How to identify and manage teen anxiety: Don’t wait for them to ‘grow out of it’

IN a landmark survey into the mental health and wellbeing of Australian kids and teens 18 years ago, anxiety didn’t get a mention. Now it’s the most prevalent form of mental health.

Many teenagers are good at covering up their fears and anxieties.

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WHEN a landmark survey into the mental health and wellbeing of Australian kids and teens was done (some 18 years ago), the issue of anxiety didn’t even get a mention.

That seems a remarkable oversight today, considering that when the second survey was published last year, anxiety disorders were found to be the most prevalent form of mental health problems among young people.

“Anxiety is more common in the 12- to 17-year-old age bracket than depression, ADHD, eating disorders and conduct problems,” Professor Jennie Hudson, of the Centre for Emotional Health at Macquarie University, says.

Anxiety disorders are the most prevalent form of mental health problems among young people.

She believes there are various reasons for this lack of attention: “In the past, people thought it was something that children would grow out of naturally. Also, when a child is anxious, it’s a more internal experience and it’s hard to know how much they worry on the inside.

Anxiety may not be as obvious as a child who acts out, for example.”

But anxiety isn’t something that should be ignored.

“An anxious teenager can miss more school, have poorer peer relationships, fewer friends and engage in fewer activities,” Hudson says.

Anxiety is also not something that you automatically grow out of, and there’s evidence that emotional disorders early in life predict a range of mental health problems later on.

For example, anxious adolescents are at increased risk for adult anxiety, depression and substance abuse.

“Early intervention is really key,” Hudson says.

“If we can give children strategies early enough, then they know how to deal with challenging situations all through their life.”

What is an anxiety disorder?

While everyone experiences some anxiety at various times, there’s a difference between feeling anxiousness appropriate to a situation and having an anxiety disorder. People are typically diagnosed with an anxiety disorder when they experience persistent, excessive worry or fears that interferes with their ability to carry out their daily tasks or take pleasure in day-to-day life.

Common anxiety disorders include:

• Social anxiety disorder – persistent fear or avoiding of social or performance situations

• Separation anxiety disorder – excessive anxiety concerning separation from the home or from those to whom the child is attached

“Teenagers may say that don’t want time with parents but we often find that it’s an effective reward.”

• Generalised anxiety disorder – excessive anxiety, worry or apprehension about a number of different events or activities

• Obsessive-compulsive disorder – recurrent obsessions and/or compulsions that are severe enough to be time-consuming and cause marked distress, such as continually washing hands and checking items such as locks.

How to read the signs

Some teens are open to discussing their worries but if they aren’t willing to talk about it, look at their behaviour. What are they missing out on? Do they want to skip school, not go to parties or out with their friends?

“Another telltale sign of anxiety is that the child may ask lots of questions that are often repetitive,” Hudson says.

“A negative thought may become stuck in their head and they can’t get rid of it.

“They may continually ask things such as, “What’s going to happen?” or “What if ‘x’ happens?”, over and over. Even if the parent says, “Don’t worry about it, everything will be OK”, they’ll keep asking.

Other signs of anxiety disorders can include expressions of panic, restlessness, being easily fatigued, difficulty concentrating, irritability or sleep disturbance.

Look out for symptoms of depression and anxiety in young children and teenagers.

How you can help

Gentle reassurance

“Avoidance is what keeps anxiety going,” Hudson says. “Gently encouraging your child to face the situation is the best thing you can do to help them.”

Rewards

Rewarding a child who has faced their fear can be very effective. This can include celebrating their bravery.

“One of the best rewards for a teenager is getting quality time with a parent such as seeing a movie together,” Hudson says.

“Teenagers may say that don’t want time with parents but we often find that it’s an effective reward.”

Step ladder

If a teenager refuses to do something challenging, start with small steps that help them confront their fear. The exposure must be long enough to allow levels of anxiety to ease, without distraction.

Realistic thinking

Shift worst-case scenario thinking with questions such as “What is most probable?” and let them form an answer.

Call an expert

Seek professional help if anxiety is having a big impact on a child’s life or family life. See

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