Teen stress and anxiety is a growing epidemic. One-third of adolescents report feeling anxiety to a significant degree, according to the National Institute of Mental Health, and 62 percent of college students said in 2016 that they feel “overwhelming anxiety;” up from 50 percent in 2011, based on a survey from the American College Health Association.
But it is an epidemic that often goes overlooked, because “people don’t see it as a legitimate illness,” Robin H. Gurwitch, Ph.D., professor and clinical psychologist at Duke University Medical Center and the Center for Child and Family Health and member of PEOPLE’s Health Squad, explains.
“Anxiety is probably one of the biggest mental health concerns, period, and yet we’re much more likely to say we’ll look at depression and post-traumatic stress disorder,” she tells PEOPLE. “We don’t give as much attention to stress, maybe because all of us experience anxiety in one way, shape or form. But when it rises to a level where it interferes with daily functioning, it becomes a problem.”
Sources of Stress
For teens, the list of possible stressors is long — from puberty to family problems to social media to gun violence — but it typically starts in school.
“The American Psychological Foundation found that the most common reports of stress among teens is in school, followed only by stress related to ‘what am I going to do after high school,’ and ‘will I get into the colleges that I want to,’ ” Dr. Gurwitch says.
And there’s more to school-related stress than just classwork. High schoolers are dealing with anxiety around their relationships, which is often exacerbated by social media.
“Social stress is a real thing,” Dr. Gurwitch says. “They are thinking about how they fit in with peers, peer pressure, bullying, relationships. But also, that attachment to their phones may be associated with increased levels of stress, because they think that if they miss a call or miss a text, and if their phone dings at 2 a.m., then they better get up to answer it or that person may move on to someone else and not me. It adds new problems.”
Some teens also have to deal with extreme stressors like absentee parents or racial discrimination, Dr. Gurwitch adds. “There’s some groups that sadly are dealing with extreme stressors … If I get stopped by the police what will happen? These are added stressors to certain groups in our country.”
Start a Conversation
Dr. Gurwitch says that helping your teen starts with being available to talk.
“It’s so important for teens to have at least one trusted adult in their circle that they can talk to and determine if this is a blip or something more severe,” she says. “Some of the things to be on the lookout for is if they’re telling us that they’re feeling nervous and anxious, or are irritable or angry, beyond what you would think is your typical teen behavior.”
Other signs include procrastinating or neglecting responsibilities, losing sleep, changes in their appetite — either eating too much or too little, getting sick more frequently and becoming unable to do tasks that they could before.
From there, caregivers can help them manage these issues.
“Help them with good sleep hygiene, like turning off the screens late at night,” Dr. Gurwitch advises. “Think about if they’re taking steps to be active, like working out or taking walks or participating in sports. Help them find a work and fun balance. If everything is about school or work, and they don’t have time to hang with friends or get alone time, that can create greater anxiety.”
Another option is have your teen focus on their strengths.
“Teens can help with their anxiety by thinking about what they’re really good at,” she says. “Maybe if they’re good at math, they join a club at school or volunteer to tutor. Spending time with others and sharing the strengths they have can be really helpful.”
But if the stress and anxiety becomes debilitating, teens need additional help.
“All of us experience some anxiety, but it doesn’t usually create a problem that we can’t push through. When anxiety becomes debilitating, it does interfere with our relationships and work or school, and that’s when it becomes a problem that we need to look at and find help for,” Dr. Gurwitch says. “Because that does not just go away, it just builds and grows on itself.”
At that point, therapy and medication are possible options.
“People have looked at medication versus certain types of therapy, and what the research tends to point out is that both medication and therapy can make a difference, but the combination is what is strongly recommended, not just one or the other,” Dr. Gurwitch says. “You can’t just give a teen an anti-anxiety medication like Zoloft or other generics and call it good. You have to help them manage their anxiety and come up with plans for when they’re anxious in the future, rather than just saying that they’ll rely on pharmaceuticals.”
The most important part is to recognize stress and anxiety as a legitimate illness.
“All of us experience anxiety at different times, so it’s hard to imagine it interfering with an ability to live our lives, so we may discount it as a mental health disorder,” Dr. Gurwitch says. “It doesn’t get as much attention, but it is significant.”