Teenage Anxiety Disorders: Beyond “Typical Worries”

When does “normal worrying” in teens become an anxiety disorder? This article will help you identify the symptoms of teenage anxiety and learn about common treatment options, including therapy and medication.

We’ll discuss frequently asked questions about adolescents and anxiety, including how to tell the difference between “normal” worrying and anxiety, signs and symptoms of anxiety disorders, and what to do if you think your teen is struggling with anxiety.

“Normal Worry” vs Anxiety: What’s the difference?

Everyone worries! In fact, worrying about potential obstacles and concerns in life can lead to helpful problem-solving strategies. However, there are important differences between helpful worrying and unhelpful anxiety.

Helpful worrying leads someone to think through a specific and concrete problem. After the person comes up with a solution or the problem is resolved, worry fades away.

Anxiety, on the other hand, leads someone to think about many potential problems that may or may not actually happen. The person might come up with potential solutions, but the anxiety persists. Additionally, anxiety is characterized by catastrophizing, or always thinking about the worst case scenarios. While helpful worrying is temporary and focused, unhelpful anxiety is longer lasting and more generalized.

Take this common teenage concern of getting a good grade on a test. A teen who is engaging in helpful worrying will think of problem-solving solutions like making a study plan, meeting with the teacher to ask questions, and taking a practice test. After the test is over, the worry stops.

A teen who is struggling with unhelpful anxiety, however, might also come up with some problem-solving solutions to help study for the test or they may avoid studying or put off studying until the last minute. Instead of just thinking about this test, unhelpful anxiety may lead to the teen thinking about future tests in this class, tests in other classes, times in the past they haven’t gotten good grades, and the consequences of getting a bad grade. After the test is over, the anxiety persists.

Signs and Symptoms of Teenage Anxiety Disorders

Anxiety in teens is very common. According to the National Institute of Mental Health [1], a little over 30% of all teens meet criteria for an anxiety disorder.

Common symptoms of teenage anxiety include:

• Frequently feeling nervous or stressed
• Increased irritability with friends, family members, and teachers
• Having difficulty concentrating or focusing on schoolwork, chores, or other activities
• Feeling “on edge”, fidgety, jumpy, or needing to move often
• Avoiding schoolwork, extracurricular activities, or spending time with friends
• Difficulty sleeping and lower energy levels
• Change in eating habits, either eating more than usual or less than usual over several weeks
• Physical symptoms such as a racing heart, shallow or fast paced breathing, nausea or other GI symptoms, dizziness, shaking or trembling, and more

The focus of anxiety can also change throughout the lifespan. Anxiety in children is often characterized by fear of something external; bugs, monsters under the bed, or losing a parent to name a few. In adolescence, anxiety often becomes more internalized, characterized by fears of how parents, peers, teachers, and coaches are judging or assessing them. Additionally, teens may also experience increased judgment and anxiety towards themselves.

Types of Teenage Anxiety Disorders

Generalized anxiety disorder

Characterized by anxiety about a number of different things. This anxiety is persistent and causes significant disruptions in a teen’s day to day functioning.

Panic attacks

Characterized by physical symptoms when experiencing anxiety, including symptoms like difficulty breathing, a racing heart, nausea, shaking, dizziness, and more. Panic attacks may occur in response to a specific trigger or might be completely random.

Social anxiety disorder

Characterized by difficulty participating in social interactions due to intense fear of embarrassing oneself or being harshly judged by others

Specific phobias

Characterized by intense fear of a specific situation or thing. Common specific phobias include fear of spiders or other bugs, heights, or getting blood drawn.

Causes and Risk Factors for Anxiety Disorders

While there is not a single, direct cause of anxiety disorders, if your teen has multiple risk factors it can make it more likely they develop an anxiety disorder. Common risk factors include:

• Experiencing a traumatic event or child abuse
• A family history of anxiety
• Having a chronic illness or other medical or mental health condition
• Substance use

It’s important to note that having a risk factor does not mean your teen will develop an anxiety disorder.

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