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Teen Angst


Causes, symptoms and treatment for anxiety and stress in the school environment.

Outline

Anxiety and stress are normal.  Every one of us experiences anxiety at some point, and in fact our brains and bodies are hard-wired to do so.  Anxiety can be thought of as our body’s way of keeping us safe.  Anxiety is what alerts us to a dangerous or overwhelming situation.  Our bodies have an amazing way of perceiving a threat before we are even consciously aware of it – for example, our “instinct” to hit the brake pedal when we see red lights, even before we know we are doing so.  Or the way our stomach might start to twitch, or the hair on our neck rise, when we enter an uncertain situation.  Even the anxiety we feel when speaking in public, when flying, when meeting new people, or when on the 25th floor of a building… all of these are our bodies’ primal way of alerting us to a possible threat or danger.  Unfortunately, sometimes the warning system can become overactive.  When this happens, our anxiety goes from being helpful to being a barrier to effective and enjoyable daily living.  When stress and anxiety occur in youth, it can have a significant impact on their school functioning, their behaviour, and their social relationships. 

It is estimated that between 15-20% of children and adolescents will struggle with an anxiety disorder at some point prior to the age of 25 (Beesdo, K., Knappe, S., Pine, D., 2009).  For one’s level of anxiety to reach the point of being a diagnosable disorder, their symptoms would have become fairly significant and be impacting their daily functioning to a moderately high degree.  Far more children and youth will experience less severe levels of stress and anxiety that will never reach what we call “clinical” levels, but which may still impact their daily life.   

Why are kids stressed?

School can be a tense and difficult environment for youth.  From academic assignments, exams, friendships, romantic relationships, identity development, or plans for the future – the high school years can throw a multitude of stressors at adolescents.  Most youth will feel overwhelmed at one point or another, and learning how to manage their time and their stress is part of the “growing up” process.  However, some youth will respond more intensely to stress than others.  This may occur for many reasons:

Predisposition

As with many other struggles in our lives, stress and anxiety often have a biological component, meaning that some youth are more anxious or stressed by nature, and therefore will have a lower tolerance for stressful experiences, will be overwhelmed more easily, and will have a harder time coping. 

Negative experiences

In addition to their biological predisposition, some youth may have had prior experiences which have caused them to feel that school, or an aspect of school, is unsafe.  This may have been things like failures in a class, bullying, being laughed at when giving a presentation, or not being picked for a team in gym class.  Any real or perceived negative experience could lead a youth to fear a similar situation in the future. 

Elevated academic expectations

Parents have always high expectations for their children, and a desire for their success.  However, many would argue that today’s adolescents face more limited prospects and greater competition in education and the job market than they did a generation ago.  As such, there is an even higher expectation placed on youth to succeed and achieve in high school.  While high expectations are certainly not, in themselves, a bad thing, they become problematic when they are not reasonable expectations, or when they are receive too much intensity of focus.  In these cases, they can lead to youth feeling more anxiety about the future than they can manage.

Shifting social demands

Social relationships have always been a source of stress for most kids at school.  The desire to be liked, to fit in, to be accepted… this theme has permeated adolescence for generations.  Modern technology, however, has added a new dimension to this social minefield.  Now, in addition to keeping up with what others are saying or thinking about you, the rise of social media means that which was private, may now be very public.  A conflict with a friend may now play out with the entire school watching, or an embarrassing moment may be captured, posted, and sent out for ongoing ridicule. 

What does anxiety look like?

Anxiety can manifest in many different ways, and may not always look the way we expect it too.  While some symptoms are easily identifiable as being associated with anxiety, other are less so.  It is important to be able to tease our whether behaviours we are observing are possibly based in anxiety, as this will influence our response.  Some of the things we might see in a youth who is struggling with anxiety include:

  • Increased agitation (e.g., distractedness, irritability)
  • Social withdrawal (e.g., isolating themselves, not engaging with their peers)
  • School avoidance (e.g., staying home, skipping classes, even seeking out prolonged “meetings” in the counselling office)
  • Somatic complaints (e.g., frequent illnesses, absences, headaches, stomach aches, disrupted sleep)
  • Decreased academic performance
  • Aggressive, defiant or argumentative behaviour
  • Panic attacks (e.g., dizziness, sweaty palms, racing heart, shortness of breath)
  • Substance use (use of substances to numb other anxiety symptoms)

What can we do to help?

Increase awareness

Unfortunately, many of the above symptoms of anxiety can be misinterpreted, or mislabeled, as other things.  A youth who is avoiding school, skipping class, or not handing in work, may be seen as “lazy”.  A youth who is isolating themselves, may be seen as “a loner”.  A youth who is arguing with their teachers, or exhibiting defiance, may be seen as “a behaviour problem”.  The lens through which we see youth will guide our interactions with them, and many behaviours will elicit quite a different, and perhaps more empathic and patient, response if we understand them as being rooted in anxiety.

Encourage talking

Most of us have at some point experienced the relief and comfort of simply being heard.  Sometimes simply talking about our problems makes them immediately seem less severe and more manageable than when they are swimming around unchecked inside our heads.  Providing a place for youth to talk through their stressors, or the negative thoughts that may be leading to their anxiety, may go a long way to decrease that same anxiety, even in the absence of other interventions.   

Organize and prioritize

A particularly common area of stress for students in their workload.  Students may feel overwhelmed by the amount of work they have to do, and may not know “where to start”.  Unfortunately many youth today have not learned how to prioritize activities, nor how to effectively organize their time.  Teaching a youth to keep prioritized to-do lists, use their agenda to keep track of tasks, or break down large assignments into short, manageable chunks are all simple and practical ways that anxiety and stress may be reduced.

Healthy Life Habits

Adolescence is a time when many youth adopt unhealthy patterns of eating and sleeping, and may not realize that this can have a direct impact on their mental health and well being.  While such things will not “cure” anxiety or remove stressors from our lives, when youth start to eat well, get regular exercise, and get adequate sleep, it can significantly increase their resilience.

Mindfulness

Anxiety and stress, by their very nature, involve thoughts and fears about the future.  In the case of youth, it may be the future of their friendships, their social status, their romantic relationships, their success at school, the reactions of their parents, their ability to get into university, or their success at life.  Mindfulness involves just the opposite.  Being mindful essentially means to focus your thoughts and senses on experiencing the moment you are in, rather than focusing on what is to come.  Research has found mindfulness to be an effective practice in the treatment of anxiety in youth, and it can be taught by anyone.  Many regions are bringing the practice of mindfulness into their schools and are seeing positive results. (Weare, 2013; Rempel, 2012)

Involve other professionals when necessary

In some cases, a youth’s anxiety will not be managed simply by the strategies above, and they may need more intensive intervention.  Referring a youth to mental health services can get them access to appropriate therapy and support. 


Other resources

There is a wealth of practical and informative resources for youth struggling with anxiety.  One particularly helpful tool is the MindShift app, a resource created by AnxietyBC which youth can download to their cell phone.  It is provides information about anxiety, as well as practical tips and coping strategies.  Some other very helpful websites, for youth and for helping professionals, include:

Anxiety BC Youth (http://youth.anxietybc.com)

Kelty Mental Health Resource Centre (http://keltymentalhealth.ca/mental-health/disorders/anxiety-children-and-youth)

Mind Check (https://www.mindcheck.ca)


References
Beesdo, K., Knappe, S., Pine, D. (2009). Anxiety and Anxiety Disorders in Children and Adolescents: Developmental Issues and Implications for DSM-V. Psychiatric Clinics of North America, 32(3), 483-524.
Rempel, K.D. (2012). Mindfulness for Children and Youth: A Review of the Literature with an Argument for School-Based Implementation. Canadian Journal of Counselling and Psychotherapy, 46(3), 210-220.
Weare, Katherine (2013). Developing mindfulness with children and young people: a review of the evidence and policy context. Journal of Children’s Services, 8 (2), 141-153.

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