Over the next few weeks I will be posting solely on anxiety. I would like to run through the various anxiety disorders I see in my office in teenagers. Let’s start with how the Diagnostic and Statistical Manual of Mental Disorders (a big, thick book therapists and psychiatrists use to find a diagnosis) defines anxiety. The DSM says anxiety is “anticipation of future threat.” It is very careful to say anxiety differs from fear. It defines fear as “the emotional response to real or perceived imminent threat.” Sometimes these sensations overlap though. What I mean by this is a person can have an anxiety disorder, and experience fear as the result of their anxiety disorder.
The first anxiety disorder we will look at closely is called Specific Phobia. I go into more detail in the next two posts. For the sake of clarity though, I will talk about it briefly now as well. Specific Phobia means you have an over-the-top fear response to something that may or may not even be dangerous. The anxiety comes into play because you anticipate the fear you’ll feel if you encounter the stimuli. If you’re afraid of heights and it is to the level of Specific Phobia, you might feel intense fear while driving up a mountain road if you can see to the bottom of the mountain. You are not really in danger of falling to the bottom, but you feel as though you’ve just fallen off a cliff. The whole day before the drive up, you fretted endlessly in anticipation of being up high. It was enough to ruin your day.
Another key component to clinical anxiety (For something to be clinical it means it’s reached a level where it interferes with your ability to function as you wish you could, and it is advisable to seek treatment.) is avoidance. People who feel or anticipate marked distress over something that gives them anxiety will often try to avoid that thing. If your adolescent daughter is fearing she’ll be teased for raising her hand in class, she will work very hard to avoid asking a question in her classes.
Anxiety is not only uncomfortable, it also causes problems. In the example we just gave where your daughter is afraid to ask questions in class, it will cause her problems if she really needs clarification on what the teacher just said but she won’t ask. Over and over again I see teens struggle to accomplish things they want because of anxiety. I see them get lower grades because they can’t manage test anxiety. I see them stay home on weekends because they don’t know how to deal with social anxiety. I see them worry constantly over small, insignificant details because of generalized anxiety. I have sat with them through panic attacks and even worked with some on agoraphobia (when avoidance becomes so intense they don’t want to go anywhere outside their perceived “safe spaces”).
Anxiety is truly crippling for teenagers. It makes teens feel miserable and frustrated. It usually makes mom or dad anxious too because they don’t know how to help. Most of the time the anxiety seems senseless, and yet it feels impossible to overcome. The great news is there have been a lot of techniques developed to help with this very real, very uncomfortable set of disorders, and many of these can be accomplished in therapy.
Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT