Anxiety is like an alarm bell in the brain. The alarm goes off when you're threatened. It tells your body to protect you. People feel anxious when they're in danger and need to get to safety. The need to succeed often causes anxiety. Teens may feel anxious doing schoolwork or learning to drive. In many cases, feeling anxiety is normal.

With an anxiety disorder, the body responds as if it's in danger. But the response is more than needed. The anxiety may be way out of balance with the threat that triggers it. Or anxiety can happen when there's no clear threat or danger. An anxiety disorder often disrupts a teen's work, school, and relationships.

Your teen may have any of these signs and symptoms:

• Constant fear for their safety or safety of loved ones
• Clingy behavior
• Problems focusing or relaxing
• Being grouchy
• Critical, self-conscious thoughts
• Worry about what others may be thinking
• Not wanting to go to parties or other social events

An anxiety disorder can cause physical symptoms such as:

• Frequent headaches or dizziness
• Stomach problems
• Sweating or shakiness
• Trouble sleeping
• Muscle tension
• Startling easily

OCD is a type of anxiety disorder. The symptoms are a bit different from other anxiety disorders. Someone with OCD has constant, intrusive fears. These are called obsessions. They may have constant fears about germs. They may worry about leaving the door unlocked or the stove on. The person then does behaviors to help ease the fear and anxiety. These are called compulsions. These can include washing hands over and over or checking a lock or stove constantly. If your teen shows any of these signs, talk to their healthcare provider:

• Too much handwashing

• Checking things over and over, like lights or locks

• A very strong need to do some tasks in a certain order 
• A very strong need to have items arranged in a certain way

• Anger or upset if they can’t do the routines or habits 

Panic disorder is another type of anxiety disorder. It causes panic attacks. These are sudden feelings of intense fear along with physical symptoms. A panic attack can happen with little or no warning. The symptoms can include:

• Chest pain
• Pounding heartbeat
• Dizziness
• Trouble breathing
• Feeling of impending doom or sense of unreality
• Feeling of being smothered
• Feeling like they’re about to lose control

Often, teens will stay away from any place where they’ve had a panic attack. This is because they’re afraid of having another one. Some teens who have had panic attacks get so afraid of having another attack that they stop leaving their homes. This is called agoraphobia.

Get help for your teen right away if you think they have any kind of anxiety disorder. Contact their healthcare provider. There is no single test for anxiety disorders. But your teen’s healthcare provider will ask questions. And your teen may need tests to rule out other problems. If not treated, an anxiety disorder can affect the quality of their life. This includes schoolwork, activities, and relationships. It can also lead to self-harm.

An anxiety disorder is often treated with therapy, medicines, or both.

Getting better from any illness takes time. Getting better with an anxiety disorder is no different. While your teen is recovering, here are things that can help them feel better:

• Be understanding. Your teen’s behavior may give you stress. Try to keep in mind that they’re still learning how to cope. Your support can make a huge difference.
• Help your teen talk about their worries and fears. Being able to talk about them can help your teen learn to work on them.
• Have your teen exercise regularly. Exercise has been shown to help ease symptoms of anxiety and depression.

• Has side effects from a medicine

• Has new symptoms or symptoms that get worse

• Becomes very aggressive or angry

• Shows signs or talks of hurting themselves(see below)

For more help and information, contact these groups:

• National Suicide Prevention Lifeline at www.suicidepreventionlifeline.org or 800-273-TALK (800-273-8255)

• National Institute of Mental Health at www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

• American Academy of Child and Adolescent Psychiatry at www.aacap.org

An anxiety disorder causes children to be intensely fearful in situations that would not normally cause fear. They may be afraid of certain things, such as dogs or snakes. Or, they may fear a situation, such as being alone in the dark. Sometimes they may be too afraid to leave the house.

Some children may have separation anxiety disorder. This means they dread being away from a parent or other loved one. They may worry that they’ll be harmed. They may worry that they'll never see their loved one again. In some cases, the child may refuse to go to school. They may have physical symptoms. These can include nausea or stomachaches.

Most children with anxiety can be helped with behavior therapy. This is done by a licensed healthcare provider trained to work with children. This may be any of the below:

• Licensed clinical social worker (LCSW)
• Clinical psychologist (PhD)
• Advanced practice registered nurse (APRN) with a mental health specialty
• Psychiatrist (MD)

The therapy is done in steps. When your child feels safe with 1 step, they can go on to the next. This helps your child slowly face and cope with their fears. For example, your child may be asked to just think about the feared object. They see that nothing bad happens as a result. The next step may be looking at a picture of the feared object. Later, they may face the feared object in person, with support and encouragement. Over time, your child will be less afraid. In some cases, certain prescribed medicines may help lessen a child’s anxiety.

Parents should talk to their child's healthcare provider first. They will need to rule out any physical problems that may cause the symptoms of anxiety. If anxiety is diagnosed, the healthcare provider can refer you to support for both your child and the family. They can help you learn ways to support your child’s mental health. Your love and support can help your child overcome their fears.

• National Alliance on Mental Illness (NAMI) at www.nami.org

• National Institute of Mental Health at www.nimh.nih.gov

• Anxiety and Depression Association of America at www.adaa.org

An anxiety disorder causes very strong feelings of panic and fear. These feelings may occur for no clear reason. And they tend to happen again and again. They may prevent you from coping with life. They may cause you great distress. You may then stay away from anything that triggers your fear. In extreme cases, you may never leave the house. Anxiety disorders may cause other symptoms, such as:

• Obsessive thoughts that are unwanted and you can’t control

• Constant nightmares or painful thoughts of the past

• Upset stomach, sweating, and muscle tension

• Trouble sleeping or focusing

Anxiety disorders tend to run in families. For some people, childhood abuse or neglect may play a role. For others, stressful life events or trauma may trigger these disorders. Anxiety can trigger low self-esteem and poor coping skills.

• Panic disorder. This causes a very strong fear of being in danger.

• Phobias. These are extreme fears of certain things, places, or events.

• Obsessive-compulsive disorder (OCD). This makes you have unwanted thoughts and urges. You also may do certain things over and over.

• Posttraumatic stress disorder (PTSD). This occurs in people who have been through a terrible ordeal. It can cause nightmares and flashbacks about the event.

• Generalized anxiety disorder. This causes constant worry. It can greatly disrupt your life.

You may believe that nothing can help you. Or you might fear what others may think. But most anxiety symptoms can be eased with treatment. Having an anxiety disorder is nothing to be ashamed of. Most people do best with treatment that combines medicine and individual and group therapy. These aren’t cures. But they can help you live a healthier life.

Many things in your daily life impact your health. This can include transportation, money problems, housing, access to food, and childcare. If you can’t get to medical appointments, you may not receive the care you need. When money is tight, it may be difficult to pay for medicines. And living far from a grocery store can make it hard to buy healthy food.

If you have concerns in any of these or other areas, talk with your healthcare team. They may know of local resources to assist you. Or they may have a staff person who can help.