Angela has missed many days of school due to frequent stomach upsets and headaches, but her family physician can’t find a physical explanation for her condition. Randy, a formerly calm child, begins to argue constantly with his family, exploding into tantrums and refusing to talk things through. His grades are suffering, and his teachers report he is “oppositional” and “unmotivated.” Steve shies away from group activities and spends much of his time worrying. He seems anxious about grades, about whether to ask girls out to a movie, and what classmates think about him. These scenarios are fictional, but they represent some of the ways typical adolescents react to stress.
Adolescence can be a highly stressful stage of life. Issues related to forming an identity and adapting to impending maturity are central to an adolescent’s anxiety. The teen years and early adulthood are times when everyone struggles with the question: “Who am I?” This struggle begins as teenagers experience physiological, psychological and psychological changes. As adults, we can be most helpful to teens by providing support and helping them make sense out of their experiences. We can also help them develop the skills to better manage their reaction to situations that trigger anxiety.
Teens will mature more happily if they know how to cope with stress. They will also be healthier. In a long-term study of alumni, Harvard researchers found markedly higher rates of physical illness in people who had difficulty managing stress during their college years. In part, stress weakens the immune system and increases the risk of a host of physical illnesses. The more we help teenagers understand anxiety and deal wisely with it, the better we prepare them to manage jobs and relationships.
Physiological changes occur quickly during adolescence. Imagine looking in the mirror each morning only to see your body stretching upward and outward. Your face seems to change shape, your skin erupts, and various body parts take on a life of their own. Meanwhile, you are developing a strong yet unfamiliar sex drive that is difficult to predict or regulate. These changes may directly affect self-image and peer relationships during adolescence. For instance, girls who reach puberty early may suddenly find themselves struggling to keep up with a new, older group of friends.
Family relationships undergo changes as well. As adolescents struggle to develop a separate identity, they also need to redefine their relationships with their parents. This creates an additional stressor: teens sense the need for adult guidance, but their quest for independence makes it difficult to ask for help. While most still worry about what their parents think, they are also keenly aware of the growing, overshadowing influence of their peers.
Both socially and academically school can be particularly stressful for adolescents. Once out of elementary school, they find their teachers putting a new emphasis on organization, deadlines and the mastery of large amounts of information. Learning differences such as attention deficit disorder may first show up in adolescence. Existing disabilities may intensify. The competitive atmosphere — social, academic and athletic – encourages adolescents constantly to compare themselves to their peers. Furthermore, to succeed in school an adolescent must be fairly savvy about dealing with teachers, counselors and other adults in their lives. Consequently, their self-image is in a continual state of redefinition. As they mature and earn more independence, decisions about the college or job, or both, can provoke a new area of anxiety. For any or all of these reasons, academic performance may suffer during adolescence, sending grades plummeting and inviting discipline at home and in school.
How can adults best help adolescents survive these stressors? First, it is important to speak to them in a non-judgmental way. For instance, teenagers often do things their parents consider wrong. But, for an adolescent, these actions represent steps toward developing a personal identity. If parents understand this, they can help their children learn from these experiences, face decisions confidently and build on their competencies.
Adults communicating with teenagers should ask themselves: “Do I appear genuine? Does my behavior reflect what I say?” “Does my child feel understood? Or does he or she feel rushed and unimportant?” “Do I show interest in my child’s whole self: the interests and relationships as well as the problems?” “Am I lecturing at him or talking with him?” “Do I help my child make sense of experiences that might otherwise be discouraging?”
Conversation with your adolescent should not be reserved exclusively for times of crisis. Talking regularly about their friends, schoolwork and outside activities lets them know you are open to their ideas and problems. There is an additional benefit to consistent communication: it helps you read an adolescent’s feelings so you can step in promptly if you sense a real problem brewing. You will know what is normal for your child, and what signs may indicate the need to seek help from a psychologist experienced in working with adolescents.
In addition to talking regularly with teenagers, it is often useful to help them learn special strategies to help them manage their anxieties. Sometimes merely having a fallback plan helps to reduce a person’s anxiety. For example, if a boy is nervous, ruminating or “feeling stuck” before a college interview, he may benefit from practicing problem solving skills. In a supportive manner, help him define the problem or source of his anxiety. Then help him generate several possible ways to intervene. From the various options, support him as he finds the plan that may best suit the situation. He may be worried about answering the interviewer’s questions or that he will say something “dumb.” In this case, part of the strategy would be to practice answering a wide variety of questions and developing a way to respond if he is unsure how to respond.
Other strategies may involve imagery or relaxation techniques. If a student is becoming sweaty and uneasy during her SAT exam, she might relax by taking a few minutes to close her eyes, breathe slowly and imagining the sights, smells and sounds of a place she finds particularly pleasant and relaxing. The strategy will not make the problem go away but it may reduce her anxiety and clear her head. Feeling more comfortable should help her relax and perform better on the exam.
Communication with adolescents is a worthwhile a challenge, especially considering the alternative. Left to their own devices, children will seek out other, possibly unhealthy solutions. To avoid constant conflicts with parents or teachers, adolescents will attempt to reduce stress by shutting you out, seeking advice only from peers, or self-medicating with drugs or alcohol. All these factors underscore the need for adults who live and work with adolescents to stay in touch with one other.
Sidebar I: Signs that an adolescent may be feeling anxiety * Avoidance of various activities: not attending class, frequent absences * Growing sense of haziness in one’s surroundings, extreme tenseness, fear of going crazy * Lightheadedness, racing heart, fear of losing control, upset stomach, * Unusual shyness or social isolation * Physical complaints that may be direct results of anxiety: stomach upset or pains, headaches * Excessive fear of social interaction * Explosive/non-compliant behavior tantrums, etc. * Sensation seeking behavior; drug use, excessively sexualized behavior and dress * Panic attacks or excessive worrying
Sidebar II Panic attacks are an expression of extreme anxiety. They can be frightening and are not uncommon in adolescents, but since teenagers want to be independent, they may not mention the attack to a parent or adult. Typically, they occur at social events, or under academic stress, but can also be brought on by a movie or in certain family situations. Inexperience may lead adolescents to self-treat to avoid the sense of panic, or they may try to avoid the stimulus entirely. The self-treatment is often drugs or alcohol, creating separate dangers. And when math tests are the stimulus for panic, avoidance can lead to academic failure. A parent can help by identifying the symptoms: a sense of entrapment, lightheadedness or the sense of growing haziness in one’s surroundings. Above all there is an undeniable urge to escape. The adolescent can learn various strategies to manage the panic attacks. Get fresh air — go outside if possible. Sit down if you’re standing, use muscle relaxation techniques or visual imagery of a safe, nurturing place.
Dr. Friedman is a licensed psychologist, practicing in Lawrenceville. Living Well is contributed by members of the Mercer County Psychological Association. For information or a referral, call the New Jersey Psychological Association at (800) 281-6572.
Kate O’Neill collaborated with Dr. Friedman on writing this article.