When Does ‘Normal’ Anxiety Become a Problem?

It seems to be trending on TikTok and it’s all over young people’s snapchat stories. Diagnoses of anxiety disorders have been on the rise over the past few years, and I’ve seen more teens in my private practice with the complaint than ever before. The pandemic and quarantine played a large role in this increase, and learning to live in a quasi post-Covid world has complicated matters even more.

But what is exactly? And is it really a new phenomenon for teens?

Before we can talk abut anxiety as a disorder, we need to understand the nature of anxiety itself. Anxiety is a human emotion, like sadness, fear, anger, and joy. It’s normal to feel anxious at times – when we are about to try something new, or when we sense something just isn’t right. It’s been with us since the beginning of humankind, and we experience it in our bodies and often what feels like deep into our souls.

Anxiety is a response to stress and can be useful

Anxiety is physiological and is a response to stress. It initiates the body’s autonomic nervous system which triggers its “fight or flight” response. We get ready to run, or to do battle, in order to survive. This was quite useful during the Paleolithic period, when humans lived in caves and struggled to survive everyday. And it can be helpful today, in many situations. I explain this as “adaptive anxiety” to the teens I work with.

You get anxious when you are about to cross a busy street, for example, and that anxiety puts you on high alert so that you are vigilant as you dart across, ensuring you don’t get hit by a whizzing car. Or you get anxious before a big test, so your body creates a surge of adrenalin to help you stay up and study in order to do well.

You are more alert and sharp as you sit down to take the test. So if someone comes to me complaining of anxiety, I explain to them that the goal is not to get rid of it, but to acknowledge it, understand its uses, and identify if it has become a problem and how it can be managed.

But sometimes anxiety can be debilitating

Because sometimes the anxiety stops you dead in your tracks, and puts limits on what you can achieve. Sometimes that feeling of anxiety just floods through your system and you don’t know why. Or the stressor in your life is removed, but the feeling of anxiety lingers.

Sometimes the anxiety is stronger than what the situation calls for – and it’s debilitating. That “flight” response can cause an avoidance of activities, intense fear, and isolation. The “fight” response can cause extreme irritability, aggression, and conflict in interpersonal relationships. When anxiety becomes overwhelming, pervasive and debilitating, it is characterized as a disorder.

There are several types of anxiety disorders

Generalized anxiety disorder (GAD):

Generalized anxiety disorder (GAD) is characterized by chronic and pervasive anxiety, even in the absence of identified stressors, and includes excessive worry and intrusive thoughts. 

Panic Disorder:

Panic disorder is an anxiety disorder that causes intense and repeated bouts of fear (with and without triggers) that cause severe physical symptoms such as shaking, sweating, difficulty breathing and dizziness.

Social Anxiety Disorder:

Social anxiety disorder (sometimes called social phobia) is defined by excessive social anxiety and self-consciousness in social situations. It can be general or specific (for example, speaking in front of groups of people.)

Specific Phobia:

Specific phobias are intense, often irrational fears of situations, objects or people that in reality pose little danger to the individual experiencing the fear. There are many types of specific phobias.

Post Traumatic Stress Disorder (PTSD):

PTSD develops after an exposure to a specific traumatic event or time in which severe physical and/or emotional harm was threatened. PTSD can occur after violent attacks, accidents, natural disasters, prolonged exposure to abuse, and military combat. Symptoms are physiological and emotional.

Obsessive Compulsive Disorder (OCD): 

OCD is characterized by recurrent and intrusive thoughts (obsessions) and specific, repetitive behaviors (compulsions) that the person cannot control or stop. Typical compulsions include hand washing, performing multiple checks on locks, lights, or household appliances, performing rituals (ie, taking three steps back the forward before entering a room), touching objects in a particular order, and hoarding, among others. If the individual cannot perform these behaviors the obsessive thoughts increase and anxiety becomes unmanageable.

If your child -or you- are experiencing any of the symptoms of an anxiety disorder, there is help available. Talking to a therapist who has experience with anxiety can be invaluable, and you can learn coping strategies and tools to help calm the storm in your brain and body.

Medication may often help as well, as it works to stabilize your system. Although these disorders are common, many more teens experience “normal” anxiety as a response to environmental and internal stressors. Understanding what anxiety is, and its purpose, goes a long way in helping to manage it.

As the college selection and application process looms, you and your teen will experience some anxiety. It’s simply a response to the stress of the situation. This anxiety is to be expected, and can be managed with the right tools (and even used to your benefit!)

More Great Reading:

5 Ways Parents and Teens Can Cope With College Application Anxiety

Why Stress and Anxiety in Teens Can Be Healthy: A Psychologist Explains

Resources:

National Alliance on Mental Illness (NAMI); 800-950-NAMI (800-950-6264)

Anxiety and Depression Association of America (ADAA); 240-485-1001