How can you recognise anxiety in teenagers? Read about its physical, cognitive and behavioural signs, how it differs from ordinary worry and how to help.
A young person who feels sick the night before a school trip, who spends hours thinking "she must be angry with me" when a friend is slow to reply to a message, who keeps an answer they know to themselves rather than speaking up in class, and who can't fall asleep every evening because "what if something bad happens tomorrow"... From the outside, most of these young people look quiet, well-behaved and responsible. Parents usually notice there is a problem only when these worries begin to narrow the young person's daily life noticeably. Anxiety in teenagers is one of the most common psychological difficulties of this stage of life, and it is often brushed aside as "moodiness", "making a fuss" or "just adolescence". Yet recognising anxiety early is a very valuable opportunity for the young person to learn to cope with this feeling. In this article we look at the signs through which anxiety shows itself in adolescence, how it differs from ordinary worry, and how parents can accompany the young person.
What Is Anxiety in Teenagers, and How Does It Differ From Ordinary Worry?
Anxiety is a natural response to situations perceived as uncertain or threatening. Feeling tense before an exam, uneasy when starting a new school or worried about a loved one falling ill is entirely ordinary. In fact, a certain level of anxiety helps a young person prepare and stay alert.
Adolescence is a period that lends itself to increased anxiety. The body changes rapidly, peer relationships gain importance, academic expectations rise and questions about the future become more pressing. Research in developmental psychology shows that, for a significant proportion of anxiety disorders, symptoms first appear in childhood and adolescence.
To understand the difference between ordinary worry and anxiety that needs attention, the following questions can be a guide:
- Proportion: Is the intensity of the anxiety proportionate to the real risk of the situation?
- Duration: Does the worry go on for weeks after the event has passed?
- Spread: Is the anxiety limited to a single topic, or does it spread to many areas such as school, friends, health and family?
- Functioning: Is the young person avoiding going to school, meeting friends or doing activities they enjoy because of the anxiety?
- Control: Does the young person say they cannot stop their worried thoughts, that their mind is constantly occupied with "what if" scenarios?
The answers to these questions give important clues about how much room anxiety takes up in the young person's life.
What Are the Signs of Anxiety in Teenagers?
Anxiety is not just a feeling; it shows itself at the level of the body, thoughts and behaviour. In teenagers these signs often blend together, and the anxiety is noticed not as itself but as a physical complaint or a behavioural problem.
Physical signs
- Frequent stomach aches and nausea, especially on school mornings
- Headaches, muscle tension, jaw clenching
- Palpitations, a sense of breathlessness, sweating
- Difficulty falling asleep, waking frequently, nightmares
- Constant tiredness, low energy
- Marked changes in appetite
Cognitive signs
- Thoughts that constantly begin with "what if"
- Imagining the worst-case scenario, interpreting small events as catastrophes
- Intense worry that others think negatively about them
- Indecision, fear of making mistakes
- Difficulty concentrating, the mind "going blank"
- Feeling inadequate or unprepared
Behavioural signs
- Avoiding situations that cause anxiety: not wanting to go to school, not speaking up in class, not taking part in social activities
- Constantly seeking reassurance: questions such as "Are you sure? Nothing will happen, will it?"
- Over-preparing, checking things again and again
- Sudden outbursts of anger or bouts of crying
- Excessively taking refuge in the phone, games or TV series
- Difficulty separating from a parent, being unable to be alone
It is worth repeating that these signs alone do not amount to a diagnosis. However, if several of them occur together and have been going on for a long time, a closer look is needed.
Why does anxiety look like moodiness?
In teenagers, anxiety may not be expressed, as it is in adults, with the sentence "I'm very worried." Many young people have not yet found the words to name what is going on inside them, or are embarrassed to look anxious. Instead, anxiety appears as slammed doors, short and sharp replies, "leave me alone" outbursts, endless getting-ready time in the morning or plans cancelled at the last minute. When a parent interprets these behaviours as disrespect or laziness, the argument escalates and the real issue is missed. That is why, in moments of sudden anger or stubbornness, asking "Could there be a fear underneath this?" can open a different door.
Types of Anxiety in Teenagers
Anxiety can appear in different forms in each young person. Some common pictures are:
- Generalised anxiety: Constant, hard-to-control worry about many topics such as school, health, family and the future. For more detailed information, you can take a look at our article on generalised anxiety disorder.
- Social anxiety: Fear of being judged negatively by others, of feeling ashamed or of being humiliated. Everyday situations such as speaking in class or eating in the canteen become challenging.
- Panic attacks: Attacks that begin suddenly, with intense palpitations, breathlessness, dizziness and a feeling of "as if I'm going to die or lose control". We cover this in our article on panic attacks in teenagers.
- Separation anxiety: Intense worry about being separated from a parent or about something happening to them. Although more common in childhood, it can continue into adolescence.
- Specific fears: Intense fear of particular situations or objects such as insects, the dark, needles or earthquakes.
These pictures can sometimes occur together; low mood, obsessive thoughts or attention difficulties are sometimes added to anxiety. An accurate assessment is only possible following a consultation with a professional. Online tests or "signs of anxiety" lists on social media can raise awareness, but they do not take the place of a diagnosis.
Factors That Fuel Teenagers' Anxiety in Turkey
In addition to the universal anxieties of adolescence, young people in Turkey face sources of stress specific to their own context. The LGS in middle school and preparation for the YKS in secondary school (Turkey's national high-school and university entrance exams) can tie a young person's daily life to an exam calendar for years. Mock exams, rankings and comparisons keep anxiety constantly alive.
After the 6 February 2023 earthquakes, many young people, even those not in the earthquake zone, were seen to experience intense anxiety with every tremor or every night when going to bed. Economic uncertainty and the family's worries about making ends meet are also making young people's anxiety about the future more pronounced. Social media, meanwhile, increases both comparison and constant exposure to bad news from around the world.
On top of this, many families have a style of communication in which feelings are not talked about and messages such as "be strong, don't cry" are given. A young person who grows up in this environment learns to bottle up their anxiety rather than voice it, and the anxiety shows itself more as physical complaints or anger.
Let's say a fourteen-year-old emails their teacher three times before handing in their homework, trying to make sure they sent the right file; in the evening they ask their mother, "Do you think the teacher will be angry?"; each time their mother says, "No, she won't, don't worry." A week later the young person asks the same question about another assignment. The reassurance their mother gives each time brings relief in the moment, but it does not stop the anxiety from returning, and more strongly, with the next assignment. This example shows how anxiety can turn into a self-feeding cycle.
How Can Parents Support an Anxious Teenager?
Parenting an anxious teenager requires striking a balance between two powerful urges: protecting them, and trusting that they can cope on their own.
Acknowledge the feeling without giving in to the anxiety
Saying "I can see this is really worrying you" instead of "There's nothing to be scared of" lets the young person feel their emotion has been seen. But acknowledging the feeling does not mean doing everything the anxiety demands. The sentence "I know you're scared, and I also believe you can cope with this" carries both compassion and encouragement at once.
Watch out for the trap of constant reassurance
Anxious young people may ask the same questions again and again. Giving reassurance every time brings relief in the short term, but it prevents the young person from learning to tolerate uncertainty. Instead, by saying "We've talked about this before; what do you think?", you can make room for the young person to find their own answer.
Don't unknowingly support avoidance
Allowing the young person to stay away from every situation that makes them anxious gradually widens anxiety's territory. Staying at home every morning they don't want to go to school, or never taking part in social activities, strengthens the belief that the anxiety is "right". Instead, support the young person in facing these situations in small, manageable steps.
Notice your own anxiety
Children learn by watching how their parents cope with anxiety. If there are topics that cause you intense anxiety too, recognising them and, if necessary, getting support for yourself is an important model you can offer your teenager.
Work with the school
Anxiety is often most visible at school. Talking to the form teacher or the school counsellor provides valuable information about how the young person comes across at school. For some young people, small adjustments, such as first giving a presentation only to the teacher or changing where they sit in class, make facing anxiety gradual. It is important that these adjustments do not turn into a permanent escape route and that, over time, things return to the usual routine.
Keep a daily routine
Regular sleep, nutrition, physical activity and screen limits directly affect the physical basis of anxiety. In particular, spending time on the phone until late at night can negatively affect both sleep and the next day's level of anxiety.
The most valuable thing you can do for an anxious teenager is not to protect them from fear, but to stand beside them as they discover they can take steps even with fear alongside them.
When Should You Seek Professional Support?
It may be helpful to talk to a mental health professional in the following situations:
- If the anxiety has lasted for more than a few weeks and is not easing
- If the young person refuses to go to school or frequently stays at home with physical complaints
- If they have markedly withdrawn from friends and from activities they enjoy
- If they experience attacks resembling panic attacks
- If there are marked disturbances in sleep and appetite
- If feelings of low mood, hopelessness or worthlessness accompany the anxiety
- If they talk about thoughts of harming themselves or ending their life
In the last case, seek support without delay; in an emergency, call 112 (emergency services). Remember that these signs alone do not amount to a diagnosis, but they may show that the young person needs support. Work in the area of anxiety and panic can be adapted to teenagers' age and needs.
How Is Anxiety in Teenagers Addressed in Therapy?
Cognitive Behavioural Therapy (CBT) is one of the approaches whose effectiveness for anxiety in teenagers is supported by research. Therapy usually begins with the young person getting to know their anxiety: How does anxiety feel in the body, which thoughts feed it and which behaviours keep it going? The young person learns to recognise this cycle through their own experiences.
Next, the young person's anxious thoughts are examined together. The evidence for and alternatives to thoughts such as "Everyone will laugh at me" or "Something bad is definitely going to happen" are evaluated. One of the most important steps in this process is graded exposure work. The situations the young person avoids are ranked from the least to the most challenging, and the young person faces these situations safely, step by step. In this way they see from their own experience that anxiety decreases over time and that the outcomes they fear usually do not happen.
Relaxation and breathing techniques, problem-solving skills and emotion-regulation work can also be part of therapy. Sessions with parents, meanwhile, help the family notice attitudes that unknowingly feed the anxiety and support the young person more effectively. Where symptoms are severe, an assessment by a psychiatrist may also be recommended.
Frequently Asked Questions
Did my child get their anxiety from me?
Both genetic and environmental factors play a role in a tendency towards anxiety. Anxiety may be seen more often in the children of anxious parents; but this is not an accusation, it is an opportunity for awareness. Learning to cope with your own anxiety also offers your teenager an important model.
Why doesn't telling an anxious teenager to "calm down" work?
Anxiety is not a switch that can be turned off by willpower. The phrase "calm down" can give the young person the message that their feeling is wrong or exaggerated, and can leave them feeling more alone. Instead, it works better to acknowledge the feeling and think together about the next small step.
Is medication needed for anxiety in teenagers?
In many young people, anxiety can ease markedly with psychotherapy and family support. Where symptoms are very severe or sufficient progress is not made with therapy, a psychiatrist decides whether medication is needed.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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