How to Recognize Anxiety Symptoms in Teens
Medically reviewed by Lori Lawrenz, PsyD
From school exams to TikTok, there’s plenty to cause anxiety in teens. If it feels like symptoms are taking over your life, it could be an anxiety disorder — here’s what that might look like.
Most teenagers navigate potential stressors even many adults would find intimidating, including:
- change, from puberty to shifting relationships with your friend group, peers, and family
- pressure to do well academically or athletically to qualify for scholarships and get into college
- social media, which often promotes comparison and competition and is always being “on”
- increasing awareness of politics and world events, which often seem scary and out of control
Anxiety isn’t always a disorder — it’s actually one of your body’s natural responses to stress. This is known as your fight, flight, or freeze response. It helps you avoid harm in dangerous situations.
Still, nearly one-third of teens live with an anxiety disorder, according to the National Institute of Mental Health. When anxiety flares up frequently, it can make day-to-day tasks and relationships more challenging and potentially signify an anxiety disorder.
Early signs
Anxiety disorders often appear during childhood. In fact, diagnoses of anxiety disorders are given to up to one in five children. These disorders include:
- separation anxiety disorder
- generalized anxiety disorder
- panic disorder
- social anxiety disorder
- specific phobias
- agoraphobia
- selective mutism
Sometimes anxiety in childhood then continues into your teen years.
The Centers for Disease Control and Prevention (CDC) highlight that anxiety in childhood can show up as:
- reluctance to go to school
- fear of separation from caregivers
- fear of specific things, such as the dark or monsters
- disrupted sleep
- physical symptoms including stomach aches or digestive issues
- crying more than usual
- hesitance about new activities, sports, or games
- tantrums
- freezing up or not speaking at all
Additionally, 2017 research and a 2018 study found that the following factors were connected to higher chances of developing anxiety disorders and other mental health conditions in preschoolers:
- stressful family settings
- temperaments with higher levels of shyness or fearfulness
- trouble with peers or bullying
- big changes, such as moving or the death of a family member
Symptoms in teens
Anxiety affects everyone differently. In teenagers, it can look like:
Social withdrawal
Retreating inward might be how you cope when you feel overwhelmed by anxiety. The urge to stay home and away from other people can be especially common for people with social anxiety or agoraphobia.
Teens with anxiety may:
- stop speaking up in class
- avoid socializing or extracurriculars
- express the wish to stop attending school altogether
Difficulty concentrating
Anxiety disorders can make it harder to concentrate in school, sometimes causing more difficulty with homework and tests or lower grades.
This is because the hypervigilance that often comes with anxiety can pull your attention in many directions as your nervous system works to keep you safe, making it tougher for you to focus on the task at hand.
Irritability
Sometimes anger or irritability are the most prominent signs of anxiety in teens.
Research from 2019 suggests teens with anxiety have a harder time regulating, or managing and responding appropriately to, their emotions. Fewer emotional regulation skills can mean more emotional reactivity, which often looks like lashing out in anger.
Perfectionism
Teenagers with an anxiety disorder might show signs of perfectionism, which can come hand in hand with black-and-white thinking and fear of failure.
Some signs of perfectionism in teens include:
- restrictive eating patterns or eating disorders
- taking much longer to complete homework or tests than others
- mostly negative self-talk
Physical symptoms
Anxiety can cause physical symptoms that interfere with school and day-to-day activities in addition to making life more uncomfortable. These include:
- insomnia
- fatigue
- brain fog
- headaches
- nausea or stomach aches
You might notice these symptoms flare up around times you experience more anxiety, like in the morning before school starts or before talking with friends.
Depression
Sometimes anxiety leads to depression, and they can also occur together. For instance, if anxiety isolates you from your friends or hobbies, you might experience feelings of loneliness or loss that grow into depression over time.
Unhelpful anxiety coping mechanisms, like avoidance or substance use, can also contribute to depression.
Substance use
Severe anxiety was linked to a higher risk of substance use in teens in a 2021 study.
While alcohol, cannabis, or other substances may reduce unpleasant feelings of anxiety in the short term for some people, they can cause dependence and even worsen anxiety symptoms.
High risk behavior
Your teen years are a developmentally appropriate time to test boundaries, but a 2017 study suggests mental health conditions including anxiety could mean a higher likelihood of high risk behaviors.
These might include:
- binge drinking
- high risk sexual behavior
- getting into fights
- unsafe driving
Getting a diagnosis
Anxiety disorders can make life feel heavy, but they’re treatable. It’s a good idea for teens feeling worried about their anxiety to reach out to an adult they trust for support and help with their next steps.
The first step toward getting a diagnosis of an anxiety disorder is usually visiting a primary care doctor or healthcare professional. They might want to first rule out any health conditions that can mimic anxiety symptoms, like heart issues or electrolyte imbalances.
A doctor can also assess you for signs of an anxiety disorder and provide a referral to a mental health professional, such as a therapist or psychiatrist.
Before choosing a diagnosis, a mental health professional might explore other potential causes of your symptoms, including:
- ADHD
- depression
- bullying
- stressful life events
- autism
- trauma-related conditions
Identifying the root of your symptoms will help ensure you get the most effective treatment and support, whether it’s for an anxiety disorder or something else.
Treatment options
The two most common treatment options for anxiety disorders are therapy and medication, but alternative care approaches may also help you manage symptoms.
Therapy
Therapy is a cornerstone of most anxiety treatment plans. Although many types exist, therapists often use cognitive-behavioral therapy (CBT) to help people manage anxiety.
In CBT, you learn skills to become aware of and change anxious thought patterns. You’ll also practice forming new thought habits that lower your anxiety over time.
A review of research highlights that in addition to being highly effective at helping teens manage anxiety, CBT also outperformed some anxiety medications.
Medication
If you want to try medication for anxiety, a psychiatrist will be the one to prescribe it.
Because these medications can cause adverse side effects, some experts recommend a cautious approach. You might consider using them only if your anxiety symptoms are severe or if other treatment methods aren’t working.
Some common medications for anxiety disorders in teenagers include:
- selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and sertraline
- serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine
Alternative approaches
You can also soothe anxiety symptoms with:
- self-care strategies like having balanced nutrition, getting enough sleep, and doing physical activity
- meditation or other mindfulness-based practices
- somatic exercises like progressive muscle relaxation
The bottom line
Being a teen often comes with a variety of stressors and pressures, from academics and sports to social life and social media, that can cause anxiety symptoms to feel out of your control.
Anxiety can manifest as withdrawal or lashing out and as falling grades or higher-than-ever standards. Getting to the root of your anxiety and connecting with a caring health professional who listens to you can be a great first step toward making anxiety feel more manageable.
