Anxiety in Adolescents
By Sharon Omiwole & Michael Keane
“Anxiety disorders constitute the most prevalent class of mental health problems in children and adolescents, with prevalence rates estimated from 15-20%.” (Psychiatry Advisor)
Anxiety can be seen as a normal part of adolescence as this can be a very stressful time in a person’s life. Not all anxiety is bad. “Some anxiety is a normal reaction to stressful situations.” Anxiety can help an adolescent study harder for an exam or even deal with a difficult situation.
There are, however, some forms of anxiety that can have a negative impact, leading a person to feel afraid and nervous to the extent that they may begin to avoid certain situations and people. The most common anxiety disorders in adolescence include generalised anxiety disorder (GAD), panic disorder and social phobia.
Generalised anxiety disorder can make an adolescent feel excessively worried about events whether they are in the past, present or future. Common worries of an adolescent with GAD may be about school, family problems, academics, their health or even things happening in the world. Adolescents with GAD have trouble controlling their worry and anxiety, and over time it affects their every day lives.
Panic disorders are characterised by distressing and intense physical symptoms of anxiety (e.g. racing heart, difficulty breathing), commonly called a “panic attack”. Part of panic disorder includes fear of more panic attacks in the future. Adolescents who have panic attacks may find that they avoid going out to places or participating in events and activities due to the fear that they may have a panic attack.
Social phobia can cause an adolescent to become shy or fearful of saying or doing things in front of people for fear they will end up being embarrassed.
Anxiety has physical, cognitive and behavioural symptoms. Physical symptoms can include chest pain, headaches and shortness of breath. Cognitive symptoms can include worrying about the future or things that already happened in the past, always thinking about the worst case scenario (called catastrophising) and having trouble going to sleep at night. Behavioural symptoms can include avoiding situations, being withdrawn or, for some people, aggressive behaviour.
Symptoms of anxiety are not always obvious, becoming more obvious when something happens to trigger it. If anxiety disorders from childhood go undetected and untreated, they can continue into adolescence and adulthood.
Approximately 8% of adolescents between the ages of 13 and 18 have an anxiety disorder; typical symptoms appear around age 6. Of these teens with anxiety disorders, only about 18% received the mental health care needed to make a recovery. (Village Behavioural Health)
There are different causes and risks that affect anxiety in adolescence. It has been found, for example, that adolescents who have a close relative with an anxiety disorder have an increased risk of developing an anxiety disorder themselves, compared to those who do not. Research has also shown that brain activity in adolescents with an anxiety disorder is different from children who do not.
Stressful events such as losing a loved one, moving to a new area or having parents go through a divorce can all lead to anxiety in adolescence. Traumatic events, stress from a chronic illness, an anxious disposition and alcohol or drug usage can all put a person at risk of having an anxiety disorder.
With regards to treatment, the adolescent should first be evaluated by a GP or a mental health professional, like a Psychologist or Psychiatrist. Then an individualised treatment plan will be discussed for the adolescent which may include, for example, medication, cognitive behavioural therapy, psychotherapy, neurofeedback, or parent education and support. However, If the adolescent is suicidal, is using through drugs or alcohol to deal with it, or is self-harming, then hospitalisation or referral to CAMHS services may be recommended.
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