Teenage anxiety – when to seek help

We were lucky enough to have Lotte Stringer, CEO of Hector’s House, join us on an Instagram Live recently to discuss how to recognise and manage teenage anxiety. In particular, we were keen to discuss the difference between normal, everyday apprehension and when to seek help for anxiety. Her advice was extremely helpful, so we decided to write it up for our blog.

Here’s what Lotte had to say:

The difference between everyday apprehension and anxiety disorders

Anxiety is something that is really, really normal to feel in everyday life. It’s the physical preparation to face something intense and we all have things in our everyday lives that spark those feelings of intenseness. Then once these things are over, the stress circle is completed and everything goes back to being more normal. We can see how quickly feelings dial up but also how quickly they dial down as well. For teenagers, lots of things can spark those totally normal responses.

When we have to be aware, and consider seeking help, is when these feelings totally take over life. When they come out of nowhere, rather than as a normal stress response triggered by something that has a start and an ending.

So look out for intense responses that come out of nowhere and are ongoing, with no respite, and that interfere with everyday life. Those symptoms are ongoing all the time and it feels as if they’re impossible to control. When it’s persistent, it’s then we need to seek professional help. If doesn’t go away, it interferes with daily life. It feels impossible to manage. If they’re describing it as “I can’t see a way out of it’, then you need to be looking at seeking some professional advice.

The best action is to make a GP appointment. You can always come to us at Hector’s House as well and we can send you a to-do list of different pathways to help you collaborate with your teen to get them the help they need.

How do I know if my teen is feeling anxious?

Notice when your teen changes or is presenting differently. Parents are usually innately tuned in to their teens, so trust your instincts if you think you notice changes.

Be mindful of what is happening in your teen’s life – particularly major events such as change of school, new school year or leaving for uni. All of these things are significant changes which can bring on anxiety. There will be a transition period afterwards, too, where the brain has to catch up with these changes – support them in that moment.

Develop a dialogue by asking questions. Open the conversation. Get curious. Ask about their day – not just about what happened but how they’re feeling about what happened to them that day. Rephrase the question if you don’t get a full response first time; don’t be afraid to ask twice. Add layers of questions, build a narrative.

We have to be vulnerable as parents, friends, care-givers and ask, “Are you feeling ok? Are you really feeling ok? Because I’ve noticed XYZ.”

Try not to write behaviour off as being dramatic or for effect. Always listen intently. Check that the feelings and reactions aren’t disproportionate to the event and if they’re not coming back down to normal levels afterwards. And anxiety can hide behind aggression, if they’re hurting inside. Explore this, get curious, listen.

How can I help if they’re feeling apprehensive or anxious?

Be honest with them. Remind them that we all feel anxious. It’s important to normalise and validate those feelings, and reassure them that everyone has them. We all have spikes to our stress response and that’s to be expected and accepted. Tell them, “That must have been really stressful for you today at school”, or “I’ve noticed that you’re looking a bit stressed”.

We’ve all suffered from social awkwardness and shyness. What teens worry about is that they’re the only ones feeling the anxiousness and shyness they’re feeling in their heads. It’s important to say, “Me too. I feel that too.” You can help them understand that it’s part of daily life. It’s the ‘why’ that’s important; what the feelings are in response to. Help them work through the thought that triggers the physical response: “I feel scared because…”

Here at Hector’s House, we know from school visits that the key is normalising anxiety and apprehension. So we say “Me too. We also feel that.” when teens talk about feeling anxious and that can be unexpected. To watch the relief of knowing they’re not alone is the best thing about our visits.

Remind them to check that their environment isn’t really hot or they’ve been physically active so that they’re having a normal physical reaction to a situation rather than feeling anxious.

Help them learn to navigate stressful situations in a way that minimises stress – eg. leaving plenty of time, making careful preparations.

Find out more about anxiety and how to manage it – we’ve got excellent resources on our website at Hector’s House, particularly our Library of Calm. You could also have a chat with your GP or read some of the great books out there – here are a couple I’d recommend:

I also like the Calm and Insight Timer apps.

When should we seek more help?

As I said, when anxiety is persistent and ongoing and it feels as if it’s taking over life, then get some help. If you’re worried about your teen feeling ongoing anxiety, personally, I wouldn’t leave it longer than a month before seeking help and exploring further. Although if there’s a very sharp increase in their feelings at any time, don’t wait. Nobody needs to suffer.

The first step is to make an appointment with your GP. Collaborate with your teen so that they don’t feel their control has been taken away. However, if you’re really worried and they’re not happy to collaborate, don’t be afraid to talk to your GP or their teachers.

Wider awareness of anxiety disorders

We’re now much more aware of anxiety. In some respects, it’s great that we’re talking about it but in other ways it then opens up to lots of people saying ‘I have anxiety, I’ve diagnosed myself’. Unless you’ve been to someone who can diagnose you clinically and have been diagnosed with anxiety disorder or anything along that line, then you may be feeling normal feelings of apprehension. And that’s ok. It’s ok to feel fear.

Covid has had an impact on us all and has made us all more aware of anxiety. The transition back to normal life needs to be slow, so that we all feel comfortable. Our world was really small and now everything has opened back up again. It’s important to take baby steps and not expect to get back to normal immediately.

Self care

I suffered chronic PTSD and anxiety after my brother Hector took his own life. I’ve learnt that the best self care is simple stuff – change your environment, drink water, eat healthily, exercise, breathe, stay off electronics for a while. Learn what works best when you are triggered. Be gentle with yourself. Work out what works best for you.

Take little steps. Make tiny healthy habits. Don’t try to change everything in one go. Focus on the 1% you can change at a time.

Concentrate on slowing down your breathing. Concentrate on what you can control and remove yourself from stressful situations where you can.

Sleep is very important for teens, especially taking the time to switch off screens a while before bedtime. Teenagers live so in the now, they need to think ahead a little. Sleep hygiene is a buzzy word at the moment but it really does help.

If life feels too much, set boundaries. Focus on and enjoy what you’re doing, Be present, manage what’s happening right now. Make sure you don’t take on too much so you feel as if you’re being pulled everywhere.

And parents, you can help by modelling these behaviours.

You can contact Hector’s House here.

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