Anxiety disorders in young people

Dr Asha Pemberton

teenhealth.tt@gmail.com

Over the last several months of drastic changes and uncertainty, many adults and adolescents have experienced symptoms of anxiety. While it is expected that we all feel emotions of fear when we perceive danger or are in new and challenging situations, persisting feelings of panic or doom can herald the development of an anxiety disorder.

Anxiety disorders are extremely common in teenagers and represent some of the most common mental health conditions that occur in this population. While some anxiety is normal, and particularly through the stages of adolescent development, there is concern when large periods of time are spent in states of fear or worry that then impacts overall functioning and quality of life.

Panic disorder in teens is diagnosed when at least two unexpected panic or anxiety attacks occur followed by at least four weeks of significant concern over another event. Young people describe themselves as losing control as they continue to worry. A panic attack is a specific episode of intense fear or feeling that something catastrophic is about to occur. Accompanyinh the intense feeling is extremely high heart rates, rapid breathing, sweating, headaches, tingling, cold fingers and toes and sometimes chest pains and abdominal pain.

Social anxiety disorder is described as an intense fear of social and performance situations and activities, including interacting with peers. This generally then prevents young people from functioning socially altogether, with significant negative impact on school and family life. The effects can remain far reaching when young people then have difficulty in future relationships, which then feeds into their fear in a vicious cycle.

Generalised anxiety disorder can be described as excessive anxiety and worry about everyday events that occurs over a prolonged period of time. Young people with this disorder uncontrollably worry about many different things daily. The worrying causes serious emotional distress, and affects all aspects of life. These feelings of anxiety usually have physical components, including headaches, aches and pains, nausea, shaking and sweating.

Young people with posttraumatic stress disorder (PTSD) may have intense fear or avoid places, people or activities after experiencing a traumatic event. While not everyone who experiences trauma develops this disorder, many of those affected cannot clearly identify the event that led to the development of the disorder. Indeed, situations which may seem quite benign to one person can evoke intense fear in another and potential development of PTSD.

Obsessive-compulsive disorder is characterised by unwanted and intrusive thoughts (obsessions) and then the intense feeling of being compelled to repeatedly perform rituals and routines (compulsions) to try and ease anxiety. Common obsessions are related to safety and hygiene, leading teens to compulsive behaviours including checking doors and windows repeatedly before leaving the house or falling asleep, or prolonged and repeated hand-washing or baths to become “absolutely clean” and reduce the fears in their minds. In our current pandemic, excessive fears of infection have occurred in increasing numbers.

Common to all anxiety disorders is the persisting and intense feelings of fear and worry that have a negative effect on life and productivity. Although many adolescents are able to cover or hide their anxiety, if untreated it eventually worsens with devastating effects. When recognised, prompt treatment is essential to recovery. The goals of therapy include teaching relaxation techniques, mindfulness and specific cognitive work to teach young people the connections between their thoughts, feelings and behaviours. This is the basis of cognitive behavioural therapy. Anxiety disorders although common are definitely amenable to treatment and management, which is essential to ensure that teenagers with these concerns live their best lives and reach their full potential. If you or any young person you know is experiencing any of these concerns please seek advice from a mental health professional.