Teens and Anxiety

Ask the Experts | Dr. Renee Catrambone

This article is part one of a 3-part series, Surviving & Thriving the Teen Years with Dr. Renee Catrambone.

Teenagers with anxiety are common now in my office. Rates of anxiety disorders among this age group have increased significantly leaving parents and pediatricians struggling to know how to help. Is this a normal anxious feeling or is it a disorder that needs some intervention?

Due to social media and the internet, many kids have self-diagnosed anxiety disorders when they are facing normal anxious feelings. Anything that is new, important, and has uncertain outcomes creates anxiety in all of us. Giving a speech in front of the class, learning to drive, and taking an important test can trigger anxiety in most teenagers. A racing heart, upset stomach, or shortness of breath are normal reactions to fear or danger. When we face our fears, the anxious feelings eventually release their grip. If teens are unable to do what they want to do or need to do this is a problem. If the teen is anxious, but is able to give the speech and feels better afterwards then this is normal anxiety. We should applaud their bravery in facing their fear and encourage them to do more anxiety producing events.

When normal anxiety is something that we try to avoid or help our child avoid, the monster grows and becomes more intense. When teens can’t go to school because they are vomiting outside the building or can’t go into the movie theater with friends because they paralyzed with fear, it is a problem that needs help. Interventions like ladders of exposure, cognitive behavior therapy and occasionally medications like antidepressants are necessary to help teens improve their ability to face their fears and anxiety. Ladders of exposure start with small steps toward their biggest fear. Have your child make a list like driving by the theater, going in to look at the lobby, going in to buy a ticket, going with one person and just sit in the theater for a few minutes during a matinee, and build up to crowded theater with friends. Applaud their bravery at each small step.

As a parent, you can help by accepting and recognizing your child’s anxiety while keeping your boundaries applauding bravery. You might say “I know you are nervous about this speech but you can’t stay home and I know you can be brave” rather than “there is nothing to be nervous about, you will do fine”. When the intensity is great don’t tell them to “calm down”. I don’t think that ever helped anyone. Ask questions and be curious. Would you like a hug? Would it help to practice in front of us? Would it help if we went for a walk? Would it help if I leave you alone? When things are not intense, have them develop some mindfulness practices to help them ground them and get out of their heads. Praise the bravery of anyone doing something that makes them anxious. If they still can’t do the things they want to do or need to do, get help from your doctor or mental health provider.


Dr. Renee Catrambone trained at University of Chicago Children’s Hospital and has been in pediatric practice for 25 years. She has a special interest in child mental health and emotional growth. She currently sees patients at Cornerstone Pediatrics.