Being a teen is tough; being a teen with anxiety is brutal. Every day, teens deal with raging hormones, changes in their physical appearance, striving for independence from their parents, educational challenges, relationship obstacles, and so much more. When you add anxiety to the mix, life for your teen becomes exponentially more difficult.
One of the worst things about anxiety is not knowing what causes it. That is true of any condition, really. Not understanding something that is happening to you creates its own share of anxiety. When your teen is diagnosed with anxiety, it is essential that you, in consultation with the medical professionals on your teen’s case, have a talk with your teen to explain the science behind anxiety.
Brain chemistry certainly has unique properties, and every brain behaves differently. Today, we will discuss how the anxious brain works, what makes anxiety happen, what triggers it, how the body is affected, and how treatments can help your teen treat and deal with the symptoms of anxiety.
The Anxious Brain
Anxiety gets the body ready to fight danger. But what if there is no danger? When there is no perceivable danger, anxiety compels the patient to keep fleeing from an invisible threat indefinitely. Many teens confuse anxiety with fear, but fear is completely different. Fear is triggered by a stimulus; when that stimulus disappears, so does fear. Anxiety is not always triggered by a stimulus. Generalized anxiety disorder, most common among teens, is just a vague feeling of powerful worry and absolute belief that something horrible is about to happen.
Anxiety seems to be created by an imbalance between the emotional and thinking inhibitory parts of the brain. “Typically, the prefrontal cortex (PFC) inhibits the emotional amygdala. The amygdala is a brain structure that is always on the lookout for threats so it can quickly react. You need it to be in full operation during a dangerous situation. However, in non-threatening situations, a healthy prefrontal cortex inhibits the lower parts and puts the brakes on the accelerated speed of the amygdala.”
When the brain is anxious, the amygdala suffers from hypersensitivity and the connections with the PFC weaken. This causes the amygdala to generate multiple false alarms, like perceiving a harmless situation, comment, or personal evaluation as threatening. While this is happening, the prefrontal cortex has trouble inhibiting the amygdala’s racing, out of control thoughts.
Anxiety also has detrimental effects on memory. The enormous amount of stress caused by unrelenting anxiety shrinks the hippocampus, the region of the brain responsible for processing long-term and contextual memories. And here is the worst news for sufferers of anxiety: all types of memories are limited “except memories that support the anxiety, trauma, or stressor. In other words, the only memory files available for immediate conscious access are the ones of failure, threat, and danger.” Memories of success, faith, and security become inaccessible.
Because of these difficulties in communication between specific parts of the brain, the anxiety a teen feels can get out of control when too many stressors or triggers are present in day to day life.
Causes of Anxiety
Though science can tell us how anxiety works, it has yet to define the causes of anxiety disorders. Life experiences and traumatic events can trigger anxiety disorders in people already disposed to anxiety. Anxiety disorders also run in families. There are medical conditions or problems that can trigger an anxiety disorder, as well as specific risk factors making one predisposed to anxiety.
For some teens, anxiety can correlate with an underlying health condition. Sometimes, signs and symptoms of anxiety are actually the first indicators of a medical illness. If your doctor suspects your anxiety is pointing to a medical condition, he or she may order certain tests to examine your physical health. Here are some specific examples of medical problems that can be connected to anxiety:
- Heart disease
- Diabetes (both Type I and Type II)
- Thyroid problems
- Respiratory disorders, like chronic obstructive pulmonary disease (COPD) or asthma
- Drug abuse or withdrawal
- Withdrawal from alcohol, anti-anxiety medications, or other medications
- Chronic pain (such as fibromyalgia) or irritable bowel syndrome
- Rare tumors (usually in the adrenal glands) that produce certain fight-or-flight hormones consistently
Your anxiety could present due to an underlying medical condition if:
- You don’t have any blood relatives with an anxiety disorder
- You didn’t have anxiety disorder as a child
- You don’t avoid certain things or situations because of anxiety
- You have a sudden occurrence of anxiety that seems unrelated to life events
- You didn’t have a previous history of anxiety
- As a side effect of certain medications
There are various factors that may increase your teen’s risk of developing anxiety:
- Trauma. Children who endured abuse, went through a trauma, or witnessed traumatic events are at high risk of developing anxiety. Teens who experience a traumatic event also can develop anxiety.
- Stress due to an illness. Teens with health conditions or serious illnesses can experience significant worry about treatment or their future.
- Stress buildup. A buildup of isolated stressful situations may trigger excessive anxiety — death in the family, school stress, or relationship stress.
- Personality. Teens with certain personality types are more likely to experience anxiety.
- Other mental health issues. Teens with other mental health disorders, such as depression, often also have an anxiety.
- Having blood relatives with anxiety. Anxiety disorders can run in families.
- Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.
The medical causes and risks are important to explain to the teen who has been diagnosed with anxiety. They may feel like they are “just crazy” or that their family will abandon them because they are sick. By being supportive and learning about anxiety together, families can create a healthier home dynamic and learn about the triggers that affect their teen.
Being able to recognize triggers for your teen’s anxiety is essential for them to maintain stable mental health. Anxiety triggers vary from person to person, but there are lots of triggers common among people with anxiety. Most people have multiple triggers; however, others have anxiety attacks triggered for no reason at all.
Identifying your triggers is necessary so you can manage them appropriately.
- Health issues – a health diagnosis that’s upsetting or difficult, like cancer or a chronic illness, can trigger anxiety or worsen it. Reduce your anxiety issues by being proactive and engaged with your doctor. Learn how to best manage your emotions around your diagnosis.
- Medications – prescription and over-the-counter (OTC) medications can trigger symptoms of anxiety. They can create uneasy feelings which can then set off your anxiety. These medications can include birth control pills, cough and congestion medications, or weight loss medications.
- Caffeine – Many people rely on coffee to wake up in the mornings, but it can trigger or worsen anxiety. Substitute noncaffeinated options any time you can.
- Skipping meals – empty bellies equal low blood sugar that can lead to shaky hands and an anxiety attack. It’s essential to eat healthy, balanced meals on a regular schedule to prevent low blood sugar, feeling nervous, getting agitated, or having a full-blown anxiety attack.
- Negative thinking – when your teen is upset or irritated, the words they say to themselves can trigger anxiety. Review the detrimental effects of negative self-talk with your teen or have your teen talk about it with a therapist.
- Parties or social events – rooms full of strangers your teen is expected to make small talk with can trigger anxiety. Always send someone along with your teen to offer them comfort and support.
- Conflict – relationship problems, disagreements, really any king of conflict can trigger anxiety. Learning conflict resolution strategies can be of enormous help if this is one of your teen’s triggers.
- Stress – everyday stressors like school or working part time can cause your teen anxiety. “Stress can also lead to behaviors like skipping meals, drinking alcohol, or not getting enough sleep. These factors can trigger or worsen anxiety, too. Treating and preventing stress often requires learning coping mechanisms.”
- Personal triggers – these types of triggers are hard to identify in many cases, but a mental health specialist can help your teen identify them. They can start with a smell, a place, a person, a food, or even music. Personal triggers remind your teen of a traumatic event.
Getting to know your teen’s triggers, and more importantly, teaching them how to cope with the triggers, will help your teen deal more efficiently with his or her anxiety. However, when anxiety is not dealt with in the mind, the body can start to show physical signs of anxiety.
If a teen’s anxiety gets out of control, it can start manifesting in physical ways that are not at all pleasant. The body has to deal with the increased levels of fear, flight, or fight present during long-term anxiety attacks. Here are some physical symptoms of anxiety:
- stomach pain, nausea, or digestive trouble
- insomnia or other sleep issues (nightmares, constant waking)
- weakness or fatigue
- rapid breathing
- shortness of breath
- increased heart rate (often described as pounding)
- trembling or shaking
- muscle tension or pain
Anxiety is your teen’s body’s response to stress and how it prepares the body to deal with perceived threats. This fight-or-flight response was never meant to be long-term – only temporary. Anxiety does not shut down the fight-or-flight response leading to physical symptoms.
When your teen’s body responds to a perceived threat, breath increases rapidly because the lungs are “trying to move more oxygen through your body in case you need to escape. This can make you feel as if you’re not getting enough air, which could trigger further anxiety or panic. Tensed muscles may prepare you to get away from danger quickly, but muscles that are constantly tense can result in pain, tension headaches, and migraines.”
An increased heartbeat and faster breathing are controlled by the hormones adrenalin and cortisol. But, these hormones can also affect your teen’s digestion and blood sugar levels. If your teen is often stressed or anxious, frequently releasing these hormones can have long-term health effects, including conditions like irritable bowel syndrome or Type II diabetes.
The good news is, there are multiple types of treatment available for anxiety in your teen.
Many parents may think that simply putting their teen on medication is the answer to the anxiety problem. While medication can help, it is not the only solution to treating anxiety. Parents should defer to the wisdom and experience of mental health professionals to evaluate and determine treatment for their teen.
Once your teen has been evaluated, treatment decisions are based on how significantly anxiety is affecting your teen’s ability to initiate self-care, keep in school, maintain relationships, and participate in a healthy family dynamic. The two main treatments for anxiety are psychotherapy and medications. Many patients benefit most from a combination of the two, though it make take several attempts to find the combination that works best.
In talk therapy or psychological counseling, your teen will work with a therapist to reduce their anxiety symptoms. They will learn about what causes their anxiety, what their external triggers are, what their internal triggers are, and what coping mechanisms will be most useful to them.
Oftentimes, once teens have learned these things about their anxiety, they can reduce the amount of psychotherapy they engage in, saving it for check-ups or emergencies only. Most teens will find that their symptoms improve as they learn how to successfully manage their anxiety.
Several types of medications are used to treat anxiety. Your teen’s primary care physician, in consultation with the mental health care team, should discuss the risks, benefits, and possible side effects of any medication regimen you are considering for your teen. Doctors will most often prescribe one or more of the following types of medication:
Antidepressants are the first line medication treatments. Examples of antidepressants used to treat anxiety include Lexapro, Cymbalta, Effexor XR, Buspirone, and Paxil. Your teen’s doctor could also recommend other antidepressants. But what is important to stress to your teen is that they will not feel better right away. It can often take up to two weeks for the positive effects to be noticed.
Due to their addictive nature, your teen’s doctor may prescribe a benzodiazepine for relief of anxiety on a short-term basis. Benzodiazepines include Xanax, Diazepam, and Klonopin.
Understanding why anxiety does what it does and works the way it does is essential for your teen in accepting treatment. It is difficult to discover that your brain is betraying you and your teen may feel isolated. Be encouraging, support their treatment plans, and above all, make sure they understand that anxiety is a scientific, medical problem, not a personal shortcoming.