Learn the signs of adolescent anxiety

In today’s fast-paced world kids have a lot to handle, so it’s not surprising that some adolescents have trouble coping. High expectations to succeed, the constant pressure of social media and a global pandemic are just some of the factors contributing to stress and anxiety levels.

Anxiety can overwhelm and paralyze children, whether from separation anxiety or vague fears of the future to concerns with friends or being afraid of the dark.

Nearly 1 in 3 adolescents will experience an anxiety disorder, according to the National Institutes of Health.

The number of children diagnosed with anxiety disorder is increasing and has been for years, but are more children affected by anxiety or is society now doing a better job paying attention?

“Historically, a few decades ago it was thought that anxiety and depression didn’t even affect children,” said Dr. Sarah O’Rourke, pediatric psychologist with Duke Health in Durham, North Carolina.

A greater recognition of anxiety and other mental health issues in children began in the 1980s and ’90s. In the 2010s research showed that high school students were twice as likely to see a mental health professional than in the 1980s, O’Rourke said.

“I think the increase in recognition is great because it allows children who are struggling with these issues to get the help they need,” she said.

Ask the right questions

Anxiety is normal, and everyone has it to some degree. Healthy feelings of anxiety can protect a person from danger, O’Rourke said.

When anxiety becomes a disruption to a child’s everyday life in school, at home or with family or peers, parents may see avoidance behaviors, O’Rourke said.

All children have fears and worries, but most are able to move forward and deal with their anxiety. Kids with anxiety disorder may have one or two things they will avoid such as large dogs, sleepovers or speaking in front of the classroom.

Common childhood fears are age-related, O’Rourke said. For example, fear of being left with a babysitter is typical for a toddler, but not for an 8-year-old.

Talking about a child’s anxiety can help a child cope. If parents start to see a pattern of behavior they can bring it up in a caring, non-judgmental, matter-of-fact way, O’Rourke said.

“A child may be relieved to talk about it or they may feel embarrassed, but it’s good to talk about their feelings,” she said.

When parents notice a problem brewing they can ask gentle questions to allow a child to think through the situation for themselves, O’Rourke said. If a child is afraid a parent won’t pick them up after a playdate, a parent may ask: Has that happened to you or anyone you know? What are the chances it will happen? What are some possible reasons I may be late?

Anxiety leads us quickly to worst-case scenarios, but a parent’s guidance can help a child think about a situation in a more balanced way, O’Rourke said. Learning to face fears helps a child learn how to cope, she said.

When to seek help

A parent’s first instinct will be to solve a problem, but don’t feed them the answers. Letting a child work it out on their own helps them recognize their ability to take control and build resilience, O’Rourke said. Practicing these behaviors increases their independence.

Maintaining healthy habits, including getting enough sleep and exercise and eating a balanced diet, can help support emotional regulation, O’Rourke said.

It’s time to seek professional help if a child is missing school or if the anxiety is causing changes to a family’s daily routine to accommodate a child’s worry, O’Rourke said. Ask your pediatrician, or to find a specialist visit the Society of Clinical Child & Adolescent Psychology (effectivechildtherapy.org) or the Association for Behavioral and Cognitive Therapies (abct.org).