What is anxiety?

Anxiety is like an alarm bell in the brain. The alarm goes off when you're threatened. It tells your body to protect you. People feel anxious when they're in danger and need to get to safety. The need to succeed often causes anxiety. Teens may feel anxious doing schoolwork or learning to drive. In many cases, feeling anxiety is normal.

What are symptoms of an anxiety disorder?

With an anxiety disorder, the body responds as if it's in danger. But the response is more than needed. The anxiety may be way out of balance with the threat that triggers it. Or anxiety can happen when there's no clear threat or danger. An anxiety disorder often disrupts a teen's work, school, and relationships.

Your teen may have any of these signs and symptoms:

• Constant fear for their safety or safety of loved ones

• Clingy behavior

• Problems focusing or relaxing

• Being grouchy

• Critical, self-conscious thoughts

• Worry about what others may be thinking

• Not wanting to go to parties or other social events

An anxiety disorder can cause physical symptoms such as:

• Frequent headaches or dizziness

• Stomach problems

• Sweating or shakiness

• Trouble sleeping

• Muscle tension

• Startling easily

Obsessive-compulsive disorder (OCD)

OCD is a type of anxiety disorder. The symptoms are a bit different from other anxiety disorders. Someone with OCD has constant, intrusive fears. These are called obsessions. They may have constant fears about germs. They may worry about leaving the door unlocked or the stove on. The person then does behaviors to help ease the fear and anxiety. These are called compulsions. These can include washing hands over and over or checking a lock or stove constantly. If your teen shows any of these signs, talk to their healthcare provider:

• Too much handwashing

• Checking things over and over, like lights or locks

• A very strong need to do some tasks in a certain order 

• A very strong need to have items arranged in a certain way

• Anger or upset if they can’t do the routines or habits 

Panic disorder

Panic disorder is another type of anxiety disorder. It causes panic attacks. These are sudden feelings of intense fear along with physical symptoms. A panic attack can happen with little or no warning. The symptoms can include:

• Chest pain

• Pounding heartbeat

• Dizziness

• Trouble breathing

• Feeling of impending doom or sense of unreality

• Feeling of being smothered

• Feeling like they’re about to lose control

Often, teens will stay away from any place where they’ve had a panic attack. This is because they’re afraid of having another one. Some teens who have had panic attacks get so afraid of having another attack that they stop leaving their homes. This is called agoraphobia.

What's the next step?

Get help for your teen right away if you think they have any kind of anxiety disorder. Contact their healthcare provider. There is no single test for anxiety disorders. But your teen’s healthcare provider will ask questions. And your teen may need tests to rule out other problems. If not treated, an anxiety disorder can affect the quality of their life. This includes schoolwork, activities, and relationships. It can also lead to self-harm.

Treating an anxiety disorder

An anxiety disorder is often treated with therapy, medicines, or both.

Therapy 

Therapy is also called counseling. It can be a good treatment for anxiety. It’s done by a trained healthcare provider. Therapy helps a teen learn to manage anxiety.

Medicines

Medicines can help manage symptoms. They can work well. But finding the best medicine for your teen may take time. Your teen may have 1 or more medicines prescribed to treat an anxiety disorder. Medicines may include:

• Anti-anxiety medicines. These can ease symptoms and help your teen relax. These may be taken on a regular schedule. Or they may be taken only when needed. Follow the healthcare provider's instructions.

• Antidepressant medicines. These are often used to treat anxiety. They help balance brain chemicals. They can be used even if your teen isn't depressed. These are taken on a schedule. They take a few weeks to start working.

If medicines are prescribed:

• Follow the instructions carefully.

• Tell the healthcare provider how your teen is doing on the medicine. Tell them if you see any changes.

• Never change the dose or stop your teen’s medicine without talking with the healthcare provider first.

• Don’t give your teen herbal remedies or other medicines.

• Check with a pharmacist before giving your teen any over-the-counter medicines. This includes medicines for colds or the flu.

Other ways to help

Getting better from any illness takes time. Getting better with an anxiety disorder is no different. While your teen is recovering, here are things that can help them feel better:

• Be understanding. Your teen’s behavior may give you stress. Try to keep in mind that they’re still learning how to cope. Your support can make a huge difference.

• Help your teen talk about their worries and fears. Being able to talk about them can help your teen learn to work on them.

• Have your teen exercise regularly. Exercise has been shown to help ease symptoms of anxiety and depression.

When to call a healthcare provider

• Has side effects from a medicine

• Has new symptoms or symptoms that get worse

• Becomes very aggressive or angry

• Shows signs or talks of hurting themselves(see below)

Suicidal thoughts are a medical emergency

Anxiety and depression can cause your teen to feel hopeless. Their thoughts may get so bad that suicide can seem like the only option. If you're concerned that your teen may be thinking about self-harm, ask them about it. Asking about suicide does not lead to suicide.

If your teen talks about suicide, act right away! Suicidal thoughts or actions are not a harmless bid for attention. They are a sign of extreme stress. They shouldn't be ignored. If the threat is immediate and your teen has a plan and the means to carry it out, call or text 988. You will be connected to trained crisis counselors at the Suicide Prevention Lifeline. An online chat option is also available. Lifeline is free and available 24/7. Don’t leave your teen alone. Remove any means, such as guns, rope, knives, or pills.

If the threat isn't immediate, call your teen's healthcare provider. Or call or text the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) or 988right away. It's open 24 hours a day, every day. They speak English and Spanish. And they have an option for those who are hard of hearing. You can text the Crisis Text Line ( text HELLO to 741741). Or visit the lifeline’s website at www.suicidepreventionlifeline.org for more information and an online chat option. This resource gives crisis help right away and can direct you to local resources. It's free and private.

To learn more

For more help and information, contact these groups:

• National Suicide Prevention Lifeline at www.suicidepreventionlifeline.org or 800-273-TALK (800-273-8255)

• National Institute of Mental Health at www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

• American Academy of Child and Adolescent Psychiatry at www.aacap.org