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Coping with anxiety is different for everyone. There is not a one-size-fits-all description of what it looks like, feels like, or how to treat it. About 9.4 percent of young people aged 3 to 17 years, which is approximately 5.8 million people in the United States, were diagnosed with anxiety disorders between 2016 and 2019, according to the Centers for Disease and Control. That number is on the rise, according to reports from JAMA Pediatrics, and between friends, family, and content on social media, there is a lot of information out there about anxiety and other mental health conditions. It can be overwhelming to decipher and understand what anxiety and its symptoms are, but there are some common signs to look out for.
Three experts, Dr. Neha Chaudhary, Chief Medical Officer at BeMe Health and child and adolescent psychiatrist at Massachusetts General Hospital and Harvard, Dr. Kathy HoganBruen, licensed clinical psychologist and founder of District Anxiety Center in Washington, D.C., and Dr. Naomi Torres-Mackie, licensed clinical psychologist at Lenox Hill Hospital in New York and Head of Research at The Mental Health Coalition, break down the facts about anxiety symptoms. Here’s what the experts had to say, and where to find the most effective resources for anxiety.
First things first — what is anxiety?
Anxiety disorders are typically characterized by feelings of tension, intrusive thoughts or concerns, and persistent, intense worry and fear, as defined by the American Psychological Association. It’s common and normal to experience anxiety at some points in life — whether it be while studying for a big exam, preparing for a job interview, or moving to a new town. But once these feelings of dread, worry, or fear begin to impact your everyday routine and weigh on you all or most of the time, then you may have an anxiety disorder.
“On a technical basis, anxiety is triggered neurologically by an excess or lack of neurotransmitters like GABA [a chemical messenger in your brain that produces a calming effect], and on a lived experience, anxiety can be triggered by anything,” Dr. Torres-Mackie explains. “Some common triggers, though, include social situations, enclosed spaces, public speaking, and new experiences.”
Anxiety can also be triggered by stressful or traumatic life events, or certain medical conditions like hyperthyroidism, heart disease, diabetes, or chronic pain, according to the Mayo Clinic. It may also be due to genetic or family history, if a blood relative has an anxiety disorder or other mental health condition.
While stress is closely aligned with anxiety, there is a difference. “Everyone feels stressed from time to time; stress is a normal part of life,” Dr. Chaudhary explains. “Anxiety, however, is a condition, and although it might be fairly common, it means that something going on with your brain is different from the usual and might need treatment or support.”
“I think of stress as the more casual version of anxiety,” Dr. Torres-Mackie adds. “If you have worried thoughts that distract you or get in your way of accomplishing tasks, or you have physical symptoms of anxiety that make it difficult to get through your day, you are likely experiencing anxiety.” There are treatment plans and ways to manage and mitigate anxiety, so if you feel that you may have an anxiety disorder, you have options. Call your primary care doctor to set up an appointment, or reach out to a trusted adult or school counselor. They’ll be able to help you navigate next steps. More information on that below.
What are the most common symptoms of anxiety?
Although anxiety disorders affect people differently, it’s important to be aware of the common symptoms. “Most teens I work with say that they know their anxiety is worse when they start feeling restless inside, seemingly without a reason, and they aren't sure how to make that feeling stop and find a sense of peace,” Dr. Chaudhary says. “Other people say that they find themselves worrying a lot about all sorts of things, and they feel like they can’t control the worrying.”
You might find yourself imagining a number of “What if...?” scenarios, Dr. HoganBruen adds. What if I fail this test? What if this plane crashes? What if I get sick? “Your thought process starts running away from you and speeds up and rattles off a bunch of worst-case scenarios,” she explains. “When those ‘what ifs’ have gotten away from you, we call that catastrophizing, which is turning small things into big things that are not really likely [to happen].”
These feelings of unease might disrupt everyday routines and the ability to concentrate, whether you’re doing homework, watching a movie with friends, or having a conversation with someone. You don’t feel present in the moment and might even feel irritable or tense. “Many people say that they notice themselves snapping more at their friends and family, and they often feel badly right after because they know it's not normal for them to do that,” Dr. Chaudhary explains.
What are the lesser-known symptoms of anxiety?
“There are several symptoms of anxiety that show up physically in your body, and although these types of symptoms are very common, they're usually not as well-known,” Dr. Chaudhary says.
You might feel your heart racing and/or knots in your stomach. Experiencing muscle tension or headaches and feeling hot and sweaty is also common, Dr. HoganBruen explains. You might recognize these symptoms before you realize they’re connected to anxiety, she says.
Feeling tired or having trouble sleeping are also behaviors to note. “Many people with anxiety feel really tired all the time, no matter how much they may have slept the night before,” Dr. Chaudhary says. “Their sleep tends to get affected as well — they may have trouble falling asleep because their mind keeps going, or they find themselves tossing and turning all night.”
What triggers anxiety?
There are many different scenarios or events that might trigger feelings of anxiousness in someone. “Sometimes there are specific things that might trigger anxiety, like a series of tough deadlines or tests in a row, a breakup, a fight with a friend, or another negative event that really impacts you,” Dr. Chaudhary says. “Other times, there's no specific trigger — it might be how someone's brain is wired based on the genes that run in their families.”
Working with a therapist can help you pinpoint these triggers and come up with a treatment plan to address your symptoms. “It's important to see your doctor to rule out other causes for your symptoms,” Dr. Chaudhary adds. “If those are ruled out and you're still struggling with some of these symptoms, it's time to see a mental health professional. They'll evaluate to see if you might have anxiety, and the good news is that if you do have it — it's treatable just like most other conditions that you might see a doctor for.”
What are the best ways to deal with anxiety?
First, check in with yourself. Make sure that you’re getting enough sleep and definitely put your phone away before climbing under the covers. “Leave your late-night scrolling behind, get in bed earlier than you usually would, and see if you can go to sleep and wake at roughly the same times every day,” Dr. Chaudhary says. The ideal sleep time for teens is 8-9 hours uninterrupted, Dr. HoganBruen advises.
Try to eat nutritious foods and do the activities that help you feel grounded, whether that be meditating, exercising, journaling, listening to music, or reading. “What anxiety does is activate your sympathetic nervous system or your fight or flight response,” Dr. Torres-Mackie explains. “To combat that, you want to activate your parasympathetic nervous system that can give you a sense of calm.”
If you find yourself asking a lot of “What if?” questions or catastrophizing situations, try asking yourself “What am I afraid of?,” Dr. HoganBruen suggests. “Try to use your best logical brain to assess if that fear is real and founded versus just a plain worry that's expanded in your head,” she explains. If your anxiety stems from something real and founded, such as an upcoming exam or low grades, you can then “move into problem-solving mode” and assess your possible solutions. “If it's unfounded anxiety, then you want [to try to] right size your worries so that you're not catastrophizing something small and turning it into something big,” Dr. HoganBruen adds. For instance, if a friend doesn’t respond to your text, that doesn’t mean they want to end the friendship – they may be busy, working, sleeping, or simply not around their phone.
However, if you feel that your symptoms of anxiety are becoming too difficult to manage on your own, it might be time to reach out to a healthcare professional or trusted adult to schedule an appointment with a therapist. If you’re unable to go to your primary care doctor or don’t feel comfortable talking to your parents or guardians, you could also go to a school counselor for help. “I have a simple rule of thumb: if you feel like anxiety is negatively impacting your daily life, then it's time to see a clinician,” Dr. Torres-Mackie says. “Also, if you are wondering if it's the right time, it likely is.”
Therapy is not as affordable or as widely accessible as it should be, but there are lower-cost alternatives. Do some research and see if there are therapists in your healthcare network who accept insurance, which often lessens the expense of appointments. Some therapists also offer services on a sliding scale, which means that the fee is based on a patient’s income. Call ahead and see what options are available, or check out the clinician’s website.
Don’t forget — several resources exist on your phone, as well. Apps such as BeMe, Calm, and Headspace offer resources, activities, and communities to help you navigate your anxiety and other mental health conditions. Lots are free to download and use, while some offer subscription plans at an additional, but more affordable, cost.
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