How to Help a Teenager with Anxiety

Teens who experience intense anxiety that causes distress and interferes with school and extracurricular activities may need help dealing with their anxiety.

Like adults, teens can have many types of anxiety, including generalized anxiety, panic disorder, agoraphobia, separation anxiety, social anxiety and health anxiety. If your child’s anxiety worsens or their coping strategies break down — or if they don’t sleep well or eat properly and their anxiety leads to other physical symptoms — contact your teen’s doctor about getting treatment

Therapists consider cognitive-behavioral therapy the gold standard treatment for anxiety disorders in teens. CBT has a successful track record of treating anxiety, lowering recurrence and relapse rates and being a useful addition to psychopharmacological treatment.

Medical research shows an association between anxiety disorders and relationship issues, whether with friends, family or teachers. There’s also a link between anxiety and school absenteeism. Studies detail significant benefits from anxiety-focused psychotherapy.

Teens can utilize CBT online or in person. Many teens prefer online therapy because it’s private, convenient and flexible. Studies show a high efficacy for online treatment for anxiety, noting that it’s as effective as in-person treatment, especially when paired with the right medication.

Anxiety Medication for Teens

Therapists sometimes suggest a combination of prescription medication and CBT for teens. The American Academy of Child and Adolescent Psychiatry recommends deferring anxiety medications unless the physician thinks the benefits outweigh the risks.

Duloxetine (Cymbalta) is the only medication approved by the U.S. Food and Drug Administration for children ages 7 years and older who have a generalized anxiety disorder. Some physicians prescribe off-label medications that have been proven safe and effective for treating anxiety but aren’t FDA-approved.

Besides your child’s pediatrician, psychiatrists, general practitioners and psychiatric nurse practitioners can prescribe anti-anxiety medications.

Antidepressants for Anxiety

Researchers have not studied the efficacy of psychopharmacotherapy among pediatric populations as extensively as they have for adults. Duloxetine is the FDA-approved serotonin-norepinephrine reuptake inhibitor, or SNRI, for children and teens.

Studies have shown, however, that selective serotonin reuptake inhibitors, or SSRIs, are more efficacious than SNRIs in treating pediatric anxiety. SSRIs are a class of drugs known as antidepressants.

SSRIs such as fluoxetine, marketed under the brand name Prozac, among others, and sertraline, marketed under the brand name Zoloft, are first-line pharmacologic treatments.

The most prescribed antidepressants for teens with anxiety disorders are SSRIs. Research shows they have some effectiveness for treating OCD, a type of anxiety-related disorder involving repetitive and disturbing thoughts. Although doctors prescribe SSRIs, studies don’t agree on how well they treat symptoms of anxiety disorders in teens.

Benzodiazepines for Anxiety

Doctors can prescribe a class of medications known as benzodiazepines, which include the drugs lorazepam and clonazepam. The drugs are usually used for short-term treatment and specific bouts of anxiety, such as flying on a plane or giving a performance. They’re not recommended for teens with anxiety disorders because of the risks of addiction.

Brand names of benzodiazepines include Xanax, Librium, Klonopin, Valium, Ativan and Serax. Use caution when taking benzodiazepines for pediatric disorders because of a heightened risk of misuse. Additional research of pharmacological treatments for teen anxiety is needed.

Parents, teachers, counselors and mentors can help teens with anxiety in different ways. Parents can model good stress management skills, normalize anxiety and talk about it openly. Teachers and counselors can learn to recognize the symptoms of anxiety and introduce relaxation and coping skills, such as the CBT-based practices of breathing techniques or mindfulness. Peers may provide important messaging around breaking the stigma of mental health challenges.

Remind your teen that anxiety is a normal part of growing up. Help them explore and express their feelings. Try shifting their focus as a way to manage stress, fear or anxiety.

Helping With an Anxiety Crisis

Sometimes anxiety escalates into a panic attack. A panic attack is a sudden and intense wave of fear that can trigger a sense of impending doom, a rapid heartbeat, sweating, trembling and shortness of breath. Suicidal ideation may accompany a panic attack.

There are ways to help your child get through a panic attack. Help them think about a panic attack as a wave that they’re riding, one that will peak and then pass.

Grounding is a strategy where you ask your child to name aloud things they can see, touch, hear and smell, which helps them focus. Deep, slow breathing can also help calm the body.