Mental Health
10 minutes

What Is Anxiety? Signs In Teens, Symptoms, Teen Treatment, and Resources

Medically Reviewed
Last Medically Reviewed on: August 17, 2023

Key Points

  • Anxiety is a state of worry, alarm, or fear over circumstances outside your control.
  • 40% of teens have some form of anxiety disorder.
  • The four primary categories of anxiety disorders are generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias.
  • Physical symptoms of anxiety include restlessness, heart palpitations, shortness of breath, stomach aches, and fatigue, among others.
  • Psychological symptoms of anxiety include excessive worry, intense dread, irrational fear, feeling out of control, and an inability to control worry, among others.
  • The cycle of anxiety begins with anticipation, avoidance, relief, and resurgence.
  • An anxiety disorder is different from natural anxiety due to the persistence and severity of symptoms, even when there is no threat.
  • Anxiety has multifaceted causes that include environmental factors, habits of thinking anxious thoughts, family history of mental illness, and behavioral patterns.
  • Treatment for anxiety includes medication, therapy, prevention and coping skills, and support.

What Is Anxiety?

Anxiety is a state of worry, alarm, or fear over circumstances (past, current, or future) that you may not be able to control. This is a natural mental state that can be experienced throughout various times in their life and can manifest physical symptoms such as restlessness, shortness of breath, heart palpitations, insomnia, and feeling tense.

Those with a diagnosed anxiety disorder may experience chronic anxiety or persistent dread and more severe symptoms like fatigue, difficulty concentrating, headaches, inability to control worry, stomach aches, and a persistent sense of anxiety or dread.[1]

Experiencing feelings of natural anxiety could be due to recent trauma, financial trouble, stress, grief, health issues, or relationship challenges. Anxiety disorders are different from natural anxiety in what causes them, the symptoms, and the severity of those symptoms.

Someone suffering from an anxiety disorder may feel anxious or fearful in everyday circumstances even when there is no immediate threat to life or person.

Four Stages Of The Anxiety Cycle & A Real Life Example

Anxiety is a cyclical experience. If left untreated, the symptoms can return when faced with the same trigger again. But when you and your teen begin to experience feelings of anxiety, what happens next? And what does the anxiety cycle look like with and without treatment?

Anticipation

When faced with a potential or immediate scenario, this is when the feelings of anxiety begin. Fear, worry, and alarm begin to form thought processes in your mind as you evaluate your circumstances.

Example: You have to give a speech in class and you begin creating worst-case scenarios in your mind, break out in a sweat, and your heart rate picks up speed.

Avoidance

Psychological and physical symptoms of anxiety can be avoided or mitigated if the situation that triggered them can also be avoided. However, that’s not always possible.

Example: Your initial plan is to avoid the class, or develop a sudden, incurable, and completely made up illness to skip school.

Without Treatment: Relief

Relief only comes due to the absence of anxiety symptoms that were not addressed, merely postponed.

Example: You feel relieved as you’ve resolved the cause of your anxiety and mitigated the risk of potential or perceived harm.

Without Treatment: Resurgence

Without intentional coping skill intervention or safely navigating obstacles faced with your anxiety, your symptoms will resurface.

Example: You get an email from your teacher that your speech has been postponed to the following week and the anxiety cycle begins again.

Relief & Resurgence With Coping Skills and Treatment

By learning practical coping skills, such as counting, alternative movements, journaling, and breathing exercises, you can alleviate or mitigate the symptoms of anxiety in spite of triggers.

Example: You’re fearful of the circumstances but you know your fear of public speaking is something you need to conquer. You also have to pass the class. You immediately begin anxiety-specific breathing exercises or take a walk outside.

Your symptoms slowly dissipate and you contact your therapist or counselor to help you prepare for your upcoming speech. On the big day, you do all the preparation you can to succeed. You still experience some anxious feelings but are equipped to manage them and safely deal with the task at hand, in spite of your fears.

Please note: This is a generalized example that may not apply to every type of anxiety disorder or every specific teen. However it’s important to recognize where anxiety treatment and coping skills can make a positive impact on practical events and quality of life.

Symptoms Of Anxiety

Perceived threats over present or future circumstances can trigger intense reactionary behaviors. This is what’s known as the natural fight or flight response. Intense fear or uncertainty related to unpredictability can lead to an anxious risk self-assessment that may.

Without treatment or coping interventions, the symptoms may not go away until the threat or uncertainty is resolved.[2]

Psychological Symptoms Of Anxiety

Anxiety often begins in the mind before it manifests in the body. Some common anxiety disorder symptoms include:[3]

  • Irrational or excessive worry
  • Feelings of self-consciousness
  • Fear of judgment
  • Feelings of impending doom
  • Difficulty controlling pervasive worry
  • Feelings of being out of control
  • Feeling tense
  • Persistent worry, alarm, or dread
  • Inability to control worry

Physical Symptoms of Anxiety

Most physical anxiety symptoms are systemic or related to nervous system function. Common physical signs of anxiety include:[4]

  • Heart Palpitations
  • Shortness of breath
  • Sweating
  • Trembling
  • Tingling
  • Restlessness
  • Difficulty concentrating
  • Headaches
  • Fatigue
  • Nausea
  • Insomnia
  • Chest pain
  • Blushing
  • Sweating
  • Clammy hands
  • Difficulty making eye contact
  • Stomach aches or “butterflies”
  • Rigidity
  • Voice changes

Identifying Anxiety In Teens

Young children are usually anxious about being left alone in the dark, monsters in the closet, and creatures under the bed. In most cases, these are fears that teens have grown out of.

Teens struggling with anxiety will be more concerned about their performance, social situations, their body, and potential family issues. Even if they showed little to no anxiousness as a child, they may still experience anxiety as a teen.

Anxiety could look like a chronic intensity and apprehension that interferes with their ability to go to school, complete daily tasks, or maintain their grades.

Here Are A Number Of Common Indicators Of Teen Anxiety:

The sooner you can identify anxiety symptoms in your team, the sooner you can begin to support them and get the help they need.

  • If your teen is frequently worried or irritable.
  • If they regularly have headaches.
  • If they seem chronically tense or wound up.
  • If they complain of stomach ages or unexplained pains.
  • If they seem to have trouble concentrating or making decisions.
  • If they’re easily fatigued or sleep a lot.
  • If they’re not sleeping well.
  • If they self-isolate.
  • If they seem overly reserved.
  • If they get overly emotional easily.
  • If they take up substance use.
  • If their grades are dropping.
  • If they exhibit severe self-criticism.
  • If they’re preoccupied and forgetting things.
  • If they complain of muscle tension.

How Common Are Anxiety Disorders In Teens?

The National Institute of Mental Health estimates that nearly 40% of teens have some form of anxiety disorder. Of that segment, at least 8% experience severe impairment in life due to the severity of anxiety symptoms.[5] Additionally, Pew Research conducted a survey of teens and discovered that 70% of U.S. teens perceive anxiety and depression as a significant concern among their peers.[6]

What Is Anxiety?

Anxiety Risk Factors

 

Anxiety and Stress: How Are They Different?

Often present together, stress is different from anxiety but can intensify symptoms. When faced with stress, you may feel anxious or when struggling with symptoms of anxiety you may feel stressed. Where stress is a natural response to adversity or uncertainty, anxiety elevates the physical and psychological reaction to more intense levels.

Anxiety and Depression: How Are They Different?

Anxiety and depression are two of the most common mental health disorders that are often present simultaneously. While it can be easy to mislabel or confuse the symptoms, these disorders are not the same. However, one may intensify the symptoms of the other or make it more difficult to implement coping skills.

Common depression symptoms include:[7]

  • Mood swings
  • Sleep disruption
  • Irrational sense of guilt
  • Withdrawing from social circle
  • Low self-esteem
  • Despairing thoughts and behaviors
  • Overly emotional
  • Feelings of worthlessness
  • Neglecting hobbies and activities
  • Hyper self-criticism
  • Low energy
  • Frequent crying
  • Thoughts of suicide
  • Self-harm
  • Poor appetite
  • Fatigue
  • Dramatic weight loss or gain

What Causes Anxiety Disorders?

Within the mental health community, it is well established that many anxiety disorders stem from multifaceted causes. Some include environmental factors, habits of thinking anxious thoughts, and behavioral patterns.

One study uses the example of how a musician can perform from muscle memory. This is due to many hours or years of practice of building neural pathways to solidify the ability to play their instrument. A teen with an anxiety disorder can build neural pathways of anxious thoughts and behaviors in much the same way, through frequent participation.[8]

Neural pathways must be intentionally and expertly deconstructed with the help of a therapist or psychiatrist. Through this process, newer, healthier pathways are built in its place.

Anxiety Triggers

Natural anxiety responses are triggered when there is an inflated perception of a threat or circumstance. This leads to excessive response and fight or flight related symptoms.[9]

Depending on the type of anxiety disorder symptoms could be triggered by social situations, stress, flying, fear, exhaustion, financial struggles, relationship challenges, catastrophic scenarios, pressure at work or school, and family dysfunction.

Long-Term Effects Of Anxiety

Anxiety disorders, even if they are not officially diagnosed, can negatively impact the daily lives of anxious teenagers or adolescents. If symptoms grow in intensity and frequency, quality of life for these young people differ significantly from those of their peers who face similar events and circumstances.

Teens who suffer from anxiety can experience serious deviations to learning ability, behavior, and emotional regulation. If untreated, these effects can lead to ongoing distress and adversity throughout life.[10]

Different Anxiety Disorders

Specific anxiety disorders fall into four umbrella categories that all share many common features.[11]

  • Generalized Anxiety Disorders (GAD)
  • Panic Disorders
  • Social Anxiety Disorder
  • Phobia-Related Disorders

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder is characterized by a consistent or chronic sense of dread or feelings of anxiety that impair normal activities. This should not be confused with occasional worry over temporary life events or due to stress.

Teens with generalized anxiety disorder can suffer the symptoms for months at a time, if not years. Symptoms of GAD include many of the common hallmarks of anxiety such as restlessness, feeling edgy, fatigue, irritability, difficulty concentrating, headaches and insomnia.

Panic Disorder

Unexpected and frequent panic attacks is a common indicator of a panic disorder. This is an intense experience of extreme fear and alarm with no imminent threat to life or person. It’s possible for anyone to experience a panic attack due to extreme circumstances but someone with a panic disorder may experience the symptoms of a panic attack for no reason at all.

Common panic disorder symptoms include chest pain, a sense of impending doom or lack of control, trembling, rapid heartbeat, and sweating or claminess.

Social Anxiety Disorder

A teenager who suffers from social anxiety disorder or social phobia will display symptoms primarily in uncomfortable social situations where they do not feel safe or in control. This could be at work, school, or even at family functions. Symptoms of a social anxiety disorder include sweating, rapid heartbeat, rigidity, extreme self-consciousness, and selective mutism where they don’t speak at all.[?]

Specific Phobia-Related Disorders

Specific phobias are anxiety disorders Based on fear of specific things, events, experiences, locations, or people. Common examples include spiders, heights or a fear of flying, needles or injections, or the sight or idea of blood.

Agoraphobia

Teens who suffer from agoraphobia will be fearful of going outside, being in open spaces using unfamiliar transportation, and crowds.

Test Anxiety

Teens who suffer from test anxiety will experience intense anxiety symptoms and anticipation of a test or during test-taking.

Separation Anxiety Disorder

Separation anxiety disorder is more common in younger children however can still linger into adolescence. A teen who suffers from separation anxiety disorder will be fearful of being alone or away from those they trust.

How Are Anxiety Disorders Diagnosed?

An official diagnosis can only be given by a teen psychiatrist or mental health professional. According to the Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5), anxiety disorders are characterized by excessive anxiety occurring more often than not or consistently around specific activities or events. A teen who may be diagnosed with an anxiety disorder will present three or more of the following six indicators:[12]

  • Restlessness
  • Easily fatigued
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disruption

Why Are Teens Anxious?

The current team generation is unlike any that came before. The world they live in is vastly changed from the world where their parents and grandparents grew up. Each teen’s experience with anxiety will be unique. It’s important to understand their perspective and concerns from an objective point of view.

Some common anxiety influences include:

  • Perfectionism – work, school, family, and self expectations
  • Peer opinions – friends, classmates, teammates
  • Family dysfunction – stress, trauma, performance, grief, dysfunction, divorce
  • Physical changes – hormones, body growth, hair growth, arousal awareness

Teen Anxiety Treatment

There are many resources and interventions effective for treating teen anxiety. Depending on the severity of the anxiety disorder, treatment plans for each individual will vary based on their unique needs.

Medication Interventions

In some cases psychiatrists will prescribe anti-anxiety medication to alleviate symptoms and provide relief for the patient. These medications are selective serotonin reuptake inhibitors (SSRIs) or serotonin and noradrenaline reuptake inhibitors (SNRIs).

These medications enhance GABA activity triggering the brain to feel calm and relaxed or sometimes drowsy. Medications include benzodiazepines like Xanax® and Valium®, escitalopram in Lexapro®, fluoxetine in Prozac®, and sertraline (Zoloft®). For some patients, antidepressants like duloxetine in Cymbalta® may also be prescribed.

Psychotherapy, Behavioral Therapy, and Counseling

Understanding the neural Pathways that have been developed due to anxious thoughts and behaviors is a critical component to building new pathways. Cognitive Behavioral Therapy (CBT), Mindfulness Therapy, Experiential Therapy, Group Therapy, Family Therapy, Psychodynamic Therapy, Motivational Interviewing, and Resiliency training are some of the most effective therapy modalities employed with teens.

During therapy and counseling patients will be under the guidance of a licensed professional as they explore underlying mental health challenges and develop new, healthier habits to mitigate symptoms when faced with adversity.

Peer Support Groups

A support group of peers is critical for any type of recovery but especially for teens. As they navigate treatment and treatment together, teens form a strong bond and support one another. Together, they will learn valuable coping and life skills, improve communication, see their circumstances from a new perspective, and learn from the experiences of others.

Dual Diagnosis: Anxiety Disorders and Substance Use

Substance use can lead to increasing anxiety symptoms in much the same way that suffering from anxiety can lead to substance abuse for temporary relief. When both an anxiety disorder and substance use disorder are present, both must be addressed individually to achieve holistic healing.

Anxiety Treatment and Academic Concerns

An anxiety disorder can often have a negative impact on a teens education. But this should not be a barrier to seeking treatment. Look for treatment providers who emphasize academic support to ensure teens don’t fall behind at school during anxiety treatment.

Coping With Anxiety: Practical Help For Teens

Whether you or your teen has a diagnosed anxiety disorder or is simply navigating stressful circumstances, here are a few helpful tips to help alleviate the symptoms of anxiety.

    • Keep open communication about thoughts and feelings
    • Learn relaxation strategies like breathing and counting
    • Stay off social media
    • Practice mindfulness of surroundings and circumstances when symptoms are strong
    • Take up meditation and yoga and put them to use when needed most
    • Stay physically active for natural happy hormone release
    • Maintain a healthy diet
    • Get plenty of rest and maintain a consistent sleep schedule
    • Be aware Awareness and Identifying Triggers
    • Surround yourself with supportive friends and family
    • Seek professional help and treatment

What Is Anxiety? A Treatable Mental Health Concern.

Feelings of anxiety are natural, but when they begin to create challenges that affect quality of life, it may be time to seek professional help.

Frequently Asked Questions

Below are some of the most frequently asked questions regarding anxiety.

Those diagnosed with an official anxiety disorder may have unique symptoms. However, there are several that remain consistent across the spectrum. 

  • Feelings of restless or tension
  • Fatigued easily
  • Difficulty concentrating on normal tasks
  • Irritability
  • Otherwise unexplained pain like headaches, muscle aches, and stomachaches.

The fight, flight, or freeze response is a natural, physiological response to a perceived threat or danger. This is the same natural response that is triggered when experiencing anxiety symptoms even when there is no threat to life or person.

Anxiety may become a mental health problem when symptoms are so severe you or your teen is unable to participate in normal daily activities like school or social activities. Any life impairment could indicate the presence of an anxiety disorder

Natural remedies for anxiety include holistic interventions like talk therapy, yoga, meditation, journaling, nature hikes, regular exercise, consistent sleep schedule, ‌stress management, healthy balanced diet, and support from family members and loved ones.

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[1]U.S. Department of Health and Human Services. (n.d.). National Institute of Mental Health. Anxiety disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders on May 30, 2023

[2]Grupe, D. W., & Nitschke, J. B. (2013, July). Nature reviews. Neuroscience. Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276319/ on May 30, 2023

[3]U.S. Department of Health and Human Services. (n.d.). National Institute of Mental Health. Anxiety disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders on May 30, 2023

[4]U.S. Department of Health and Human Services. (n.d.). National Institute of Mental Health. Anxiety disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders on May 30, 2023

[5]U.S. Department of Health and Human Services. (n.d.-b). National Institute of Mental Health. Any anxiety disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder on May 30, 2023

[6]J.M. Horowitz, N. Graf. Pew Research. February 20, 2019 (n.d.-c). Most U.S. Teens See

Anxiety and Depression, as a Major Problem, Among Their Peers Retrieved from https://www.pewresearch.org/social-trends/wp-content/uploads/sites/3/2019/02/Pew-Research-Center_Teens-Report_FINAL-1.pdf on May 30, 2023

[7]Maughan, B., Collishaw, S., & Stringaris, A. (2013, February). Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Académie canadienne de psychiatrie de l’enfant et de l’adolescent. Depression in childhood and adolescence. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565713/ on May 30, 2023

[8]Grupe, D. W., & Nitschke, J. B. (2013a, July). Nature reviews. Neuroscience. Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276319/ on May 30, 2023

[9]Anxiety – statpearls – NCBI bookshelf. (n.d.-c). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470361/ 

[10]Centers for Disease Control and Prevention. (2023, March 8). Centers for Disease Control and Prevention. Data and statistics on children’s Mental Health. Retrieved from https://www.cdc.gov/childrensmentalhealth/data.html on May 30, 2023

[11]Anxiety – statpearls – NCBI bookshelf. (n.d.-c). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470361/ on May 30, 2023

[12]National Center for Biotechnology Information. (n.d.-e). DSM-IV to DSM-5 Generalized Anxiety Disorder Comparison. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t15/ on May 30, 2023