Anxiety & Panic in Teens
See also: Anxiety & Depression in Preteens ... More Advice about Anxiety & Depression in Teens & Preteens
Parent Q&A
Archived Q&A and Reviews
- 15-year-old very anxious and worried, can't sleep
- Very anxious 14-year-old - what might help her?
- 17-year-old's terrible anxiety
- Support Group and CBT for 16-year-old son with anxiety attacks
- Anxiety-riddled 13-year-old wakes me at night, calls me at work
- 13-year-old thinks she has GAD (General Anxiety Disorder)
15-year-old very anxious and worried, can't sleep
June 2011
Our 15 year old daughter is very anxious (or worried, not sure if this is the same or not). Before softball practice, before games, before tests at school...she feels sick to her stomach, is overly-worried and insecure, cannot sleep, and so on. This happens several times a week, and every night when she goes to bed.
She says she cannot sleep because her comforter is not right, too fluffy, too flat, too something. She has a very hard time going to sleep, and wakes me at least three times a week in the middle of the night because she cannot sleep (although I cannot help her, either).
I am at the point where I am no longer too understanding, because I am exhausted and frustrated. It seems totally irrational to me, and yet I know she cannot help it. She is also frustrated and embarrassed.
What to do? Therapy? Which kind? I hate to think that she has to live like this forever. I feel that if she just had some coping mechanisms, she could help herself in these situations, rather than shut down and give in to her feelings of insecurity and worry. Need some sleep!
I was like this as a child and teen (the bedtime part is especially easy for me to relate to). I stumbled around as an adult, trying to cope with my anxious feelings, which I didn't even know how to describe. I generally attributed my bad feelings to having done something wrong, or something outside of myself causing them, or to being depressed. My therapist helped me recognize them as anxiety, and I began realizing that I was anxious whether there was anything wrong or not. That helped me break the cycle and I do better now with emotional tools I have figured out for myself.
I do wish my parents had taken me to a cognitive behavioral therapist so I could have developed good tools for anxiety when I was younger. CBT helps people slow down their thinking so they can recognize their anxiety triggers and break the cycle. There is individual therapy and group therapy. A friend saw Dr. Elke Zuercher-White (http://drzuercher.com) and I met her as well. She may not be in your area, but she specializes in this and might be able to refer you to someone near you.
Anxiety is very treatable, but it does take willingness and effort on the part of the patient. You have to be brave and stand up to your fears in order to make them go away. a little brave every day
How frustrating for both of you! I'm sure she doesn't like being sleep deprived either, on top of teen stress and hormones.
Things your daughter might try before bed: 15 minutes of stretching or yoga or meditation (pay attention to breath and try to quiet the ''tapes'' running in her head). Avoid lights, TV, computer. Avoid protein, but eat an apple or crackers. Try chamomile or Sleepytime herbal tea, or chamomile, MELATONIN or TRYPTOPHAN supplements from health food store. A child's dose of Benadryl can help with sleep, especially if she has allergies anyway this time of year.
In general, during times of stress, eat protein with breakfast and exercise daily. Avoid chocolate, sugar, caffeine and alcohol. Good luck!
I, too, have an anxious teen. Imagine how hard it is for them to make it through each day with the anxieties!? We got her on a low dose of zoloft (her pediatrician subscribed) and she is doing much better! Some kids are just wired that way---and luckily there are medications which can help immensely. If your insurance covers it, I recommend a psychiatrist at Children's Hospital. We saw Dr Lisa Hardy years ago and she was wonderful. Good luck and don't despair but don't wait any longer to get her help. mom of a worrier
More on addressing the sleep deprivation: There was just an article in the paper about cooling the head giving relief to insomniacs (not only in going to sleep, but sleeping better). This may be connected to the fact that body temperature must go down in order to sleep.
About anxiety generally, maybe she could get a referral to a psychologist who could prescribe some mild anti anxiety meds. Good Luck!
Hello there, I sympathize with you as I also have a daughter who has suffered a bit like your daughter. She would get excruciating stomach aches at the most random times as a result of stress over her teams or teachers, etc. Since your daughter is already a teen, I would suggest only two things: regular yoga classes and a new comforting bedtime routine. I'm not a yogi myself, so I can't recommend any place in particular, but I know from first hand experience that yoga does work in subtle yet miraculous ways. My daughter took some yoga classes at the YMCA. Now, she immediately goes into a yoga pose on the floor when she feels that stressful stomach pain coming on. Yoga, or something called Praniyama, has taught her how to breathe to calm herself, which would also help your daughter sleep better.
In terms of a comforting bedtime routine, there is strong scientific evidence showing that both a cup of hot milk and a smallish piece of bread help the body sleep. If she won't/ can't drink milk, then chamomile tea. If your daughter is unhappy with her duvet, consider buying her a new one that's more evenly distributed. I'm like her. My duvet has to be just right or I don't sleep well either. I found that light, but several, layers work best for me, that way I can throw them on or off as I need them. Of course, make sure her room is dark and quiet and that she gets some direct sunlight during the day. It also helps to turn off all the screens (tv, computer, texting, etc.) an hour before bedtime.
I would like to add that we developed our responses to our daughter's stress after consulting with her doctor. We asked for a therapist referral, but our doctor said to try these holistic approaches first and they totally work. Believe me, yoga and a calm bedtime routine are much less expensive than therapy. And this is even more important: Instead of thinking of herself as ''needing help'', yoga and the easy bedtime routine have actually empowered our daughter to know she can handle the stress herself. Thankful for yoga and praniyama.
I have written in before but want to recommend Dr. Lester Isenstadt again for working with children/ teens with anxiety, depression, school issues, etc.
Years ago I saw a child (whose parents were going through a difficult divorce) thriving when I expected her to be hitting bottom. It turns out that she was seeing Dr. Isenstadt - a great recommendation for taking our daughter to him. He has worked with depressed and anxious kids for 30 or 40 years and, five years ago, helped repair our daughter's self-esteem as well as treating her anxiety disorder and depression. He is extremely experienced, skillful, as well as up-to-date on current brain research. He's a Psychiatrist so can prescribe medications if chosen, but also does counseling directly with the kids he sees so he really knows how each child is progressing.
There is so much pain in anxiety. We are grateful for Dr. Isenstadt's skill in addressing our daughter's anxiety and hope that your child finds similar relief and self-confidence. If needed, his number is 510-848-2170. Wishing you all the best
Very anxious 14-year-old - what might help her?
March 2011
Our 14 year old daughter has always been more emotional and anxious than her sister. Even as a toddler, she would scream (for example) if the sun was in her eyes, whereas her sister would just cover her eyes with her hand. I never thought much about these types of reactions, but now that she is a teenager, I see that she has probably always been very anxious. She worries a lot, and with most new situations, her first reaction is negative or fearful. She is often fearful at night (around bedtime), and is in general a fairly stressed out, anxious, or worried kid.
What might help her? I think she might be a good candidate for meditation, or yoga, or something to help her help herself. I have sort of concluded that this is who she is, but if she were to develop some coping strategies, or ways to calm her fears, her life would be so much easier. Therapy? Any ideas? Mama of anxious girl
Yoga and meditation can actually make a sensitive person more sensitive. If you go in this direction make sure there is someone teaching who knows how to deal with any experiences that might come up (in my case a kundalini awakening at age 16). Neurofeedback and EMDR could be very helpful for your daughter. Melanie
Your daughters sound like they could be mine: my oldest (age 20) is fearless and loves to live her life independently and spontaneously while my youngest (age 17) worries about anything and everything to the point that she is afraid to take any risks whatsoever. In the past year, my daughter's anxiety levels increased to the point where she was having trouble sleeping, was constantly stressed out and was experiencing panic attacks with increasing frequency. She wasn't interested in yoga or meditation, (too self-conscious), and talk therapy with a LCSW was not helping at all. Recognizing that we needed to do something fairly immediately, especially if my daughter was to have any chance of success at going away to college this fall, we both talked to her doctor who recommended Cognitive Behavioral Therapy and specifically Dr. Daniela Owen at the San Francisco Bay Area Center for Cognitive Therapy on College Avenue in Oakland.
I was not familiar with CBT, but I read the postings on the BPN website and the info on the Center's website (www.sfbacct.com) and realized that this was exactly what my daughter needed: work with a professional who could help her to recognize her self-defeating patterns and teach her skills to help her break out of her downward-spiral-way-of-thinking about how things could go wrong. My daughter has now been seeing Dr. Owen for about two months and I can't say enough good things about Dr. Owen and the impact she has had on my daughter. At the end of each session, she comes home with a written plan about the work she is to do on specific items: getting to bed earlier, finishing certain college-related tasks, etc. She is visibly happier, getting more sleep, and is getting better about making decisions and accomplishing goals. All of this is reducing her stress and anxiety and more importantly, she is learning how to help herself. I highly recommend that you at least start by reviewing the information on the BPN and SFBACCT websites to see if this might be something that would work for your daughter. Mother of a not so anxious teen
17-year-old's terrible anxiety
Jan 2011
My 17-year old son has been dealing with terrible anxiety for two years now. Therapy and a failed attempt at meds have not worked. In both instances, he was the one who put the brakes on these avenues for help. His world is getting smaller and smaller because he is fearful of pushing himself into new situations. His anxiety has become a self-fulfilling prophecy...he gets worried that he may get sick and, thus, does whether it is for presentations in a classroom setting, taking tests, sports, going into SF with buddies, etc. Any ideas are welcomed. We are currently trying hypnotherapy and I would appreciate input you have had with this or other alternative approaches.
We struggle with the same issue in our 15 y.o. son. I don't have any perfect answers, but I'll mention a few other things we've tried.
We did biofeedback (there's someone at Children's, and there are independent people; it doesn't appear to require someone who is ''the best'' for this to work.) My son became readily able to reverse all anxiety while in the office doing the exercises. He was not so successful generalizing it to the outside world, but some are.
We also did EMDR with Colleen West in El Cerrito. (She's good.) This only really works if there are some traumatic memories associated with the anxiety. In my son's case, it was simply memories built up about panicking when trying to do homework or attend school. The EMDR (only three treatments needed) helped substantially with these discrete areas, but didn't impact the more generalized anxiety in other areas.
At this age, of course, their initiative in trying to combat it is essential, and so we are relatively powerless. I'm convinced that in the long term he will use meditation or exercise as big parts of managing this, but that's going to be in his court. We thought our son would not be able to attend high school, but to our mutual joy, he is managing so far. I've had to work constantly to train myself to not reflect back his anxiety, to try to show that I know he's going to get through it, rather than wringing my hands and joining his insomnia etc. Good luck. trying to model serenity
Support Group and CBT for 16-year-old son with anxiety attacks
March 2009
My 16 year old son is experiencing daily anxiety and occasional panic attacks. He sees a therapist and a psychiatrist for medications. He is in the process of finding medicine that helps. He has expressed an interest in group therapy with other teens who experience anxiety. He is also interested in changing his therapy to someone who will teach him some Cognitive Behavior Therapy. We live in SF. Mom trying to help son
My 14 year-old is provoked by various anxieties and receives therapy in weekly small group sessions at Communication Works (cwtherapy.com - inquire w/Kris who has researched and leads anxiety groups.) The focus of my son's therapy is on examining the social thinking/cognitive component of interactions with others - e.g. for insight to probable results of particular responses. Then practicing newly learned behaviors - through communicating from a broader repertoire of choices - is encouraging his success and coping. It's an opportunity for direct application of his growing awareness through very concrete skills! Good luck from another caring mom. lize
My 16 yo daughter has anxiety disorder and so do I. I can't say enough good things about how effective CBT is for treating this disorder. It's really the way to go and to learn the skills as a teenager is fantastic. You might start with The San Francisco Bay Area Center for Cognitive Therapy in Rockridge, 510.652.4455 for recommendations/referrals. I highly recommend Deborah Efron,LCSW. She can be reached at 510-717-1415. I don't think she is taking new patients but she does provide referrals. Best of luck to your son! CBT Fan and Mom
Anxiety-riddled 13-year-old wakes me at night, calls me at work
March 2009
Okay, so I my 13-year old daughter is going through a lot. She misses school 2-4 days a month because of severe menstrual cramps, migraines, and a knee problem that stared this year. She tries to catch up but gets stress about it from teachers. But is her anxiety-riddled behavior normal? She always wants to know when I am going to get home from work. She calls me at work to report problems when she is home sick and her Dad is right there. She wakes me up at night because she can't sleep; had a bad dream; has a headache; has cramps, etc. Just last night I went to bed early so as to get to work early for an important meeting and she woke me up right when I went to sleep. I have explained to her my sleep problems. If I am awaken I get an adrenaline rush and it takes me up to 2 hours to settle back down. Her Dad was still up in the living room and she could have gone to him! I am trying to help her be more self-sufficient and let her Dad help. I know there are times when you just need your Mom, but her Dad is a great guy and I am the primary wage-earner and I need my sleep. Should I be taking her to the doctor or a physcologist for this? Is this much anxiety normal? JK
This message is also for the mom who wrote about her daughter having generalized anxiety symptoms. I am the mother of two teens and am also a psychotherapist who specializes in working with adolescents and their families. What I would suggest is for the parents to have a consultation with a therapist who works with teens. If possible, get a referral from someone you know who has had a good experience with a therapist for their teen. Articulating all of your concerns should give the person enough information to evaluate what would be the best treatment. Good luck. jan
To the mother of the daughter who is missing school, waking her up in the middle of the night needing reassurance: my heart goes out to you and her.
Please don't rule out the possibility that your daughter has experienced or is experiencing some sort of trauma (bullying or more). Start by asking her. Hopefully it's not the case, but if it is, the issue needs attention right away. Concerned fellow parent in San Leandro
I am not a dr, but there is something wrong with the picture you have described. It sounds like your daughter is crying out for help. You haven't mentioned what kind of relation your daughter has with her father (step father?). Is he concerned? And, why has he not been pro active in helping your daughter? She is still a child but if she is not going to her ''dad'' for help, there is a reason why. You need to figure out those reasons. He may be a ''great'' guy but obviously there is something else to the dynamics you have described. anon.
Dear JK,
I'm a mother myself, and this doesn't sound like a normal level of anxiety to me. Is it possible that your daughter has suffered and/or continues to suffer from some kind of trauma or abuse and is having trouble telling you about it? It might be easier for her to talk about this with the help of a professional. I would suggest getting help for her right away. My best suggestion is Dr. Marc Schwartz, who is wonderful with teens, and was a great help to my son in dealing with his issues of depression, etc. Marc's number is (415) 945- 4077. Good luck! Another Mom
To the parent seeking help with GAD. We spent 8 years working with 5 therapists to finally get a diagnosis of GAD for our daughter and she is now on Prozac. It made a world of difference. Getting the right diagnosis in our experience has everything to do with the quality of the therapist you employ- even with such a VAST selection of therapists in the Bay Area we were stunned by the ineptitude of even the ''finest'' (according to some) therapists. We got our daughter's diagnosis at last through educational testing with Jessica Lipkind (Albany PsyD.) Jessica is very professional,thorough and scientific about her work- her evaluations follow the child throughout her educational life so she is very very precise. From there we found an adolescent psychiatrist for the prozac. We are also having our daughter see a homeopath to deal with ''secondary anxiety symptoms'' - apparently the prozac only works so well with some kids (the Super Anxious) and they often recommend a Beta Blocker for secondary symptoms. That's simply TOO much medication for a little body (young teen). We have found the homeopathic remedies to be spot on- super effective. If your child's anxiety is not over the top, I would recommend seeking homeopathic help FIRST- there are many many effective remedies for anxiety and the homeopathic philosophy takes into account the WHOLE person- unlike psychologists who essentially are looking for ''disfunction''- Good luck finding the right practitioners, it is the single most important part of the journey- be sure you feel your provider is really good. anon mom
You are not alone! Your daughter has a twin and he is my 13 year old son. He calls constantly throughout the day if I am not home asking me when I am returning. If I lay down to sleep he waits until I am sleep and gets in the bed with me. I have to keep putting him out. Every decesion, he wants my help and will wake me up for anything. He won't go outside and play unless I go with him and we live directly across the street from Ohlone Park. An evaluating therapist gave me hard but honest information. We are enabling them. We have to ''push our beautiful birds out of the nest.'' You have to ask support from your husband in front of your daughter. Tell them both I am going to sleep. Do not respond to her attempts to wake you. If you are out of the house and she is with your husband and calls either don't answer or keep the call very short, ''I will be home when I get there, please only call for emergencies''. If she has a sick day from school, do not stay home with her. It is so hard. I am home on disability and he is so happy sitting up under me. Now I make sure to leave the house everyday without him, even just to go to the library or Starbuck's. You may want to get a therapist involved and get help. We found there were some other issues that needed attention. You can email me anytime. T.
13-year-old thinks she has GAD (General Anxiety Disorder)
Feb 2009
I am looking for advice/professional help for my 13 year old daughter who thinks she has GAD (General Anxiety Disorder). We are very close but I think we are at a point where either I need to seek advice or she needs professional help. Her situation is not serious but I am very concerned with the symptoms she is showing. Thanks for any input/advice :) A Worried Mama
My daughter, now 14 , was diagnosed last year with ''Anxiety Disorder, Not Otherwise Specified'' because of severe generalized anxiety. Here are the professionals who helped us, in the order in which we saw them:
-Dr. Marianna Eraklis, Orinda, a behavioral pediatrician who's terrific at sorting out normal teenage behavior vs. symptoms needing treatment. Great place to start -- highly recommend her. 925-254-4000
-Dr. Sonia Partap at Stanford, specialist who ruled out neurological disorders. Our regular pediatrician referred us to Stanford after the Children's Neurology Dept. was unable to give us a prompt appt.
-Dr. Petra Steinbuchel, psychiatrist at Children's Hospital Oakland, diagnosed her and put her on a combined antidepressant/antianxiety/mood stabilizer (Abilify) and another mood stabilizer (Topamax) . She has vastly improved on these meds. 510-428-3571
-Adolescent Psychiatric Unit, Herrick Hospital, Berkeley. My daughter has been hospitalized voluntarily twice in the last 6 months, due to thoughts of cutting herself and suicide. Great program, really helped my daughter.
-Partial Hospitalization Program (PHP), Herrick Hospital. Daytime outpatient program, child sleeps at home; provides transition between hospital and usual life.
-UC Psychology Clinic, Berkeley. Open to public; sliding scale. PhD grad students provide care under supervision. We've worked with Jenna for individual therapy and Lian for family therapy. Both are excellent. 510-642-2055
-Marchus School, Concord. Public school for kids with emotional and social problems interfering with regular school. Outstanding staff and program. 925-602-6150
-Contra Costa County Dept.of Mental Health. Providing free therapy at school site. Contact your county dept.for info.
I know how scary this can be. Feel free to email me at for support. Nancy
Hi,
I'm a retired primary care doc. Yes there are important differences. Prozac (fluoxitine) tends to be more energizing while sertraline is more calming. I don't have statistics but there were reports of teen suicides with Prozac many years ago. They may not have proved statistically significant. You can probably find out about that by Googling Prozac and teen suicide. In terms of adults, sertraline tends to have greater positive results for depression, but as you say, it has to be individualized. As far as OCD, my own choice is, as much as it may dismay you, marijuana. You can Google Dr. Mike Alcalay (now deceased) who was the expert in the field of medical marijuana and for OCD. Under his name you may (hopefully) find a segment on 60 minutes with Mike where a very young child with OCD was so unmanageable that he could not be kept in school. On marijuana that his mom cooked into brownies every day he became almost instantly calmed and returned to school and was integrated well when the report was done (maybe 20 years ago). I don't know how much weight the poor child put on and I don't have any follow up into his teen years. He took a high dose. My choice of anti-depressants in elders has long been sertraline. Taken before bed it can also help them sleep. Medicating a 13 old with psychoactive drugs requires close monitoring (hopefully by a counselor).
Marc Sapir MD, MPH
I cannot speak to comparing the 2 medications but here is how to avoid any side effects with either med. Instead of starting say at a dose of 10mg of Fluoxetine, ask the Pharmacist for tablets in stead of capsules. Then you can cut them into quarters. Start off at 2.5mg for 2 weeks, then every 2 weeks increase by 2.5 mg. This will do 2 things: 1) There will be zero side effects with this gradual build up, and 2) it will help you titrate exactly how much medication is needed so your child will not take more than is needed to control their symptoms. You will know when an adequate dose is reached and it may be 7.5mg rather than 10mg, or 12.5 rather than 20mg for example.
Hi! I would recommend treating the ADHD first- once this is treated other things fall into place. I have lifelong experience with this. The longer the ADHD is treated, you have positive experiences to build self esteem. When the adhd treatment (medication) isn’t there it’s like riding a bike without glasses.
Hello! I’m so glad you are considering medication treatment for your child! I’m a family med doc who prescribes SSRIs for a range of ages and conditions. Also, my son took Zoloft for 3 years for depression and I have friends whose dtr has responded really excellently to Zoloft for OCD
Everyone responds differently to different SSRIs but the 2 main differences are that Prozac is more energizing (which can be a pro or a con) and also Prozac has a longer half life so if your child is likely to miss doses (due to all kinds of individual and family-related factors) then the effect of the Prozac will be steady even in the face of erratic dosing.
good luck to you and your family