DEAR MAYO CLINIC: My 15 year old daughter has always been anxious, but her anxiety seems to get worse by the day. She worries about everything from COVID-19, even though she is vaccinated, to being accepted into a good college. There are days when she doesn’t want to get out of bed and go to school. Other days, she worries about performing well during her soccer game and refuses to go to train. I wonder about my next steps. Should she see a therapist?
ANSWER: Everyone experiences anxiety from time to time. It’s a normal part of life. However, the COVID-19 pandemic has certainly amplified fear and uncertainty for many people.
Although everyone experiences fear and anxiety from time to time, when excessive and persistent worry begins to regularly disrupt a person’s daily activities, it could be a sign of an anxiety disorder.
I recommend that you make an appointment for your daughter to see her health care provider. A visit to a family doctor or pediatrician is often a good starting point for an initial assessment, and for receiving advice and identifying resources that can help a teen manage an anxiety disorder.
People who suffer from an anxiety disorder may experience feelings of nervousness, worry, fear or panic that are difficult to control, out of proportion to the real danger, and that last a long time. They may avoid certain places, people, or situations in an attempt to prevent these feelings.
In teens, an anxiety disorder can interfere with their ability to attend school or do homework. It can be difficult for them to maintain friendships and participate in extracurricular activities. Teenage anxiety can also lead to problems in family relationships.
When anxiety limits a teen’s activities, or if excessive worry, fear, or anxiety persist for several months, it’s time to seek professional advice. Your daughter’s health care provider can assess her situation to get a better idea of the possibility that she has an anxiety disorder. He or she may also perform an assessment to see if there may be an underlying medical cause for your daughter’s anxiety.
Certain medications and medical conditions can trigger anxiety. If this is the case, switching to another medication or treating the underlying condition could ease the anxiety.
If your daughter’s health care provider suspects an anxiety disorder, they can help you find a mental health professional who specializes in treating children and youth. Treatment for anxiety in adolescents usually begins with exposure therapy.
Exposure therapy is different from counseling. It is a form of therapy that involves gradually meeting the circumstances that trigger the anxiety, so that a teenager can gain self-confidence to deal with these anxious situations and feelings. This approach also involves teaching parents how to provide meaningful support to a child in managing anxiety. Exposure therapy typically consists of around 10 sessions per week.
While research has shown exposure therapy to be one of the most effective ways to treat anxiety in adolescents, programs that offer exposure therapy to adolescents are not available in all areas. Some large academic medical centers, including the Mayo Clinic, offer intensive exposure therapy programs that last less for families who have to travel to receive this care.
In some cases, medications to help control anxiety may also be recommended in addition to exposure therapy. When exposure therapy is not available, anti-anxiety drugs can be used as the first step in treatment. But a teen should always be evaluated and diagnosed before starting to take anxiety medication, and a health care provider should monitor the medications regularly.
It can be difficult to know when to ask for help for your child. The Mayo Clinic Anxiety Coach is another resource that can offer information on the differences between anxiety disorders and stress, as well as available treatments and tips for finding the right treatment options. Effective treatment is available for anxiety, and it can often be controlled successfully.
– Dr Stephen Whiteside, Psychology, Mayo Clinic, Rochester, Minnesota
In teens, an anxiety disorder can interfere with their ability to attend school or do homework. It can be difficult for them to maintain friendships and participate in extracurricular activities. Teenage anxiety can also lead to problems in family relationships.
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