What does anxiety in adolescence look like?

Do your find yourself in a state of constant worrying?  Do you struggle with building friendships or making small talk? Do you ever lay awake stressing about school, social drama, or what will happen after graduation? 

Anxiety is quite common amongst teenagers in the U.S. (Costello et al, 2005; Baxter, Scott, Vos, & Whiteford, 2013), particularly social anxiety.  Some attribute this to the increased use of technology for communication (Pierce, 2009), which decreases the frequency of face-to-face interaction. 

Teens who struggle with anxiety may have similar problems as adults might, particular with identifying the differences between emotions and thoughts.  Feelings of anxiety arise when we anticipate a threat or uncertainty to prepare us to respond.  Clinicians divide anxious feelings into bodily symptoms (somatic) and mental symptoms (cognitive).  Bodily symptoms include might include shakiness, edginess, irritability, and difficulty sleeping.  Mental symptoms include worry, difficulty concentrating, and fixation on certain fears or thoughts.  Many of teens (and adults) tend to confuse anxiety with fear, seeing them as one state of being. 

Although very similar, fear and anxiety have a few important distinctions (DSM-5; Getz, 2014): 


Fear:  Emotional response to an actual and present threat (e.g. a bear is attacking you right now)

Anxiety:  Emotional response to an anticipated threat (e.g. you think a bear is going to attack soon)

When It Happens

Fear: Typically occurs when the threat is present

Anxiety: Occurs when one believes a threat is oncoming or possible

How the Body Responds

Fear: Brief “Fight or Flight” response:

  1. Threat is detected
  2. Stress hormones (e.g. adrenaline and cortisol) flood the bloodstream
  3. Blood vessels constrict, pupils dilate, heartrate increases
  4. Body is prepared to address the threat by attacking (fight) or running away (flight)
  5. After the threat is addressed, body returns to baseline and relaxes

Anxiety: Long-term “Fight or Flight” response:

  1. Threat or uncertainty is anticipated
  2. Stress hormones are released into bloodstream
  3. Body become alert (hypervigilant) and prepared for threat
  4. Body maintains state of alertness, but threat may not occur
  5. Brain begins to associate alertness with safety, thereby making anxiety the default

Why It Happens

Fear: To survive immediate danger

Anxiety: To prepare for future danger

As you can see in the “Why It Happens” section, fear and anxiety both have a functional purpose.  Fear helps us address immediate threats, and anxiety helps us feel motivated to preemptively address threats before they happen. 

Yet, anxiety can become dysfunctional when it keeps us from living life in accordance with our values.  Left untreated, symptoms of anxiety can be extremely disruptive and harmful (van Beljouw, Verhaak, Cuijpers, van Marwijk, & Penninx, 2010), even for physicians and other health professionals (Yelin, Mathias, Beusching, Rowland, Calcucin, & Fifer, 1996).

Examples of how anxiety may impact the life of a teenager might include:

  • Difficulty making new friends
  • Decrease in academic performance
  • Avoidance of social situations
  • Conflict with adults regarding responsibilities or expectations

Do not let anxiety rule your (or your teen’s) life.  If you or someone you know struggles with anxiety, there is hope.  Schedule your first meeting with me today to get the help you need.

Treatment for anxiety

As a clinical psychologist, I take a careful and direct approach to helping teens overcome anxiety.  Cognitive-Behavioral Therapy (CBT) has been found to be one of the most effective treatment options for anxiety (Öst & Ollendick, 2017; Warwick et al, 2017). 

In treating anxiety disorders, my process begins with a thorough intake interview and diagnosis.  Based on the diagnosis and the goals you have for improving your life, I design an evidence-based treatment plan with a focus in symptom reduction. 

Therapy can help teens with anxiety:

  • Increase confidence
  • Develop a realistic self-esteem
  • Build social skills
  • Decrease avoidance behaviors
  • Identify the cause of anxious feelings
  • Regulate feelings to meet the situation
  • Tactics for dealing with panic
  • Tolerate anxious feelings
  • Gain awareness of anxiety triggers

Therapy is the fastest, most effective way for teens to address their anxiety.  Although adults may also wish to discuss options for medication for anxiety symptoms, teenagers may need to wait until adulthood (when neurological growth begins to finalize development).  These options will be discussed in our first meeting if desired. 

Sometimes anxiety can keep people from seeking the help they need.  Take the first step towards regaining control of your life, and schedule your first session today.     

Interested?  Let’s connect!

If you are interested in therapy services, please contact me as soon as possible. I would love to hear from you and answer any questions you may have about my practice. 

It is never too late to receive treatment.  I believe I can help make a difference in your life. 

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I help people and their families in the Newport Beach area, but I also work with folks from Irvine, Newport Beach, Costa Mesa, Laguna Beach, Rancho Santa Margarita, Aliso Viejo, Laguna Hills, Mission Viejo, Anaheim, Orange, Tustin, Huntington Beach, Seal Beach, Dana Point, Fountain Valley and more.

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Baxter, A. J., Scott, K. M., Vos, T., & Whiteford, H. A. (2013). Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychological medicine43(5), 897-910.

Costello, E. J., Egger, H. L., & Angold, A. (2005). The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. Child and adolescent psychiatric clinics of North America14(4), 631-648.

Cummings, C. M., Caporino, N. E., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological bulletin140(3), 816.

Essau, C. A., Lewinsohn, P. M., Olaya, B., & Seeley, J. R. (2014). Anxiety disorders in adolescents and psychosocial outcomes at age 30. Journal of affective disorders163, 125-132.

Getz, G. E. (2014). Applied biological psychology. Springer Publishing Company.

Lindert, J., von Ehrenstein, O. S., Grashow, R., Gal, G., Braehler, E., & Weisskopf, M. G. (2014). Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis. International Journal of Public Health59(2), 359-372.

Öst, L. G., & Ollendick, T. H. (2017). Brief, intensive and concentrated cognitive behavioral treatments for anxiety disorders in children: A systematic review and meta-analysis. Behaviour Research and Therapy.

Pierce, T. (2009). Social anxiety and technology: Face-to-face communication versus technological communication among teens. Computers in Human Behavior25(6), 1367-1372.

Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014). The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. International journal of epidemiology43(2), 476-493.

van Beljouw, I. M., Verhaak, P. F., Cuijpers, P., van Marwijk, H. W., & Penninx, B. W. (2010). The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study. BMC psychiatry10(1), 86.

Warwick, H., Reardon, T., Cooper, P., Murayama, K., Reynolds, S., Wilson, C., & Creswell, C. (2017). Complete recovery from anxiety disorders following Cognitive Behavior Therapy in children and adolescents: A meta-analysis. Clinical psychology review52, 77-91.

Yelin, E., Mathias, S. D., Buesching, D. P., Rowland, C., Calucin, R. Q., & Fifer, S. (1996). The impact on employment of an intervention to increase recognition of previously untreated anxiety among primary care physicians. Social Science & Medicine42(7), 1069-1075.