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Parenting - Anxiety in Teenagers

Parents looking back on their own teenage years might think that anxiety was a normal part of the experience of awkwardly growing into their adult selves. And in fact, a certain level of anxiety is normal in everyone, says Dr Ron Rapee, Director of the Centre for Emotional Health at Macquarie University. But when your teen’s anxiety is starting to interfere with everyday life and preventing them from doing things they should normally enjoy, this could be a sign that your adolescent has a form of anxiety disorder. Parents are usually the first to notice anxiety in a teenager because anxious behaviour is often not obvious to teachers who are more likely to have their attention drawn to students with disruptive behaviour.

Is My Teenager Suffering from Clinical Anxiety Disorder?

“One in 10 people suffer from a clinical level of anxiety disorder so it is quite common,” points out Dr Rapee, and all adolescents have a certain level of self-consciousness, so it can be difficult for a parent to work out whether to seek help. Importantly, if you are concerned that your teenage son or daughter is more anxious than their peers and if you have noticed that they are distressed, then you should seek the assistance of clinical psychologist via a referral from your family doctor. Ron Rapee advises that as “anxiety can be very subtle and harder to pick up”, it is best to seek a psychologist with an expertise in anxiety and preferably with experience working with adolescents.

What are the Signs or Symptoms of Anxiety in a Teenager?

The main symptom present in an anxiety disorder is some form of avoidance: your teenager may be avoiding normal activities because of fears they have for themselves or others. You may also find that “anxiety is sometimes displayed as anger in a teenager. They may simply lose the plot when they are anxious or they might frequently be cranky” says Dr Donovan, Lecturer in Psychology at Griffith University. Some teenagers may refuse to attend school and in this case, parents are strongly advised to seek professional help.

Self-harm is more commonly linked to depression. However, anxiety and depression may co-exist as symptoms so if parents have any concerns about depression or self-harm in their teenager, they are advised to seek medical expert assistance. A useful site for reference if your teenager may have depression is Youth Beyond Blue .

What Type of Anxiety Disorder Does My Teenager Have?

There are a number of types of anxiety disorder, and often teenagers will present with a combination.  Dr Donovan, together with colleagues, will soon publish results of research carried out with anxious adolescents and found that 84% of teenagers with anxiety in that study presented with more than one type of anxiety disorder. Your child’s clinical psychologist will assess your teenager and provide you with information about diagnosis and treatment. Here is a quick guide to more commonly diagnosed anxiety disorders:

Generalised Anxiety Disorder (GAD): symptoms include excessive worry. Your teenager may be constantly and repeatedly seeking reassurance from you and worry in advance of things happening. Examples could be constant concern about health, finances or whether parents will divorce. Teenagers with GAD may get headaches, often feel sick or have trouble falling asleep.

Specific Phobias: your teenager may have an intense or irrational fear of a particular thing such as dogs or heights and the fear may be interfering with their life. These fears often get in the way of your teenager attending events or places they would normally want to be. Social phobia is a disorder where your teen son or daughter seems to have an excessive fear of being judged, or embarrassing themselves or avoids interacting in groups and meeting new people.

Separation Anxiety: Your teen may worry that something will happen to either you the parent, or themselves if they are separated from you; for example, they may refuse to go to school because they are scared of leaving you, be reluctant to sleep over at a friend’s house or go on school camps.

Obsessive Compulsive Disorder (OCD): If your teenager suffers from OCD, she may have repetitive thoughts or repeat certain actions over and over. For example, she may be anxious or fearful of having unclean hands and constantly wash her hands, or she may be concerned about burglary and constantly check the locks on your house.

Other anxieties include Post Traumatic Stress Disorder, Panic Disorder and Agrophobia.

How Can Parents Help Their Anxious Teenager?

“It’s important for parents to be aware that teens will avoid things that they feel frightened of or uncomfortable about” says Dr Donovan “and this is where parents can really make a difference. Because the more they avoid that anxiety, the longer it is likely to continue and the more severe it may become.” Avoidance may make your teenager feel better but this reinforces the behaviour so “if parents continue to allow their teen to avoid, it’s not going to help in the long run,” advises Dr Donovan. For example, your teenager may ask for a note to avoid going to a school sports day or ask for a parent to make a phone call for them; in most cases, parents giving in to these requests would be unhelpful because to do so reinforces their teenager’s avoidance of activities. A skilled therapist will be able to advise parents about the best way to lovingly and firmly support their teenager.

Dr Rapee provided some general guidance for parents with teenagers who have anxiety disorders:

  • Often anxious parents have anxious children. This puts you in a unique position of empathy. Let your child know that you understand how it feels to be anxious and tell them (in an age-appropriate way) about your own experience of anxiety.
  • Try very hard to discourage avoidance behaviour. Don’t take over tasks to help your teenager avoid discomfort.
  • Keep the lines of communication open and try to understand what your child is worried about.
  • Be careful about how you communicate with your teenager: there is a fine line between not adopting a harsh or dismissive tone but still not “buying” into the avoidance behaviour and making things easier.
  • Talk about how things might be different if your teenager did not avoid certain activities; point out the benefits of facing their fears.
  • And, accept that your teenager may not want to talk very much with you - that is normal!
  • Dr Caroline Donovan provides the additional suggestion of rewarding your teenager when he or she faces up to an anxiety and attends an event. So, for example, you might say “I know it is really hard for you but if you do get up and do this today, we’ll go out and have dinner to celebrate at your favourite restaurant." Don’t make a fuss of your teenager in front of their friends but privately acknowledge that you are aware of how difficult it was for them to achieve that result.

The Centre for Emotional Health has produced a program called Cool Teens. This program is used by the adolescent and includes 8 skills training modules which are used over a 12 week period. Cool Teens is described as an integrated skills training course that is designed to help adolescents learn to manage their feelings so that they no longer interfere with their everyday activities. It includes a Cool Teens CD Rom and Parent Companion .

Queensland researchers Professor Susan Spence, Dr Caroline Donovan, Dr Sonja March, Ms Renee Anderson, and Ms Sam Prosser have developed the BRAVE program for teenagers with anxiety. It consists of 10 therapist-monitored sessions conducted over the internet. In research published about BRAVE, it was found that this program was as effective in treating anxiety as face to face therapy session.

For a list of clinical psychologists in Australia, parents can refer to the Australian Psychological Society Website.


Comments (1)

Parenting anxious teens

I greatly appreciate your points on the subject of teens who are anxious. As a single mom of a clinically depressed teenager, I watch as my son struggles with anxiety and depression combined - its a tough issue! I also very much like the BRAVE resource! Keep up the articles about parenting through the deep stuff!