Anxiety in young people

Anxiety in young people (aged 12+ years)

Becoming a teenager can be a fun and exciting time but also full of highs and lows as they move towards becoming young adults. Feeling anxious is common and normal in teenagers and young people as they are dealing with lots of changes and stresses common to this stage of life such as friendships and schoolwork.

Anxiety can be helpful in some situations – for example, the desire to do a good job generally encourages people to prepare, such as before a test or part-time job interview. But if worry or fear gets too overwhelming and prevents someone from doing things they enjoy or managing daily life, they may require some extra support to move through these feelings and behaviours.

Depending on their temperament, your young person may have experienced anxious feelings during childhood that worsen during adolescence as they faced increased pressures or new triggers, such as the desire to do well at school. Or they might have never experienced anxiety and suddenly start to when they reach puberty. Social anxiety and panic attacks are two common types that can start during adolescence.

Types of anxiety

There are many different types of anxiety people may experience, but the most common in teenagers and young people are:

• Social anxiety disorder or social phobia – an intense fear of being in public or social situations, or being judged or embarrassed in public; it can also include intense FOMO (‘fear of missing out’ or being excluded from social situations).
• Generalised anxiety disorder – excessive worry about many common situations, rather than any one specific thing.
• Panic disorder – repeated and unexpected panic attacks (overwhelming fear or terror).
• Specific phobia – an intense fear of a certain object or situation, for example, fear of heights or dogs.
• Agoraphobia – fear of being in a situation or place where they might not be able to escape or get help.
• Separation anxiety disorder – a fear of being separated from home or a loved one.

You’ll find detailed information about different types of anxiety on ReachOut’s website.

Causes and triggers of anxiety in young people

When people experience anxiety there generally isn’t a single cause. Anxiety is usually caused by a combination of factors including genetics/family history and sometimes experiences of trauma or stressful events. Additionally, factors that increase the risk of young people developing anxiety include:

• pressure from school/work/uni or caring responsibilities
• stress about money or job stability, or their future generally
• not getting enough sleep
• not looking after themselves – for example, not eating healthily or exercising regularly, or having too much caffeine from coffee and energy drinks
• conflict in relationships or friendships
• a traumatic or stressful event, like the death of a friend or family member.

For younger teens, the move from primary school to secondary school can be stressful. It often means a new environment, changes in friendships and teacher relationships, and usually big changes to daily routines and academic (study) load. Many children say making new friends and missing the old ones are the most difficult parts. Navigating new friendships can trigger anxiety in teens who tend to worry.

While younger children may be fearful of external things (like dogs, the dark or monsters), teenagers’ anxiety is often focused on themselves. Teens tend to be worried about how they look (especially upon entering puberty) and what other people think of them. Most young people are self-conscious about the physical changes of puberty – especially if they go through it before or after their friends. Comparing themselves to ‘perfect’ people on social media can also damage their self-esteem.

In this age group anxiety sometimes looks like perfectionism – your child might be anxious about doing well at sport or getting only high grades at school.

Thinking about the future can also cause anxiety in young people. They may be worried about what to do after school, or coping with the move to the workforce or higher education. Young people may also worry about the impacts of climate change and global conflicts.

Signs of anxiety in young people

Anxiety affects young people in a broad range of ways – from occasional nausea or ‘butterflies’ before an exam or driving test to feelings of panic that can come and go, preventing them from doing things they enjoy. Anxiety in teenagers can be hard to identify because they often hide their feelings – or express them in explosive ways because of the hormonal changes they’re dealing with.

It can also be difficult to determine if their reaction is a reasonable response to a stressor or difficult experience, a sign of anxiety, or a symptom of a physical condition. If you’re unsure speak to your general practitioner (GP), who can be a great source of support. A GP will help rule out any physical condition and provide further supports if required. Learn more about the role of a GP in this video.

Find a time when your child is calm and relaxed and discuss whether they’re open to visiting your GP to explore getting some support.

Common signs of anxiety in teens and young people

• Worrying about, or being extremely afraid of, certain situations (sometimes many, or seemingly everything).
• Complaining that they can’t think straight or have too many thoughts in their head.
• Physical symptoms like chest pain, rapid heartbeat, excessive sweating, nausea and digestion issues and shortness of breath or shallow breathing.
• Avoiding social situations.
• Refusing to go to school.
• Difficulty sleeping.
• Constantly seeking reassurance.
• Trouble concentrating or remembering things.
• Being extremely self-conscious.
• Misuse of alcohol and/or drugs.

What you can do

Talk about it

If you have noticed some signs of anxiety in your teenager or young person, the first step is to talk to them about it. Find a time when the two of you won’t be interrupted or rushed, and they (and you) are not overly stressed. Tell them what you’ve noticed and why you’re worried. For example, you might say:

‘I’ve noticed you don’t seem to be sleeping well. Everything OK?’

Or,

‘You seemed really excited about Matt’s party, but then didn’t go. Is there anything you want to talk about?’

Listen, empathise (even if you don’t understand or agree) and try not to judge. Practise ‘active’ listening skills, so that you’re not just hearing what they say, you’re actually listening to their voice and contemplating their words. They might say things such as, ‘I feel like I’m going crazy’, ‘Everyone is judging me’ or ‘I can’t stop thinking about…’.

Reassure your young person that anxiety is common in people their age and there are strategies and supports available that will help them manage it. Encourage them to learn more about anxiety and provide resources for them to read, for example:

• Anxiety and how to manage it: pre-teens and teenagers (Raising Children Network)
• Anxiety and teenagers (ReachOut – for Parents)

Support and encourage them

There are many ways you can support your child to identify triggers and find ways to manage their anxiety.

In addition to our general advice on supporting a child with anxiety, the following are some practical strategies especially for young people. Evidence shows these strategies help young people manage their symptoms and improve their quality of life so that anxiety doesn’t stop them from doing things they want to do and achieving their goals.

Encourage and support your child to:

• eat well, get enough sleep (8–10 hours per night) and stay active – all important things that will help their overall mental health and wellbeing. Encourage them to join a sports team, walk the dog every day, or do some kind of physical activity they enjoy
• talk about it – with you, siblings or other family members, friends, coaches or teachers. There may be a counsellor at school or uni they feel comfortable talking to. This can be helpful if, for example, they need support in managing their study load or extra time to complete assessment
• learn about stress and different ways to manage it. ReachOut has some great tips for young people to deal with stress and anxiety
• focus on the present, and try not to worry about what happened in the past or might happen in the future. Suggest they try having a planned ‘worry time’ – setting a time when they’re allowed to think about their worries and write them down, so that they don’t take over their thoughts all the time
• notice – and gently challenge – unhelpful thoughts. This can help them become aware of how their thoughts influence their anxiety, and learn how to respond
• face, rather than avoid. Tell them it’s normal to want to avoid the situations, people or places that make them feel anxious – but that in the long run, avoidance actually makes anxiety worse. Suggest they try coping strategies that are proven to reduce anxiety over time
• avoid or limit alcohol and drug use. Drinking or taking drugs might ease the discomfort or make them feel more confident in the short term, but makes things worse in the longer term and can increase mental (and physical) health problems. If you suspect your teen is struggling with alcohol or drugs, speak to your GP for support and advice (or refer to the list of further resources at the end of this fact sheet)
• try relaxation, mindfulness and/or breathing strategies. There are many apps that teach young people relaxation and mindfulness meditation techniques, like ReachOut’s Breathe2Relax and Smiling Mind.

If your teenager or young person finds apps particularly useful, direct them to ReachOut’s list of professionally reviewed mobile health and wellbeing apps.

Getting professional help

It can be very difficult to tell if your teenager’s or young person’s anxiety is just a behavioural phase, or an indication they’re struggling with anxiety and need help from a health professional. As a general rule, if their symptoms are ongoing (more than two weeks) and prevent them doing everyday things, talk to them about the benefits of getting some specialist support and the types of professional help that are available.

There are many effective treatments for anxiety and young people usually respond to these well. The earlier they get help, the more quickly they can get back to ‘normal’ life and the less likely they are to experience ongoing mental health difficulties.

Offer to make an appointment with your GP, or help your teenager or young person to find one with an interest and training in adolescent mental health. Encourage them to check out websites that provide information about anxiety for young people (our recommendations are listed below). You could text or email them links to online and phone support services so they can talk about their situation and the types of professional help available.

Be curious, patient and caring about what your teenager or young person is experiencing so you can support them to manage the ups and downs of these years. By helping them access further anxiety support if required, you’ll also be helping them to build their resilience, and support them to live their best life.

Information about anxiety for young people

Free online and phone support

If face-to-face counselling is not an option (for example, because of distance, illness or available times), online or phone support is another option to consider.