Data from leading public health officials and agencies in the U.S. shows the prevalence of mental health disorders among adolescents increased steadily over the past twenty years. Behavioral disorders such as ADHD increased by 5 percent from 2003-2007, by 7 percent from 2007-2011, and by 22 percent from 2011 to 2016. Diagnosis of depressive disorders among adolescents increased by 30 percent from 2005-2014. Despite these steady increases in behavioral and depressive disorders since the year 2000, one mental health disorder remains over twice as common as behavioral and depressive disorders: anxiety disorders.

The latest information from the National Institutes of Health (NIH), the Centers for Disease Control (CDC), and the Child Mind Institute show this alarming statistic:

Almost one-third of adolescents in the U.S. (31.9%) meet the clinical criteria for an anxiety disorder.

Here’s a quick reality check: that’s about 7.5 million teenagers. Of, if reading that in number form will have a greater impact, we’ll say it this way:

7,500,000 teens across the U.S. have a mental health disorder that may prevent them from fully participating in the most basic activities associated with family, school, or social life.

If your teenager has an anxiety disorder, your primary goal is to get them the help and support they need so they can manage their symptoms and engage in and enjoy their teen years. You can do this by seeking treatment at a behavioral health treatment center for teens. Skilled, licensed, and committed professionals receive years of training to secure positions in behavioral health treatment, and many make it their mission to support teens with mental health disorders, including anxiety.

Your teen can learn to manage their anxiety and live a full and productive life. The first step is receiving an accurate diagnosis from a mental health professional, which requires a full evaluation and assessment from a therapist in private practice or at a behavioral health treatment center for teens. If you’re the parent of a teen you suspect has anxiety that meets the clinical criteria for an anxiety disorder, we recommend arranging an assessment as soon as possible.

In the meantime, however, you can read this article to learn more about anxiety in teens, what kind of treatment works best, and how to find a treatment center for teens that meets your family’s needs.

We’ll start by defining anxiety and talking briefly about the different types of anxiety disorders common in teens.

Anxiety Disorders: Definitions, Signs, and Symptoms

The National Association on Mental Illness (NAMI) indicates that all the various anxiety disorders recognized by mental health professionals share a common characteristic:

“A persistent, excessive fear or worry in situations that are not objectively or inherently dangerous.”

Many people are aware of anxiety disorders, but unaware that there are several types of anxiety, each with different clinical diagnostic criteria. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies seven distinct anxiety disorders that occur in children and adolescents:

1. Generalized anxiety disorder (GAD)
2. Separation anxiety
3. Social anxiety disorder (SAD)
4. Panic disorder
5. Agoraphobia
6. Specific phobia
7. Selective mutism

Among these, the three most common among adolescents are generalized anxiety disorder (GAD), separation anxiety, and social anxiety disorder (SAD).

Here are the symptoms of anxiety parents should watch for in teens:

Emotional:

• Excessive fear of regular daily situations
• Excessive irritability
• General restlessness
• Assuming negative outcome for any future event
• Extreme agitation
• General nervousness

Physical:

• Rapid heart rate
• Hyperventilating
• Sleep problems: too much or too little
• Excessive fatigue
• Frequent headaches
• Twitching or tremors
• Excessive sweating
• Frequent nausea/stomachaches
• Frequent trips to the restroom

Those are the symptoms common to most, if not all, anxiety disorders. We’ll now offer the symptoms specific to GAD, separation anxiety, and SAD.

Generalized Anxiety Disorder (GAD)

GAD occurs in about 2.2 percent of teens in the U.S. (500,000)

GAD involves constant worry that interferes with daily activity and persists for over six months. Specific signs include:

• Insomnia
• Muscular tension
• Restlessness
• Difficulty concentrating
• Worries about family
• Worries about health issues
• Excess worry over things like chores, appointments, or daily activities

Separation Anxiety

Separation anxiety occurs in about 7.6 percent of teens in the U.S. (1.9 million)

Separation anxiety occurs when teens become extremely anxious or fearful of being away from people to whom they’re emotionally attached. To meet clinical criteria, symptoms must last for four months or more, and may include the general symptoms listed above, as well as excessive fear or worry about:

• Going on sleepovers
• Attending school
• Going to sleepaway camp
• Travel that takes them away from friends or family they love

Social Anxiety Disorder (SAD)

SAD occurs in about 9.1 percent of teens in the U.S. (2.3 million)

Also known as social phobia, SAD involves anxiety, fear, and discomfort about being embarrassed, humiliated, or rejected by peers during social interactions. To meet clinical criteria for SAD, symptoms must be present for six months or more, may include some or all the general symptoms listed above, and may also include fear of:

• Public speaking
• Meeting new people
• Eating or drinking in public
• Being the center of attention
• Making mistakes in front of others
• Doing new things
• Dating
• Making eye contact
• Attending social events

Any anxiety disorder can be debilitating for a teenager, and disrupt their home, family, and school life. Social phobia is particularly difficult – and potentially damaging – for teens because social settings are critical for “acquiring new knowledge and adaptive capabilities that are imperative to the psychosocial development,” a.k.a. social learning, which is defined as “a change in understanding, attitudes, or new knowledge acquisition that takes place through social interaction.”

Many people – including some parents of teens with anxiety – are unsure why those with anxiety can’t get over it, stop worrying, and get on with their lives. Further, they wonder why there’s a clinical diagnosis, and whether treatment at a behavioral center for teens is necessary. The answer to the first question is simple: they can’t get over it because mental health disorders are medical conditions and people diagnosed with them need treatment and support. The answer to the second question straightforward as well:

Undiagnosed, untreated anxiety can escalate, and have a negative impact on psychosocial development, last into adulthood, and create a significant impediment to the overall quality of life, wellbeing, and happiness.

That’s why mental health professionals make a big deal about anxiety among teens: it’s a big deal and can have long lasting implications – especially when it goes undiagnosed and untreated. With all that said, though, it’s important for parents to know that evidence-based treatment for anxiety – typically provided at behavioral health treatment centers for teens – is proven effective by decades of peer-reviewed scientific and clinical research.

We’ll now discuss the most effective treatments and therapies for anxiety disorders in teens.

Anxiety Disorders in Teens: Effective, Evidence-Based Treatment

Research shows the best way to treat anxiety disorders in teens is with a combination of psychotherapy (talk therapy) and medication:

• Common psychotherapeutic approaches include:
  • Cognitive-Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Exposure Response Prevention Therapy
• Medications typically include:
  • Anxiolytics, a.k.a. anti-anxiety medications
  • Anti-depressants

In addition to talk therapy and medication, complementary therapies are now widely accepted as effective approaches managing anxiety. In the context of professional mental health treatment and support provided at behavioral health treatment centers for teens, complementary means in addition to and not in place of. While the following approaches can help on their own, evidence shows they’re most effective when learned under the guidance of a licensed therapist or clinician, in conjunction with traditional modes of treatment:

• Mindfulness-Based Stress Reduction (MBSR):
  • Breathing exercises
  • Self-guided relaxation
  • Awareness exercises
• Meditation
  • Walking meditation
  • Seated meditation
• Yoga
  • Power Yoga
  • Hatha Yoga
  • Hot Yoga
• Tai Chi
• Chi Kung
• General Exercise:
  • Running
  • Cycling
  • Walking
  • Group exercise: aerobics, etc.
  • Boxing
  • Weight training
  • Sports

It’s important for parents of teens with anxiety, and for the teens themselves, to understand that moderate-to-severe anxiety disorders may require long-term treatment. Anxiety can be cyclic, meaning that symptoms can go into remission for long periods of time – week, months, or years – and then return in response to unforeseen, stressful life events.

That’s why treatment is critical – and the sooner, the better.

How Treatment for Anxiety Helps

Research indicates the average age of onset (when they first appear) for anxiety disorders is 11 years old, and that 75 percent of anxiety disorders develop before age 21. Additional research shows that anxiety disorders are most often chronic and progressive, which means they can last a long time – or recur often – and without treatment, they can get worse as time passes. What this means for parents is that clinical anxiety rarely improves or resolves without professional treatment and support.

A study called The Child/Adolescent Anxiety Multimodal Extended Long-Term Study (CAMELS) presented a significant conclusion:

“Acute positive response to anxiety treatment may reduce risk for chronic anxiety disability.”

Don’t worry – we’ll translate.

What that means is the quicker an adolescent diagnosed with anxiety receives treatment for that anxiety disorder – acute positive response – the greater their chances at long term treatment success, i.e. reduce risk of chronic anxiety disability.

When your teen receives evidence-based treatment for anxiety at a behavioral health treatment center for teens, they’ll learn:

1. The facts about their anxiety diagnosis
2. The basics about how their brain works
3. How anxiety affects their brain
4. How those effects affect their thoughts and behavior
5. Positive coping skills, techniques, and mechanisms for managing their symptoms
6. That they’re more than their diagnosis
7. They can live a full and productive life despite their anxiety

In addition to seeking and initiating treatment for your teen, the best thing you can to help them is offer your unconditional love and support as they learn to manage their anxiety. It may be difficult, and there may be ups and downs. Symptoms may fade, and then return, which can be frustrating. But when a teen learns the skills to manage their symptoms, they own those skills for life. While they’re learning those skills, your support is essential. When you participate in treatment, you learn and grow along with your child. With a strong support system behind them, their chance of treatment success increases dramatically. Together, you and your teen can work restore harmony and balance to your family – and they can get back to being a teenager.