to go back and relive the traumatic experience while undergoing eye movement therapy. This is done to activate the hippocampus and timestamp the traumatic memory so that it can be successfully stored and in turn become less powerful. This form of therapy is an effective form of treatment for trauma with fewer sessions required than other therapeutic methods.

Trauma-Focused CBT (TF-CBT)

TF-CBT is a form of CBT that’s ideal for working with families and also has a trauma-centered focus. This form of therapy is designed to bring families together and cope with any traumatic event as a unit with the results of restoring family bonds and building trust, communication, and coping skills.

Dialectical Behavioral Therapy (DBT)

DBT is a form of therapy that is rooted in CBT but designed to help clients achieve emotional regulation and balance, manage emotions and behavioral patterns, and effectively cope with the stresses that life can bring. This form of therapy typically lasts six months, although every individual is unique so this can vary from one person to the next. 

Equine-Assisted Psychotherapy (EAP)

Horses have long been used to aid in therapy over the years, and the trend is growing. Horses are especially helpful in the healing process as it relates to trauma. The benefits of working with horses are vast and include improved self-esteem, setting healthy boundaries, and encouraging empathy, confidence, self-control, trust, honesty, social skills, self-discipline, self-respect, responsibility, accountability, and more—the list goes on!

What Can Parents Do?

If a child or teen you know is struggling with anxiety, it’s important to know that you are not alone and that teen anxiety is treatable. With a bit of extra support and patience, anxiety symptoms can be managed and their root cause can be determined so the healing process can begin. 

Sometimes as parents, siblings, and friends, we want to fix the problems we see our loved ones struggling with, and it can make us feel helpless when we’re unable to offer a solution. The best thing you can do to help your loved one is to listen, offer your support, and let them know that it’s okay to ask for and receive help whenever they need it. Anxiety doesn’t mean that a person is weak; rather, it’s a testament to how strong they are to carry the extra burden of it every day. 

Let your child or teen know that they are enough as they are and that they are valued and appreciated. It’s also important to stress the importance of support, as there’s a natural tendency after experiencing trauma to want to avoid the topic altogether. Unfortunately, the trauma will need to be faced in order to move on and heal from it, but with the right support and care this can be a transformational experience that sets a child or teen on a better track for the future.

Parents can ask their kids about the stresses they’re experiencing in life. They should also be mindful of the expectations they place on their kids. Focusing on things that can trigger external stress can hinder growth along the path toward healing, so it’s important to talk to kids about their internet and social media usage as well.

 

References

  1. Ghandour, R.M., Sherman, L.J., Vladutiu, C.J., Ali, M.M., Lynch, S.E., Bitsko, R.H., & Blumberg, S.J. (2018). Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics. https://www.jpeds.com/article/S0022-3476(18)31292-7/fulltext
  2. Gonzalez-Gonzalez, N. L., Suarez, M. N., Perez-Pinero, B., Armas, H., Domenech, E., & Bartha, J. L. (2006). Persistence of fetal memory into neonatal life. Acta Obstetricia et Gynecologica, 85, 1160-1164. doi:10.1080/00016340600855854
  3. https://childmind.org/2015-childrens-mental-health-report/
  4. https://www.childhealthdata.org/learn-about-the-nsch/NSCH
  5. Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. doi:10.1016/j.jaac.2010.05.017

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