September, for some, may mean the coming on the fall season and the approach of the close of the year, while for others it can mean a new beginning. A new school year that is... Our teens start another year of education, socialization, and the possibility of more and more anxiety. If you are a teenager or adolescent that is confused as to why you may feel this way - or if you are a parent or adult who is wondering why the adolescent you are watching over or thinking of is acting like this, please - continue to read. The following will explore what fear is, in comparison to anxiety, and what has changed in the world from back in my day to now.
Let's start with just the definitions. Fear is an emotional response to an immediate threat and is more associated with a fight or flight reaction – either staying to fight or leaving to escape danger. Fear can be a normal reaction to a perceived threat, or a threatening event, or even a jump-scare halloween movie. Fear can be helpful, because it makes the individual more aware and observant to their surroundings. However, when fear becomes anxiety, it is approached as a future threat, rather than a response to an event that is either happening at the moment, or has already happened and the person is concerned about another event. According to Dr. Mona Potter, Medical Director at McLean Hospital’s Child and Adolescent Outpatient Services, “Anxiety becomes a problem when it takes over, is out of proportion to the actual event, or when it just overwhelms the individual to the point where they are just stuck or causes the person to make decisions or behave in ways that keep them from functioning or doing whatever they would normally need to do.” You can view the educational video from Boston Children’s Hospital here.
If you have a loved one who experiences any of these symptoms, or a mixture of the above, do not hesitate to talk to them about these fears and concerns.
When adolescents are involved, not only does the same thing occur with them, but it could be “felt” more extreme. This may be because, as an adult, you are more aware and able to acknowledge, identify, and express your feelings - which can be helpful when going through anxiety. Adolescents cannot process their world in ways that adults can because their cognitive functioning is not fully developed. Whether or not it seems, or literally, is irrational; children and adolescents only know what they’re feeling versus whether or not it is an actual potential threat. As an adolescent, not only do you not have all the ability to acknowledge or identify what you are feeling, but most situations would prove that adolescents are, either, not able to express their feelings as they feel them because they are not sure what they are feeling and now to express it adequately, or, they are not given the opportunity to express their feelings because they are too young to be experiencing the sensation. This is not the case with every adolescent, and the inability to identify, thus, express them adequately, is usually the case. However, it is something that adolescents, especially teenagers, are often told how they are feeling, rather than asked.
With the onset of a new school year and the accompanying academic expectations and social situations that come with it, our teens also experience the possibility of a significant change in feelings or thoughts. School brings a safe haven for some who immerse themselves in education or the social aspect. School can also bring fear, concern, and anxiety to others for the same reasons. So how can someone identify if their adolescent is having anxiety, especially if the adolescent themselves may or may not be able to identify it themselves fully. What are the differences between normal jitters and excitement for the new school year that eventually wears off and anxiety that may or may not grow in intensity with time?
Unfortunately, simultaneously, Covid19 still has a residual effect on the world, especially our youth. Our students had to go from their routine school activities to sitting in their houses, on a screen, and learning in a way that may or may not have been beneficial. These students had their 2019/2020 school year cut short, due to the lockdown that happened in March of that year. In the following year, the regulations would change in the blink of an eye, but not necessarily for the better. The following school years consisted of more screens, virtual learning, some with no breaks or snow days, and pressure to not only learn what they were being taught, (regardless if they learn better another way) but to actually retain some of the information so they could continue with their education and not be behind.
Our students had no real preparations to conduct themselves in a manner in which they were unaccustomed to. What comes with that lack of preparation comes a heavy sense of inadequacy and confusion.
Somewhere along the way in the last school year, things started opening up, going back to the way they were before, and began to become normal again. However, one thing that was not calculated into making the changes, was how it was going to affect the mental health of those students, and staff, that had to actually implement those changes and pretend that everything was normal. Our students had no real preparations to conduct themselves in a manner in which they were unaccustomed to. What comes with that lack of preparation comes a heavy sense of inadequacy and confusion. Not only are they supposed to be learning what the curriculum needs to be teaching them, but they are also learning how to establish a future in this new world.
Anxiety itself can vary in intensity and range from mild to severe. A child or adolescent with mild anxiety may look like a child refusing to participate in class or avoiding going to large social gatherings such as a birthday party or a school dance. An adolescent that shows more of a severe example of anxiety can be one that refuses to go to school all together or has a major emotional outburst whenever faced with a difficult task.
The main concern or issue that is usually brought up is the fact that not all the signs point to the adolescent. They dont always feel that way or they don't feel that way at all but they feel a different way and, again, it is more difficult to express and explain how they are feeling - especially when they are not aware of what exactly is going on.
To help with this, we’ve added a brief overview of the types of anxieties that one may face. Types of anxiety, specifically in teenagers, include generalized anxiety, social phobia (or social anxiety), specific phobias, panic disorder, agoraphobia, and separation anxiety.
Generalized anxiety disorder is a type of anxiety disorder where people have uncontrollable and persistent worry that affects their day-to-day life on an ongoing basis. Those with it will often present with an uncontrollable worry about many things most of the time, often tired but cannot sleep, difficulty concentrating and meeting with friends or doing everyday activities because the worry will overwhelm them.
Social phobia/anxiety is disproportionate, recurring fear in social situations. More than just being shy or nervous, like giving a speech at an event, but more about being watched in public, like eating in front of others. Oftentimes in the social situation the individual feels afraid or concerned with being judged, criticized, or humiliated in front of others, especially their peers. This fear may very well interfere with relationships, success, and other mental health areas such as depression. Individuals that report social anxiety may present with feelings of self consciousness, speech issues such as stutters when trying to speak, and physical ailments such as stomach aches, feeling sick, sweating, and dizziness.
Specific phobias are just that. Some individuals are fearful of snakes and spiders, or heights, or deep water. Fear is rational in these situations because it can possibly pose a threat to the individual or others’ safety. One thing to remember is that those who have specific phobias are often aware of their fears and concerns being irrational but it's not as if they choose to act as they do, it is an involuntary reaction to the fight or flight response (Read More Here).
Panic disorder may not be as well known as the symptoms of panic disorder. Panic disorder is highlighted by it’s most prominent symptom: a panic attack, which we likely have all heard of at least once. But what is a panic attack? Generally speaking, a panic attack is a response to stimuli (or situation), and the individual feels as if they are losing control. Some symptoms are like symptoms of other anxieties; dizziness, increased heart rate, etc. but this also comes with sharp pain in the individual's chest, feeling faint, and often feeling breathless. One thing to consider is to be diagnosed with panic disorder you must have a lot of panic attacks, not just a few here or there, and one must also be in constant fear of the next one. This is very exhausting, scary, and can be life altering significantly.
Agoraphobia is an anxiety disorder in which people fear having a panic attack in certain places - such as school, the park, or any other public situations where escaping seems difficult or even impossible. Some individuals that have this present with anxiety or panic attacks to the point they avoid situations and agree only to go places if there's other individuals there that they know and trust.
Last on the list is separation anxiety. You normally see this more in younger children and toddlers but it does not mean that it is not found in older children or adults. This is when someone has anxiety, oftentimes severe, when separated from a parent or family member of whom it feels safe.
If you have a loved one who experiences any of these symptoms, or a mixture of the above, do not hesitate to talk to them about these fears and concerns. It is very important to not discuss this information as if they are being punished for feeling this way, because many times the individual is unaware of the cause and is just focusing on survival mode. An important consideration is to not assume that they are exaggerating or making it up. This language just further stigmatizes the person and may add in barriers to accessing appropriate care.
Most of the anxieties mentioned above can be addressed with a combination of evidence based strategies, possibly including grounding techniques, deep breathing, meditating, talking about what is going on in their minds and environment, and a variety of cognitive behavioral strategies. NJ Recovery & Wellness has several therapists who frequently work with adolescents and are specifically trained in effective interventions to treat anxiety.
Some may even be appropriate for pharmaco interventions, after being evaluated by a medical professional. Medication may be helpful as certain medications, specifically SSRI’s and SNRI’s, can play a crucial role in making practice of the routine body based and cognitive interventions more accessible. In essence, it attempts to make it an even playing field so that the person can then focus and attempt to gain control of their emotions, situations, and fears.
Anxiety is a normal human emotion that we all experience from time to time. Having an anxiety disorder, however, is not the same. We need to recognize the difference and hear out our youth, or anyone for that matter, who struggles with their experience of anxiety. Seeking professional help also can make a difference. However even prior to making a call for support, it goes a long way to sit with your loved one and listen. Our teens need to know that they have people on their team, even if their fears or anxieties like to insist that they do not. Be their person.