Being a teenager is a time of turmoil and transition. As a parent, you want to do everything you can to smooth out this experience. But, as we've all experienced ourselves, there's no perfect way to handle it; it's part of the universal human experience.

With any tumultuous time, there's going to be a lot of anxiety involved. Anxiety about a coming date or relationship, anxiety about school transitions, anxiety over gender and sexual identity, anxiety over long-term relationships and goals, the list goes on and on.

Watching from the outside, you know what this was like, but at the same time, there's a disconnect. You can't fully know everything your child is going through, and there's only so much you can do to help.

Some of this anxiety will resolve itself over time, as your teen gains more experience, navigates relationships and life, and grows into the person they'll become.

Other times, the anxiety stems from something deeper, and the best course of action is treatment, whether it's through CBT, DBT, or even medication.

The question is, how do you know when their anxiety can be resolved by waiting it out, and when it can't? It's a difficult situation, especially from the outside, but you can watch for the signs and make the best decision for your child.

We've put together five of the most common signs that your teen could use some form of treatment for their anxiety. If your teen is experiencing any of these, consider reaching out to schedule a consultation today.

DISCLAIMER: This article is for informational and educational purposes only and should not be considered medical or psychological advice. The information presented here is not intended to diagnose, treat, cure, or prevent any mental health condition or replace professional therapeutic care. Every individual's experience with trauma and mental health is unique. Please consult with a qualified mental health professional, therapist, or healthcare provider to determine the most appropriate treatment approach for your specific situation. If you are experiencing a mental health crisis or emergency, please contact your local emergency services or crisis hotline immediately.

Sorting Out Stress vs. Anxiety

The first bit of analysis you should do is check if the issues your teenager is experiencing are related to anxiety or are rooted in stress. The teenage years are undeniably stressful, with puberty issues, body image changes, relationships, school, extracurricular activities, and future planning all coming to a head.

The signs and symptoms of stress and anxiety are overall quite similar, and they can feed into one another. Being anxious is stressful, and stress can cause anxiety in a feedback loop that can be hard to break.

In general, your teen is stressed if there's a specific focus for their anxiety. They're worried about the big game, or about a relationship, or about a coming exam. These stressors are real, but they can be resolved, and the stress can be alleviated when the event happens and time passes. Stress tends to come and go as the schedule for these kinds of events progresses.

Anxiety, on the other hand, is more persistent. Your teen is anxious despite no clear trigger point or event that would cause it. They're overwhelmed, and they can't figure out how to control their feelings. Anxiety is overbearing and limits how they function in their day-to-day life.

The good news is, even stress can respond to many of the same treatments as anxiety, and a psychotherapist can help your teen sort out their feelings and develop coping mechanisms that can handle regular stress as well as more generalized anxiety.

So, what are the signs that your teen is experiencing anxiety and could benefit from treatment?

#1: Your Teen is Becoming Increasingly Avoidant

Avoidance is one of the most common symptoms of anxiety, and also one of the most visible from the outside.

Avoidance is characterized by resistance to, or outright refusal to, activities and events. It's especially clear if these events or activities are things your teen previously enjoyed, or even does enjoy when they manage to pass through the anxiety and do the activity anyway.

The things your teen avoids can vary. They might skip school entirely or skip certain classes. They might withdraw and avoid social situations, such as those with people they don't know, those with authority figures who hold power over them, or with peers with whom they have a rocky or uncertain relationship.

Some avoidance is very clear when your teen starts to avoid something that they previously enjoyed as a hobby or activity. A child who enjoys sports suddenly avoiding practice, a child who loves hanging out with friends never wanting to join in; these are fairly common examples.

Other times, avoidance may not be obvious. Would you even notice if your teen was given an opportunity in school, something they would previously have jumped at the chance to do, and declined and never talked about it?

Seeing a pattern of avoidance that grows over time is a common and clear sign of anxiety.

#2: Your Teen is Experiencing Unexplained Physical Symptoms

While anxiety is characterized as a mental health disorder, that doesn't mean it's all in your head. Anxiety disorders can come with a host of physical symptoms, many of which can be stark.

• Insomnia or difficulty sleeping.
• Ongoing fatigue that sleep doesn't solve.
• Loss of appetite and loss of interest in food.
• Generalized body aches and tension.
• Headaches.
• Stomach aches and nausea.
• Shaking or trembling, or feeling like shaking without actually shaking.
• Restlessness and fidgeting.

Some of these may come and go, often in line with stressors like tests and events. Others linger, and may ebb and flow but never fully go away.

There can also be more severe symptoms, such as chest pain, rapid heartbeat, and an overwhelming sense of fear or doom. These symptoms can even mimic a heart attack. With an anxiety disorder, it's possible that they are having a panic attack.

Teenage anxiety with physiological symptoms can be difficult to diagnose. It's an age where medical conditions can start to crop up, where puberty and other biological changes are happening, and where activities can lead to injury or illness as well.

You might bring your teen to a doctor or urgent care, only to find nothing is physically wrong with them. This is a clear sign that these symptoms stem from anxiety and that the treatment will involve the underlying anxiety disorder.

It's important to remember that these symptoms aren't just mental. The mind controls the body, and anxiety has real physical symptoms and repercussions. Moreover, chronic stress and anxiety can compound and even lead to long-term health issues. Treat it with the gravity it deserves.

#3: Your Teen Expresses Negativity and Catastrophic Thinking

Part of anxiety is the worry about things going wrong. Some people express this through a negative self-image; that things go wrong because they aren't good enough, aren't smart enough, aren't charismatic enough. Other times, it's about external failures; what if the car breaks down, what if their wallet is stolen, what if an event is canceled?

This is one of the hardest symptoms of anxiety to notice. Pay attention to the way your teen talks about both themselves and their activities.

One characteristic to watch for is negative self-references. Does your teen respond to criticism by attributing it to their own lack of worth? Do they say "I suck" and other self-demeaning language frequently?

Always expecting the worst possible outcomes is known as catastrophizing. An individual with anxiety focuses on identifying the worst possible outcomes and failure states, whether it's being rejected at an interview, being in a car crash on the highway, or whatever else is most relevant to the given activity or event. Rather than evaluating the likelihood of such an event, planning around what can be mitigated, and moving on, a person with anxiety will then focus on the worst outcomes and spiral, convinced that those outcomes are all but guaranteed.

Everyone can have these negative thoughts from time to time, but they are part of a larger anxiety disorder when they take over thought patterns and self-reinforce, becoming all they think about.

#4: Your Teen Experiences Uncontrollable Mood Swings

A certain amount of mood variability is normal for the teenage years. But then, the same can be said for everything on this list.

Mood swings and extreme moods can include:

• Outbursts of anger or rage.
• Being easily startled and reacting strongly, often with anger.
• Feeling an ongoing sense of dread.
• Crying spells, often over relatively minor triggers.
• General irritability and abrasiveness.
• Loneliness and withdrawal.
• A low tolerance for frustration and irritation.
• Outsized reactions to small triggers in general.

In particular, experiencing two or more of these throughout any given day, regularly, or going from one extreme to another in a short amount of time or in response to a small trigger all indicate a mood disorder.

This doesn't necessarily have to be from anxiety. Depression, the early signs of bipolar disorder, knock-on effects of trauma, even chronic pain and more can all be expressed in similar ways. When anxiety is the root cause, you'll often see these behaviors grow over time, when the anxiety isn't resolved, and the stress builds up.

#5: Your Teen Seeks Reassurance that Doesn't Help

One of the most visible signs of an anxiety disorder in your teenager is that they seek reassurance from you that things will be okay. They'll ask you questions and seek comfort from you as their safe haven.

• "Will I be okay? Are you sure?"
• "Did I do something wrong?"
• "What if this goes bad? What if something happens?
• "Can you promise nothing is going to happen?"

This kind of language is normal for a single event, but when it surrounds every social engagement or scheduled activity, it becomes a pattern that indicates an underlying anxiety disorder.

In particular, this reassurance-seeking comes with two details. One is that it's repeated; despite your reassurance, it doesn't soothe their fears or put their mind at ease. The other is that it can fade over time, as your teen learns that your reassurance isn't actually helping them, so they stop asking for it.

Short of coming to you and saying, "I think I have anxiety", this kind of reassurance-seeking is one of the strongest indications of anxiety your teen can express to you directly.

Other Warning Signs of Anxiety in Teens

The five signs listed above are the most common, but there are a few others worth mentioning.

One is a hyperfocus on the opposite end of the spectrum. Instead of withdrawing and not trying, your teen throws all of themselves into every activity, seeking nothing but the utmost perfectionism. This isn't necessarily a drive to succeed, but rather an avoidance of failure and a fear of making mistakes. It's a maladaptive coping mechanism; maybe the voice in the head will quiet down if they're just good enough that it has nothing to criticize. Obviously, it doesn't work that way.

Another sign is a need for control. If anxiety centers around all the things that could go wrong, simply take control of every possible variable. Plan every minute of the schedule. Pack every possible item to solve any conceivable problem. Demand perfection from others so that no mistakes can be made. It becomes overbearing and isolating as others step away rather than deal with it.

Risk-seeking behaviors are also a possible expression. Your teen may feel that, if something is going to go wrong anyway, they might as well take the risks. In some cases, this is because the dopamine release of thrill-seeking can quiet the anxiety. In other cases, turning to drugs or alcohol serves as a kind of self-medication, and eventually addiction and dual-diagnosis situations.

Taking the Next Step

If you're pretty sure that your teenager has anxiety, the best thing you can do is get them to see a specialist. But, this can be a challenge. Your teen might not want to acknowledge that there could be something wrong with them, or they might not want to reveal their inner thoughts to a stranger, or even to you.

You can help alleviate some of those fears. For example, your teen has a right to privacy, and the things they discuss with their therapist are kept between them; even you don't necessarily have the ability to access that information outside of specific circumstances.

You can also try to lower barriers to starting therapy, such as scheduling virtual visits instead of an office visit.

Remember, even therapy appointments are not immune to anxiety and avoidance.

Here at BMC-Troy, we offer everything you need to get your teen to a healthier state of mind. We offer psychiatric evaluations and fully confidential assessments. We serve children, adolescents, and adults in our practice. We offer both in-person and telehealth visits to fit any schedule. Our staff offer a range of kinds of therapy and treatment options, so there will be something right for your teen's needs. We also handle medication management if your teen needs an anti-anxiety medication

To get started, you can fill out our online new patient intake form and medical consent form here on our website. You can also call our office at 248.528.9000 to ask any questions you may have. We're happy to help you and your teenager live a happier and healthier life.