How to Recognize and Support Teens with Anxiety
By: Cayley Fleischman, BSc. Neuroscience & Psychology Student, University of Lethbridge
This week’s blog focuses on how anxiety impacts adolescents and their brains, common symptoms of anxiety disorders, and what caregivers and educators can do to help support teens with anxiety.
In 2013, roughly 3 million Canadians over the age of 18 reported that they had a mood and/or anxiety disorder (Canada). Of these individuals, 27% reported that their condition had a significant impact on their ability to function (Canada). With such a strong prevalence rate both in Canada and abroad, research regarding the impacts of anxiety and mood disorders on the brain has seen an increase. Though a majority of this research has focused on adults, studies are now looking at how anxiety impacts adolescents as these disorders often begin to emerge during the teenage years.
The word anxiety is used quite broadly, but at its simplest it is a term used to describe a normal reaction to stress. In response to a stimulus, our brain alerts us to any dangers and helps us to pay attention and prepare for a situation. This reaction is actually quite beneficial, and not all anxiety is inherently bad. However, some people have dysfunction of this reaction and experience prolonged, intense anxiety. In this context, anxiety is often used to describe several different conditions:
- Generalized Anxiety Disorder (GAD): a condition characterized by excessive, persistent worry about a variety of things. Common symptoms include restlessness, fatigue, difficulty concentrating, irritability, physical pains such as headaches or stomach aches, uncontrollable feelings, numbness or tingling, muscle tension, and sleep disturbances.
- Panic Disorder: a condition characterized by frequent and unexpected periods of intense fear, discomfort, or feelings of danger without an immediate trigger. Symptoms of these episodes include racing heart, sweating, shaking, chest pain, shortness of breath, feelings of impending doom, and feeling out of control. Often times these episodes share many symptoms of heart attack.
- Social Anxiety Disorder: a condition characterized by an intense, persistent fear of social situations. Symptoms include flushing, sweating, trembling, racing heart, stomach aches, speaking in an overly soft or quiet tone, difficulty making eye contact, rigid or timid body posture, and intense feelings of self-consciousness.
- Phobias: a term that encompasses a variety of conditions defined by an intense fear or aversion to something (such as flying, blood, spiders, needles, etc.). Common symptoms include irrational or excessive worry, taking active steps to avoid the situation or object causing the phobia, and intense fear when enduring unavoidable situations.
A major diagnostic criterion for these disorders is that symptoms persist and significantly interfere with daily activities, work, school, and relationships. It is natural for everyone to experience anxiety in response to life stressors, uncomfortable situations, or fearful events; however, experiencing severe, prolonged anxiety is usually cause for concern.
In addition to these symptoms, there are several behaviours that caregivers or educators may recognize that are indicative of anxiety in adolescents. Teenagers with anxiety often have excessive fears or worries and appear restless, wary, and hypervigilant. They may also have low self-esteem and perfectionist tendencies. Socially, these teens may appear to be withdrawn, overly emotional, or overly restrained. Adolescents may also be shy, avoid engaging in new experiences, and may even avoid school or extracurriculars. In extreme cases, some teens may also turn to substance abuse in order to alleviate their symptoms. Often times, adolescents are usually just as puzzled as their caregivers as to why these symptoms are occurring and often feel afraid or frustrated.
From a neurobiological perspective, there is not a sole area of the brain responsible for anxiety. Rather, many areas and neural networks that monitor fear, learning, emotional regulation, stress response, memory, and attention work together to create the symptoms we see. Brain regions such as the amygdala, prefrontal cortices, hippocampus, striatum, hypothalamus, and sympathetic nervous system, which controls our “fight, flight, freeze” response, all exhibit changes in structure, volume, and connectivity in adolescents with anxiety.
But why do several mental health disorders, including anxiety, emerge during the teenage years? Researchers have proposed that significant brain plasticity in this period of development may be responsible. In adolescence, the pathways that regulate our emotions are not yet fully developed and tend to be underactive, which often leads to emotional instability and irrational behaviour. Conversely, the systems that manage fear conditioning, reward, and stress are very active and sensitive to change. Because these systems and brain regions, many of which are implicated in symptoms of anxiety, are still being refined, this makes adolescents vulnerable to developing anxiety disorders. This vulnerability increases if teens have risk factors such as trauma, abuse, or a family history of the condition.
Untreated anxiety can harm relationships, social functioning, and school performance, so it’s important to watch for signs and symptoms and to address them with a medical professional.
Treatment for anxiety disorders vary from person to person; however, most treatment plans involve a combination of medication and therapy. Medications such as anti-depressants, anti-anxieties like benzodiazepines, and beta-blockers all aid in helping to alleviate symptom severity so patients can better manage them. Therapeutic interventions like cognitive behavioural therapy (CBT) help patients to identify thought patterns and behaviours that contribute to their feelings of anxiety so that patients may change them. Other counselling interventions such as support groups or workshops aimed at stress management are often effective in helping manage symptoms.
For caregivers and educators, supporting individuals with anxiety disorders requires patience and empathy. Participating in support groups or educational workshops can help manage your own mental well-being as well as increase your understanding of how anxiety impacts youth. Validating your adolescent’s feelings and working to help them identify and address their symptoms are crucial components to managing these disorders. Showing respect, demonstrating understanding, and creating a non-judgemental environment are all ways to help create and maintain a strong, supportive, and safe relationship.
Resources:
Here to Help BC: https://www.heretohelp.bc.ca/infosheet/helping-your-anxious-child-or-teen Anxiety Canada: https://www.anxietycanada.com/free-downloadable-pdf-resources/
My Health Alberta: https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=anxty
References
Canada, P. H. A. of. (2015, June 3). Mood and anxiety disorders in Canada. Canada.ca. Retrieved from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/mood-anxiety-disorders-canada.html
Cleveland Clinic. (2020, December 17). Anxiety disorders: Types, causes, symptoms & treatments. Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders
Mariner, B. (2022). Main theory of CBT [Infographic]. PsychCentral. https://psychcentral.com/pro/the-basic-principles-of-cognitive-behavior-therapy
National Institute of Mental Health . (2022). Anxiety disorders. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders
Xie, S., Zhang, X., Cheng, W., & Yang, Z. (2021, August 4). Adolescent anxiety disorders and the developing brain: Comparing neuroimaging findings in adolescents and adults. General psychiatry. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8340272/