All teens experience some amount of anxiety at times. Anxiety is actually a normal reaction to stress, and sometimes it helps teens deal with tense or overwhelming situations. For many teens, things like public speaking, final exams, important athletic competitions, or even going out on a date can cause feelings of apprehension and uneasiness. They may also experience an increase in heartbeat or excessive sweating. That’s how the brain responds to anxious feelings.

For some teens, however, anxiety can go beyond these typical symptoms to negatively affect friendships and family relationships, participation in extracurricular activities, and even their schoolwork. When feelings of anxiety interfere with normal daily living, the presence of an anxiety disorder should be considered. According to the National Institute of Mental Health, approximately 25% of 13- to 18-year-olds have an anxiety disorder, and just under 6% have a severe anxiety disorder.

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Given that teens experience a wide variety of physical and emotional changes as they grow, an anxiety disorder can be difficult to spot. Many red flags may seem like usual teens struggles or be chalked up to hormones. Watch for these hidden signs of anxiety in your teens:

Emotional changes

While some anxious teens express feelings of pervasive worry, others experience subtle emotional changes such as:

  • Feeling “keyed up”
  • Feeling on edge
  • Irritability
  • Difficulty concentrating
  • Restlessness
  • Unexplained outbursts

Social changes

Anxiety can negatively affect friendships. If your once social teen suddenly avoids his favorite activities or stops making plans with friends, think twice. You might notice your child:

  • Avoiding social interactions with usual friends
  • Avoiding extracurricular activities
  • Isolating from peer group
  • Spending increased time alone

Physical changes

Many of the physical complaints that can occur with an anxiety disorder mimic average teen complaints, which tend to increase as they get older. Pay attention to patterns. A couple of headaches here and there shouldn’t be a cause for concern, for example, but frequent headaches are a red flag. Watch for these common psychosomatic complaints:

  • Frequent headaches, including migraines
  • Gastrointestinal problems
  • Unexplained aches and pains
  • Excessive fatigue
  • Complaints of not feeling well with no obvious medical cause
  • Changes in eating habits.

Sleep disturbance

The American Academy of Pediatrics recommends that teens aged 13 to 18 get 8 to 10 hours of sleep on a regular basis to promote optimal health. Pediatricians also recommend shutting down screens 30 minutes prior to bedtime, and removing all electronics from the bedroom.

It’s no big secret that homework demands, changing brain structure, extracurricular activities, and screen time can all cut into the sleep habits of teens. Therefore, it can be difficult to know whether fatigue is a product of anxiety or of a busy schedule. Watch for these red flags:

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Frequent nightmares
  • Not feeling refreshed after sleep

Poor school performance

Given that anxiety can affect everything from sleep habits to eating habits to missing school due to physical issues, it should come as no surprise that poor academic performance can also result from untreated anxiety. School avoidance, missed days due to anxiety-related illness, and persistent worry can make it difficult for anxious teens to keep up with their workload. Watch for these changes in your teen:

  • Significant jump in grades (usually downward)
  • Frequently missed assignments
  • Describes feeling overwhelmed by workload
  • Procrastinates on, or has difficulty concentrating on, homework assignments more than usual

Symptoms of panic attacks

Not all anxious teens experience panic attacks, and some experience mild symptoms of panic without enduring a full panic attack. The following symptoms are common among people with anxiety disorders:

  • Rapid heartbeat
  • Sweating and trembling
  • Dizziness
  • Upset stomach
  • Difficulty breathing
  • Chest pain
  • Feeling like they’re dying
  • Feeling like they’re “going crazy”
  • Numbness or tingling in arms and legs
  • Derealization.

If your teen appears to be struggling with anxiety that interferes with school, friendships, family relationships, or other areas of daily functioning, it’s important to get an evaluation from a licensed mental health practitioner. Anxiety is treatable, and most teens can learn to cope with and manage their anxiety independently.

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Last Updated: Feb 13, 2018