Anxiety and Adolescent Stress: Navigating Teen Mental Health

By: Andrea O’Morrow, NAMI Metro Suburban Education Manager; Claudia Hypes, NAMI Metro Suburban Community Education Coordinator

I was well into my twenties the first time a medical professional told me I was displaying symptoms of an anxiety disorder. I felt a lot of things at that moment. Mostly relief, but also confusion. Shock. Sadness. Not sadness for the life I was currently living, or for any desolate fate that I thought would come from this new diagnosis, but sadness for all the life I had already lived. For the years that were plagued by unmanaged and persistent feelings of worry, fear, and failure. Feelings that I had convinced my teenage self were perfectly normal; an unfortunate side effect of being human. 

The first one I can pinpoint was at the age of 9. My fourth-grade teacher returned a quiz on which I’d misread the instructions and gotten every question wrong. I remember feeling the blood drain from my face. My breathing became short, my hands started to shake, and I quickly excused myself to the restroom to cry in private. What would my parents think? Had my teacher told the other staff how much of a failure I was? Did they laugh about me in the break room? Had anyone else seen the bright red score at the top of the paper? Would I be the next topic of gossip in the cafeteria? While I eventually composed myself and returned to class, I spent the remainder of the school year thinking about that moment and gasping for air any time an assessment landed on my desk.

Experiences like this one continued to define my adolescence. Like the time my dance coach asked me to learn a new style, and in a panicked response I abruptly quit the team. I told everyone it was a time management decision while internally mourning the loss of an activity I loved. Or the time I broke down in the high school office over what amounted to a miscommunication and a lost doctor’s note. Or perhaps most notably in all, the days I stayed home under the guise of a stomach ache when worry over a test or the mere thought of social interaction made it too difficult to function.

-Andrea (31)

It really pains me that stress and anxiety have become such entangled terms nowadays that they are used incorrectly or as synonyms for each other. It is already so difficult for younger individuals to know when something is atypical or problematic since they are learning and experiencing so much change. I, like most people as teenagers, experienced the stress of simply growing up. With the pressure of academic deadlines, parental expectations, creating friendships, presenting in a certain way, and understanding oneself, it is no wonder teens are stressed. What is lacking, though, is discernment between a natural human stress response and persistent feelings of dread and fear.

For so long, I labeled my symptoms of anxiety as stress, and if I were to have just the tiniest bit of separation between the two, I truly would have been able to get help much earlier. I think this is the case with a lot of teens today- they don’t know where one ends and the other begins, which prohibits them from being aware and seeking help. In turn, this sets a societal standard of what “stress” looks like, and I believe over time that standard has and will be pushed over the limit leading many people to confuse the two. 

I didn’t know that my constant cycling of worries that made me dissociate and forget an entire period was not just “normal teen stress” but a serious mental health condition. I didn’t know it was abnormal to spend hours fixated on picking at my skin until it bled and biting my nails until they were raw. I did not know that my lack of ability to make a decision which resulted in rage, anxiety attacks, gallons of tears, and physical pain was a symptom of anxiety. I did not realize that the reason I felt constantly fatigued, lightheaded, and like I was nearly about to faint was that my body and brain were so overloaded that I was quite literally not breathing properly. I didn’t understand the muscle spasms, loss of appetite accompanied by episodes of binge eating, paranoia, vivid dreams that gave me night sweats, permanent feeling of being cold even on the sunniest of days, dizziness and vision loss, irrational fears and worries, continual demand to know what was going on at all times, inability to stop thinking of an event, ticks and tremors, lashing out about little things, sweating, stomach pain that made me so nauseous I avoided eating, extreme caution in public settings, rambling to ensure I was understood, brain fog, or refusing to go somewhere unless I knew who would be there.

For so long, all of these experiences were labeled as “stress”; just another symptom of the human condition. This was until I was diagnosed with GAD and finally, those beliefs, emotions, and behaviors found their rightful home under the term of anxiety.

-Claudia (22)

While we wish situations like these were unique, the reality is that anxiety in teens and adolescents has been on the rise for many years. According to a recent report from the CDC, 42 percent of U.S. high schoolers experienced persistent feelings of sadness or hopelessness in 2021, while 22 percent seriously considered attempting suicide. With numbers like these, it’s easy to see why so many professionals continue to sound the alarm about a youth mental health crisis. And while we continue to feel the effects of a global pandemic and a rapidly changing social and political landscape, so many adults find themselves struggling to understand the line between anxiety and typical teen behavior, particularly within the context of the last few years.

So, how can we, as parents, teachers, caregivers, and advocates, distinguish between the difficult realities of the stress of adolescence and a mental health condition like anxiety? Stress is generally short-term, and a teen (or an adult for that matter) will typically display a stress response appropriate to that situation- keeping in mind that for a teen, many of these situations feel much bigger than they may seem to an adult. When the stressor is gone, the stress response should alleviate. Knowing that adolescents experience emotions much more strongly than adults, we may notice this cycle of stress somewhat frequently. But using tools and strategies to manage these feelings and move forward generally indicates pretty positive mental health.

For teens and adolescents dealing with anxiety, however, these feelings may not alleviate even after the stressor is no longer present. We may notice a continued stress response to events that happened weeks, months, or even years ago. We can also look at the impact of these stressors on daily functioning to consider the possibility of a mental health condition. While a stress response can certainly be uncomfortable and difficult, it shouldn’t have any long-term effects on daily functioning. When we notice a prolonged disruption to a teen’s normal routine or a sudden inability to complete daily tasks like maintaining hygiene, getting enough sleep, and attending school, it’s probably time to speak with a professional.

The good news is teenagers are more educated and interested in mental health than ever before with the implementation of student mental health days in Illinois, a number of mental health/social/emotional school initiatives, and perhaps a surprise to many, the advent of social media (the hashtag mental health has been searched on TikTok over 67 billion times!). One of the best things we can do to support our teens, whether they’re dealing with stress or anxiety, is to join the conversation. Listen, ask questions, empathize, and help them find the tools and resources they need to be healthy and successful. 

And when you do decide that it’s time to seek professional treatment or support, remind your teen that they are not alone. Anxiety is one of the most commonly diagnosed mental health conditions- and also one of the most treatable. Recovery is not just possible, it’s probable with the right support and treatment.

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