|Treating Anxious Teens in an Anxious World|
|Janet DiGiorgio-Miller, Ph.D.|
Anxiety is often found in adolescence, as it is a time of stress developmentally. They are questioning themselves in every aspect of their life and comparing themselves even more due to social media. Many teenagers who experience anxiety are unable to effectively manage their stress.
Child and adolescent anxiety have increased during recent global events, as it has for most people. This is especially true during these “extraordinary and uncertain times,” where it would be “normal” for teens to be worried (Parsons, 2020). The resolution of our current health crisis will not necessarily alleviate underlying circumstances that contribute to pediatric anxiety. Instead, clinicians need to continue to help clients to continue to effectively manage their anxiety.
Anxiety has been the most prevalent mental health disorder experienced by children and adolescents in the United States for decades. In 1999, the U.S. Surgeon General described the prevalence of pediatric anxiety disorders in the U.S. as higher than that of all other mental disorders of childhood and adolescence, experienced by 13 percent of children and teenagers. In addition, as described by the Surgeon General, the relationship between childhood mental disorders and stressful life events is well-established, in which adverse developmental and environmental factors are part of the context within which mental or behavioral health difficulties occur. “Even more than for adults … children must be seen in the context of their social environments” (Satcher, 2000). It is no surprise, then, that anxiety in children and teens has increased during the pandemic (Bera et al., 2022).
One important aspect is that adolescents have been impacted by the pandemic in ways most of us have not, academically. Not only do they worry if they can compete with other potential college/job applicants due to virtual learning but they are closely watching the economy and the impact it will have on them. Not to mention, no social activity to mark significant life events. The adolescent brain still has about ten more years to develop so each event is significant.
However, some anxious children and teens actually feel more comfortable during the isolation, especially if they experience social anxiety. Required restrictions partly eliminate the stress that social interactions and expectations may otherwise bring. At the same time, these young people also have more time to imagine the worst for themselves, their families, and the world around them. On top of that, not knowing what is ahead itself may increase anxiety. Even social media has become a stressful environment due to racial and political tensions.
Clinicians need to address the source of anxiety for young people, but we also need to address and treat the anxiety itself to help clients discover ways to better manage it. Mindfulness and meditation when used with traditional CBT are more efficient ways to work with anxious teens. CBT can mitigate fears and mindfulness and compassion can assist in having the client feel supported in changing thoughts and emotions. Meditation is supported by research as helpful in managing anxiety (Jennings, & Jennings, 2013; Mostafazadeh et al., 2019). Nevertheless, it is difficult for many clients to embrace these techniques or ideas because they may have difficulty sustaining focus or finding time, or remembering to meditate, or perhaps even believing that meditation is effective or has a place in their life. These are obstacles to overcome in helping young people learn that they have the capacity to manage their anxiety, in part by breathing, attending to the moment, and grounding themselves.
When we take a pause, breathing in a meditative fashion (for instance, counting to four with each breath in and out, several times), a more mindful state of mind develops in which we can consider and adopt a more balanced perspective. Mindfulness can create a comfort zone in which our clients can use their own breath or surroundings to feel grounded in an unpredictable world. Mindfulness is empowering when teens learn that if they can manage their breath, they can slow the beat of their heart, emotionally relax, better handle stress, and make better decisions.
Compassion for self and others enhances the body’s preparedness for stress. (Bluth & Eisenlohr, 2017; Lathren et al., 2019). Mindfulness allows young people to become more aware of their judgments and adopt a kinder view of themselves and others. This takes practice, of course, as the self-perceptions of many at-risk adolescents often lead to harsh self-evaluation and evaluation of others. One simple technique teaches young people how to take a mindful pause to notice critical self-talk—but just notice, not judge. They are thus able to become more aware of these automatic negative thoughts and can use a mindful space to challenge them. Similarly, the “lovingkindness” meditation—which has young people wishing well to themselves, someone they love, someone they find difficult, and the world around them—usually involves four simple phrases related to being safe, being healthy, being calm, and living life with ease.
Anxiety often leads to a problematic form of self-focus, in which anxious young people focus on holding their anxieties at bay, rather than on managing it and being present and part of the world around them. It is important to help them learn how to better respond to others, but it is also important to help them become more mindful in their interactions with others. Mindfully listening to help us become attuned and create a safer emotional and social environment for the teen. For many at-risk teens, this process is not natural; it takes time and practice for them to develop the skills to take pause and be present. It is the practitioners’ job to be mindfully patient and support the teen through this process of learning and practice. As the world events impact us as well as our clients, it is important that we take care of ourselves mentally, emotionally, and physically. Self-care can include the very techniques listed above.
As with other mindfulness techniques, these methods take practice and regular use. There are easily accessible resources. Dr. Kristen Neff’s website, for instance, describes and teaches self-compassion and other techniques https://self-compassion.org.
This author disclosed that this article was previously published in The Circle and used with permission: circle magazine link
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Bluth, K., & Eisenlohr-Moul, T. A. (2017). Response to a mindful self-compassion intervention in teens: A within-person association of mindfulness, self-compassion, and emotional well-being outcomes. Journal of adolescence, 57, 108–118. https://doi.org/10.1016/j.adolescence.2017.04.001
Jennings, S. J., & Jennings, J. L. (2013). Peer-directed, brief mindfulness training with adolescents: A pilot study. International Journal of Behavioral Consultation and Therapy, 8(2), 23.
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