Written by:Dr. Karmen Smith, LCSW, DD

Published On: October 7, 2021

Medically reviewed by: Minkyung Chung, MS, LMHC

Reviewed On: February 9, 2022

Updated On: July 5, 2023


Updated on 2/9/2022

Anxiety in teens can be common. According to the National Institute of Mental Health, it’s estimated that close to 32% of teens aged 13-18 will be diagnosed with an anxiety disorder.

It may be a difficult topic to discuss, but avoiding the topic won’t make it go away. Helping an anxious teen understand how to manage their stress can teach them to navigate things they’ll likely face throughout adolescence, and even into adulthood. It’s important to also understand the differences between anxiety and other mental health conditions, like anxiety vs. depression, to diagnose and manage each correctly.

In this article, we’ll take a closer look at anxiety in teens from what causes it to how to deal with anxiety through online counseling for teens.

What Causes Teen Anxiety?

Teen anxiety can be caused by a number of things. Peer pressure, hormonal changes, insecurities about their looks or relationships, or the fear of being different can all cause a young adult to have anxiety.

Teens today are under an incredible amount of pressure. They face more demands, have busier schedules, and deal with more distractions than any generation before them. Add to this the intensified scrutiny on their looks, clothes, body type, social circles, and more — all largely the result of social media influence — and it’s easy to understand that teens and anxiety go hand in hand.

Of course, we can’t forget about all the expectations that are placed on teens today. Many are expected to remain constantly engaged in school, get good grades, participate in sports and other extracurricular activities, and try to get into or do well in college.

So when we talk about anxiety disorder in teens, it’s no surprise that this is a reality for many of our youth today. Anxiety can lead to depression, substance abuse, or in the worst cases, thoughts of self-harm or suicide.

We need to understand the pressures an anxious teen may face today so we can learn how to help them manage their anxiety before it manifests into something even worse.

“We know that teens who struggle with anxiety or low self esteem can be susceptible to feeling triggered by some content on social media, especially when they compare these “highlight reels” with their own day to day life. Talking with our teens about managing anxiety in healthy ways can be instrumental for their mental health and wellbeing.”

Licensed Clinical Social Worker (LCSW), DD Karmen Smith

How Does Anxiety Differ in Teenagers?

Anxiety is different for teens than it is for younger children or adults. Though the differences can be subtle, they’re key to gaining insight into how to treat anxiety in teens.

Compared to anxiety in younger children:

They’re generally more anxious about external worries or fears. A younger child’s anxiety may be about monsters, bugs, being afraid of the dark — any of the things that children worry about can cause them to have anxious feelings. However, children may also experience anxiety from trauma and parental worries.

Compared to anxiety in adults:

Adults tend to experience anxiety due to a wide range of factors. They typically have anxiety that’s often related to major life responsibilities and stresses — financial pressure, worries about children, and career demands are all common culprits of anxiety for adults.

Understanding anxiety in teens:

Unlike the external fears of younger children or the life stressors that adults experience, teen anxiety can often be more about internal stresses. Teens worry about school, sports, grades, what others think of them, their bodies, and more. And the increasing social pressure and expectations that are placed on teens to do well in all areas of their lives can contribute to how severe their anxiety is.

“Anxiety in teens is similar to adults, with it manifesting as excessive worry or fears, though for teens we often see irritability on the surface. Once we dig a little deeper, we discover that irritability or anger can often mask feelings of anxiety.”

What Are the Symptoms of Teenage Anxiety?

Symptoms of anxiety in teens can range. A teen who is diagnosed with an anxiety disorder may feel continuous nervousness, stress, excessive worries or fears, a sense of inner restlessness, or an inclination to be hyper-vigilant.

In addition to these internal anxiety symptoms, teens may experience physical symptoms as well. A teenager with severe anxiety may have anxiety chest pain, stomach pain, headaches, muscle tension, cramps, excessive fatigue, and pain in their back or limbs. They may have physical reactions to their stress, too. Some teenagers will startle easily, tremble, sweat, flush, or hyperventilate due to their anxiety.

Another sign that a teen may be experiencing anxiety is when they begin avoiding a social interaction, situation, or activity that they once enjoyed due to experiencing social anxiety. They might seem shy all of a sudden. Or, they may have the opposite reaction and begin to engage in risky or impulsive behaviors. They might start using or experimenting with drugs, begin or increase sexual activity, or partake in other reckless behaviors.

If you’re helping a young adult with anxiety, an overview of symptoms can be useful. Anxiety in teens can present itself as any of the symptoms below or a combination:

  • Irritability
  • Sensitivity to any criticism
  • Intense self-consciousness
  • Avoiding new (or difficult) situations
  • A sudden dip in school grades
  • Refusing to go to school or avoiding school
  • Sleep issues
  • Recurring sudden fears or worries about normal daily life
  • Difficulty concentrating
  • Unexplained withdrawal from social engagements and activities
  • Chronic headaches or stomach aches
  • Asking for reassurance repeatedly
  • Substance-abuse

If you think a teen in your life may be showing symptoms of anxiety, consider starting with our anxiety test. You can learn more to see if they should connect with a licensed therapist.

Common Forms of Anxiety in Teens

Some forms of anxiety disorders are more common than others. The most common forms of anxiety in teens include:

  • Generalized anxiety disorder – Characterized by difficulty concentrating, being easily fatigued, feeling irritable or restless, having sleep issues, and more. GAD includes consistent, long-lasting feelings of anxiety that affect a teen’s daily life.
  • Social anxiety disorder – Being easily embarrassed, blushing, having a hard time talking to others, making eye contact, speaking up, and more. As the name suggests, social anxiety shows up mainly in social situations.
  • Panic disorder – Symptoms may include having repeated, unexpected feelings of extreme fear, racing heart, dizziness, trembling, shortness of breath, and more. A panic attack can be caused by a certain trigger in their environment or at random.
  • Specific phobias – Intense fears about specific things or situations that aren’t really dangerous: dogs, heights, flying, etc. Teens can have specific phobias of death, deep water, and many other things.

Teenage Anxiety Triggers

Anxiety in teens can be triggered by a variety of factors. Common and known anxiety-related triggers include a teen feeling anxious about how they’re performing in school or around their peers. 

“Teens primarily are triggered by academic pressures. Worry about doing well is paramount for high achievers or for teens who are expected to do well or feel they should be performing better. Social dynamics are another trigger point for teens. Worry over friendships, dating relationships, social groups, acceptance all take center stage during adolescence. Feelings of insecurity give way to symptoms of anxiety.”

With the increased pressure that teenagers face daily to do well in school, they may fear not living up to expectations or not doing well in the eyes of others. Note that this can be a significant issue even if outside pressure is not being put on the teen. Some teenagers will still experience anxious feelings, even if they’re repeatedly reminded and reassured that they shouldn’t stress over grades, tests, social situations, or college admissions. 

How to Treat Teenage Anxiety

Managing anxiety disorder in teens should be a thoughtful, planned effort. Anxiety disorders can be treated by a licensed therapist or other mental health care provider. The goal of treatment is to reduce anxiety symptoms and relieve stress, but there should be careful monitoring to ensure the offered treatment isn’t having a major effect on the teens’ school, social, or development process.

Talk therapy

Overwhelmingly, one of the most effective forms of treatment for teen anxiety is a type of talk therapy known as cognitive behavioral therapy (CBT). During CBT sessions, teens will learn how to identify ways they’re thinking or behaving that contribute to their anxiety. They’ll find new ways to act and think that will help them manage stressful situations. They’ll learn coping skills that can alleviate stress, like breathing or relaxation techniques.

Medication for anxiety

Sometimes anxiety medication is needed alongside therapy. One type of medication commonly used in anxiety treatment is selective serotonin reuptake inhibitors (SSRIs). This type of antidepressant is one of the most commonly used medications for helping teens with anxiety. It has shown to be very effective in reducing symptoms of anxiety.  However, there are more anxiety medication options that a teen’s therapist may prescribe.

Additional ways to help anxiety in teens

Other forms of treatment or ways to get help might include, but aren’t limited to:

  • Long-term psychotherapy (talk therapy)
  • Family therapy
  • Talking to parents or other adults about their anxiety
  • Getting exercise
  • Focusing on good nutrition
  • Getting enough sleep (and establishing regular, consistent sleep habits)

“The key to treating teenagers, no matter what they’re going through, is to develop trust. Let them slowly tell you who they are and what they’re struggling with. Opening up about their symptoms can feel very vulnerable and potentially trigger more worry. I always advise therapists to take it slow, acknowledge and normalize their feelings and let that give way to any specific intervention.”

If a teen you care about is struggling with anxiety, it’s important to remember that with the proper treatment, there can be a bright future ahead. Anxiety doesn’t have to rule their life.

See References

Dr. Karmen Smith, LCSW, DD

Dr. Karmen Smith is a board-certified Clinical Social Worker in the state of Nevada. She has worked over 20 years for Clark County Family Services with abused and neglected children in the shelter, adolescents in juvenile detention, and adults who have suffered severe trauma. Dr. Smith is a shamanic teacher and minister of metaphysics and her doctorate is in Pastoral Counseling.

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