Anxiety

5 Ways to Reframe Anxiety for Your Worried Teen

Anxiety in teens is common — and stressful. With ADHD, the adolescent years are ripe for outsize worry and fear of the unknown, especially in the midst of a pandemic. By acknowledging your teen’s feelings and changing their relationship to anxiety, you can help them take steps to independently manage anxiety in healthy ways.

anxiety in teens - illustration of teen girl sitting stressed

One of my patients, Kyra, is a teen with both ADHD and anxiety. She recently listed her top concerns when we met: “The pandemic, not being on the swim team, getting bad grades, not seeing my friends every day, and saying the wrong thing in class. I stay on mute.”

Worried about illness, academic pressure, teasing and/or rejection, she edits her behavior rather than take social or academic risks. Does this sound familiar?

Anxiety thrives in the petri dish of adolescent development – surging hormones, budding independence, and questions of identity lead teens to push limits, prioritize friends, and focus on what matters to them.

Studies show that approximately 33 percent of children with ADHD aged 3-17 years old have an anxiety diagnosis, with anxiety rates higher for females with ADHD than for males with ADHD.

Anxiety differs from worry. Anxiety is a physiological response to negative thoughts and beliefs. We cannot wish anxiety away, or outthink it. It’s a natural response that has evolved for survival.

[Click to Read: Symptoms of Anxiety Disorder in Children]

ADHD and Anxiety in Teens

Despite its propensity for misdiagnosis, ADHD differs significantly from anxiety.

Teens with ADHD wrestle with organizational problems, working memory challenges, and impulse control. Teens with anxiety struggle with compulsive, obsessive, or perfectionistic behaviors, psychosomatic ailments, debilitating phobias, and issues related to food, house, or job insecurity. Systemic racism and/or trauma intensify anxiety.

Why do ADHD and anxiety in teens travel together? Executive functioning challenges and delays make it harder for teens with ADHD to manage big feelings. Teens with ADHD often miss visual or auditory cues and misread facial expressions, fostering social anxiety.

They have struggled academically and/or socially. Over time, they become vigilant about what they say or do. This amps up to become persistent worry about the next time that they will mess up or forget something important. When they can’t cope, anxiety moves in.

[Read: Is Your Child Worrying Too Much?]

Anxiety in Teens: Changing Our Reactions to Uncertainty

Anxiety can take over a teen’s life. It is a shape-shifter – just when a teen thinks they have figured out how to deal with one issue, another one pops up. Without internal resources, anxious teens freak out or refuse to do anything for fear of failing. They can’t tolerate and deal with uncertainty, realistically evaluate the safety of a given situation, and apply tools from past successes to the present.

When kids can handle the discomfort of not knowing and the possibility of disappointment, when they have effective strategies on which to rely, they develop the resilience to become competent, successful adults. The goal is for your teen not to totally eradicate anxiety, but to recognize it for what it is and take logical steps to deal with it.

To help your teen cope with their frustration, you’ve got to know how their anxiety operates. It’s a person’s reaction to the worry, not getting rid of it, that makes the difference. Dismissing their concerns (“This isn’t a big deal. You’ll be fine.”) doesn’t honor the reality of the worry. It will grow. Reassurance (“Don’t worry, everything will work out.) also doesn’t provide a lasting solution.

You can validate their concerns by saying, “You’re right to be scared. You’re not sure you can handle that. It’s natural to worry in that situation.” This says that you acknowledge their feelings, and you can now guide them toward managing it.

Anxiety in Teens: 5 Coping Strategies

1. Change your teen’s relationship to anxiety

Think like Sherlock Holmes and investigate anxiety like a puzzle. When, where, and how does anxiety show up? What are its triggers? Brainstorm with your teen about what to say when worry arrives: “Hmm, that sounds like worry. What could you say to size it down?”

Separate anxiety from who your teen is. Many kids feel powerless about anxiety, and benefit from redefining it as something distinct from who they are.

2. Stay neutral and compassionate

Though you must intervene in situations of bullying, violence, academic failure, or risky behaviors, most of the time your teen just needs your support in thinking through responses to tricky situations – not for you to do the solving.

Teens of anxious parents are likely to be anxious themselves. Monitor and manage your reactions to your child’s anxiety, and refrain from discussing your concerns in public. React neutrally, regardless of their irritating, frustrating, or scary behaviors. Such behaviors indicate how out of control your teen feels.

3. Start small to build confidence

Anxiety erases memories of past successes, which is especially devastating for teens with ADHD and working memory challenges.

Choose a goal that’s within reach and start with small steps. What would your teen do if anxiety weren’t there? Help them recall times when they took a risk and it paid off. Then discuss how that could apply to the situation. Offer language: “I’m willing to feel unsure. I can get up my courage and try this.”

4. Opt for curiosity over anxiety

It’s tough to live with uncertainty, and adolescence is filled with unknowns — especially now. The lack of control our teens feel in their lives fuels their anxiety.

Instead of harboring worried thoughts, have your teen practice shifting to curiosity. Anxiety shuts down teens and predicts negative outcomes, but curiosity opens them up to possibilities. Help them learn to say, “I wonder about…” rather than, “I’m worried about…”

5. Focus on building resilience

Resilience is the antidote to anxiety. When teens identify their strengths, the people who care about them, and their interests, they feel more confident.

Find ways to connect with things that matter to your teen, like a favorite computer game or a funny YouTube video. Demonstrating this connection will make your teen want to work with you in taking on anxiety.

Anxiety in Teens: Next Steps


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