Generalized Anxiety Disorder in Teens

Worrying from time to time is a natural part of life.  Yet, if the worry feels out of control, unmanageable, or negatively impacts your overall health and wellness, it is likely you are experiencing a more significant anxiety disorder.  Anxiety disorders are amongst the most common mental illnesses in the United States today, including generalized anxiety disorder (GAD), which affects millions of people each year.

What is Generalized Anxiety Disorder?

Generalized anxiety disorder (or GAD) is a mental health disorder marked by excessive, often uncontrollable worry.  Put simply, anxiety is a feeling of apprehension or fear that signals the body to go into “alert mode.”  Several areas of the brain are responsible for fear and anxiety production, including the amygdala and the hippocampus.  But in general, anxiety is experienced when there is a disruption in the brain signals used to identify danger.

Those who suffer from generalized anxiety disorder tend to worry about everyday circumstances such as finances or job security.  Yet teenagers with generalized anxiety disorder tend to have a different set of worries.

• Future events
• Past behaviors
• Being socially accepted
• Expectations of others
• School performance
• Personal abilities

Statistics

In this country, approximately 8% of teenagers suffer from generalized anxiety disorder.  Of that 8%, less than 20% seek treatment.  Certain risk factors can increase a teens chances of having generalized anxiety disorder, including being female (girls and women are twice as likely as males to have generalized anxiety disorder), having major depressive disorder (generalized anxiety and major depression are frequently co-occurring), and being in a family with a history of generalized anxiety.

Signs and Symptoms

If you suspect your teen may be struggling with generalized anxiety disorder, there are certain signs and symptoms to look out for.  Typically, teens and adolescents who are suffering from generalized anxiety disorder experience physical, emotional, and behavioral symptoms. 

Behavioral

• Reassurance seeking – in an attempt to relieve themselves of fear or worry, teenagers will regularly seek reassurance from the adults around them. Even if reassurance is gained in the moment, the relief is often very short lived.
• Procrastination – for some, anxiety can lead to procrastination (or avoidance). This is especially true for teenagers, and this procrastination shows up in various ways (school work, chores, etc.).  Not only does anxiety sometimes lead to avoidance of situations, but also of people.  Teens with generalized anxiety frequently isolate themselves from others.  This isn’t necessarily your teen trying to avoid specific people, but avoid the anxiety that may arise when around others.
• Trouble sleeping – excessive worry can interrupt a teens regular sleep pattern, and being deficient in sleep contributes to increased anxiety. Thus, lack of sleep can contribute to a difficult cycle.
• Nail biting or skin picking – often teens attempt to “self-soothe” when their anxiety is elevated. Self-soothing sometimes occurs subconsciously, and shows up through behaviors such as nail biting, skin picking, or even hair pulling.

Physical

• Tachycardia – anxiety can sometimes cause tachycardia in teens and adolescents. Tachycardia is when a person’s heart beats at a faster rate, even when at rest.  Stress and anxiety are known triggers for this.
• Stomach aches – hugely common in teens with generalized anxiety disorder, gastrointestinal distress is one of the most prevalent physical symptoms of GAD.
• Feeling “keyed up” – if you notice your child struggling to sit still, or see that he or she is often jittery or “keyed up,” this could be an indicator of generalized anxiety disorder.
• Headaches – headaches are regularly related to stress and anxiety. It is important to take note if your teenager is repeatedly complaining about headaches or migraines.
• Muscle pain – tension, tightness, and feeling stiff all contribute to general muscle pain, which many people experience as a result of anxiety.
• Sweating – anxiety and sweating tend to go hand-in-hand.  Anxiety activates stress hormones, and thus stress responses in the body.  Stress responses in the body cause increased respiration and an elevated body temperature.  The body then attempts to counter the increase in body temperature through sweating.

Emotional

• Feelings of dread – although feelings of dread are associated with all anxiety disorders, it is especially apparent for those with generalized anxiety disorder.
• Irritability – anxiety is connected with stress and tension. Stress and tension are primary contributing factors to feeling irritable.  If your teen has generalized anxiety disorder, you may notice him or her snapping or lashing out at others.
• Guilt and Shame – these are often described as some of the most difficult feelings to have, and while they are often used interchangeably, there is an important distinction. Shame arises when a person has a negative evaluation of self, and guilt results from a negative evaluation of one’s behavior.  Essentially, guilt is a feeling of doing something wrong, and shame is a feeling of being
• Pessimism – many people with generalized anxiety disorder have a negative outlook on life in general. This may be a result of the constant fear/worry feelings that can cause someone to think “the worst.”

Causes

Although not proven, experts believe generalized anxiety disorder is caused by both environmental and genetic factors.  The environment in which a child grows up can hugely contributes to the likely he or she develops generalized anxiety.  Parents and/or caregivers often “model” certain behaviors that are then picked up by the child/teen.  For example, if a parent is fearful of spiders, his or her child may learn to fear spiders as well.  Regarding genetics and GAD, teens that have an imbalance of norepinephrine and serotonin in the brain are likely to develop generalized anxiety.  While generalized anxiety disorder can have significant impacts on a teenagers well-being, it is also a highly treatable mental illness.

Treatment

As with most mental health disorders, the use of prescribed medication in conjunction with psychotherapy is one of the most common treatment approaches for generalized anxiety disorder in teens.  Of course, depending on individual needs and severity of symptoms, the therapeutic intervention and/or type of medication may be different.

Psychotherapy

• Cognitive Behavioral Therapy – one of the most popular interventions for teens and adolescents, cognitive behavioral therapy (or CBT) uses empirically supported approaches to challenging and changing the behaviors and thoughts that contribute to elevated anxiety and worry.
• Family therapy – teens sometimes “learn” their anxious ways from parents or caregivers. Family therapy not only facilitates a better understanding of the origins of the anxiety, but can also educate the family on ways to better support the teen in managing that anxiety.

Medication

There are several medications that could be prescribed as a part of your teens generalized anxiety disorder treatment.  Depending on severity of symptoms and individual health, your teen may be put on any of the following:

• Benzodiazepines – such as Valium, Ativan, Klonopin, or Xanax, benzodiazepines work by increasing the action of the GABA neurotransmitter in the brain, which in turn has a calming effect.
• Selective serotonin reuptake inhibitors (SSRIs) – considered effective for child and adolescent anxiety disorders, SSRI’s (such as Celexa or Lexapro) are frequently prescribed to help manage the difficult symptoms associated with generalized anxiety disorder.

If you have concerns about your teenager taking medication to manage his or her anxiety, you are not alone.  Many parents worry about possible side effects, or their child becoming dependent on the medication.  Either way, it is important to discuss your concerns with the medical or mental health professional prescribing the medication.  

Self-help

Whether or not your child is prescribed medication or participates in psychotherapy, there are ways for him or her to start to incorporate healthy habits to manage the anxiety.

• Schedule – schedules provide teenagers with structure, and thus, a sense of predictability. Anxiety often stems from the fear of the unknown, so by helping your child to keep a set schedule, he or she may notice a decreased sense of anxiety. A schedule should incorporate school, after school activities, socialization/fun, and set times for homework.
• Sleep routine – sleep is important to everyone’s general mental health and wellness. Because anxiety can have such a significant impact on a teenager’s sleep cycle, he or she may find a bedtime routine helpful. Encourage your child to go to bed at the same time each night, and begin to wind down 30 minutes prior to that time.  A sleep routine might incorporate self-care activities (shower, bath, brushing teeth), reading, etc.
• Food and nutrition – surprising to some, many anxious teens and adolescents forget to eat, or struggle to experience hunger (as anxiety can cause stomachaches).  Having nutritious snacks on hand, and making time for family meals can help your child nourish their body and brain for optimal functioning.
• Physical activity – being in a constant state of worry can cause those with anxiety to feel lethargic and an overall lack of motivation, especially when it comes to exercise. By encouraging any activity that promotes your teen in moving his or her body will help with anxiety management.

If your teenager has generalized anxiety disorder, or you worry he or she may be struggling with anxiety, contact Polaris Teen Center at (844) 836-0222 to find out more about treatment services and options.

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