A Deep Dive into Adolescent's Anxiety - Dandelion Training & Development

The NHS defines anxiety as “a feeling of unease, such as worry or fear, that can be mild or severe”, it’s prevalence in the population has seen a steady increase over recent years and in 2016 Mind.uk identified that around 6 in 100 people suffer with anxiety issues and Anxiety UK suggest that 1 in 6 teenagers will experience anxiety. This means that on average there will be around 5 children in any given classroom experiencing anxiety symptoms at any one time. The Fundamental Facts of Mental Health Paper 2016 found that ‘in the UK, women are almost twice as likely as men to be diagnosed with anxiety disorders. From the APMS (2014) results it can be deduced that, in England, 6.8% of all women were diagnosed with general anxiety disorder compared to 4.9% of all men.’ It was shown that generalised anxiety disorder diagnosis’ rose from 4.4% in 2007 to affect 5.9% of the population by 2014.

Types of anxiety include:

Separation Anxiety– most often found in younger children who are fearful/worried about being away from one or both parents
Generalised Anxiety– Anxiety about a wide range of issues or situations
Specific anxiety– Anxiety related to a specific thing, situation or activity (may progress to phobia in some cases)
Social Anxiety– Anxiety related to social situations
School Based Anxiety– Anxiety focused around school routines, activities or transitions

Anxiety symptoms vary from mild to severe and as such every individual with anxiety will experience different issues to navigate. The most common symptoms include: raised heart rate, excessive worry, panic like feelings, feeling tearful or upset, sleep issues or nightmares, fear, regressing behaviours including bed wetting, negative thought patterns, avoidance of situations, social isolation, withdrawal, difficulty concentrating, anger, fidgety behaviour, increased toilet visits, physical symptoms (stomach aches, chest pain, breathlessness, sickness) and panic attacks. These may be isolated symptoms or in any given combination, or in specific combinations depending on the scenario being experienced.

So, what exactly is anxiety and were does it come from?

Anxiety is a scenario in which the brain’s thought processes are living in the future and therefore in a state of fear of ‘what might happen’. In its simplest term the brain is functioning in a fight-flight mode where it feels that situations that are ‘coming up’ will be dangerous or unsafe so the central nervous system releases a set of reactions to prevent the person from entering this ‘unsafe territory’. Whilst one school of thought was that the subconscious mind (where these behaviours are created) was programmed to ‘keep us safe’, Watts (2016) explores the concept that our subconscious is reacting to a “stimulus or sequence of stimuli with a response that has been employed before under similar circumstances – and because you are not dead (i.e. it led to survival) such response would be ‘tagged’ as valid” as such, once the brain has learnt a set of programmed responses of anxiety to given circumstances it repeats these patterns until it is taught something new.

If we look at the symptoms of anxiety their primary goal is to ‘warn’ us that something isn’t right – if we do not heed their warning we will not move forward into the situation, albeit school, exams, tests or new events. Their sole purpose is to ensure that the human remains safe and well so if the warnings are not listened to and we ‘push’ or encourage the individual to push forward we often find that these anxiety symptoms continue to progress. This miscommunication in the brain’s thought processes mean that the individual may struggle to cope with situations that they previously found to be fine.

So why does it happen?

The answer lies within our brain development brain compromises three core areas:

The Reptilian Brain – the physiological function part of the brain
The Limbic Brain– the emotional/motivation/behaviour part of the brain
The Neocortex– the rational/logical part of the brain

All the messages within these sections are run by neural pathways which run through the brain carrying messages. These regulate everything from our behaviours, to development of learning areas and our emotional regulation. Whilst we are aware that a huge part of this development occurs during childhood this continues to progress through adolescence, particularly in the limbic part of the brain, and studies indicate that this development continues to 25 years where it slows (but continues developing new pathways and learning). The brain reinforces and strengthens or changes the neural programming developed as we refine our skills throughout this period to find the most efficient pathways, this is examined in the concept of ‘brain plasticity’ in which we see adolescent’s thought processes become cemented and set rather than more fluid in younger years. The fast changes and stimuli influences from the environment in adolescence can cause disruption to this development and as such adolescence shapes much of the brains development for future years.

Whilst all three parts are active in your teenager this may already explain why when you explain that their anxiety is ‘irrational’ in some contexts they already know this but are distressed because it doesn’t FEEL this way. The reason being that their anxiety is created as a conflict in the limbic system. Essentially in the concept of anxiety the limbic part of the brain is overactive, the messages being received are exasperated by fear and are not rationalised.

The fast development of the limbic brain during adolescence therefore lends itself to being more susceptible to anxiety, and as such the individual labels themselves as ‘anxious’ and starts to adapt their behaviours to avoid any situations which make them feel this way, over time consolidating the pathways and as such taking these behaviours into adulthood. It is worth noting here that in situations where children reside in a home with parents also experiencing anxiety this process is often seen in greater effect as the ‘norm’ to avoid particular situations or to normalise anxiety is higher from the point of nurture from our environments (NB: This is not a point of blame merely a fact that children are influenced by the behaviour patterns that they experience during this rapid period of development).

So why are teenagers experiencing higher anxiety than previous generations?

Overstimulation from social media

Social media, having only been in existence for the last ten or so years, is quintessentially a component to teenage anxiety that has never been experienced by previous generations. The growth of technology and smart phone access in the last few years means that it is a rarity to meet an adolescent (or adult) who is not connected to one and thus social media channels. Multiple reports and studies have shown that the overstimulation that social media creates to the reward based system in the brain interrupts sleep, concentration and social connections for many young people. The Child Mental Health Report 2017 identified that ‘nearly 90% of 16-24 year olds use the internet for social networking’ and this usage has an impact on adolescent mental health.

The rapid development of the limbic system during adolescence combined with the heavy usage of social media (to connect, distract, network and play with) is shown to be increasing the susceptibility of anxiety and depression in adolescents. As the brain development is changing constantly and neural pathways are programming and changing to become more efficient the overstimulation from social media can exasperate the fear response in some teenagers.

Social media encourages us to explore, experience and connect with visual and auditory stimuli we would otherwise not encountered. The utilisation of social media platforms, Youtube and connecting platforms means that at the touch of a button we can view content that would have previously been removed from our view. Think for instance, that 10-20 years ago the news would have ‘spoken’ about incidents but now we can log onto social media and witness videos of terrorism, murder or animal abuse at the mere touch of a button and often completely involuntarily as one networked person sharing this content means that we can view it. In adolescence, as the brain is developing coping mechanisms and pathways for emotional development this content can create a fear response and anxiety in the individual viewing it, especially if they had previously experienced anxiety responses.

Perfectionism extremes

Social media has brought with it a new pressure to be ‘perfect’. Rewind 10 years and the most that a teenager had to contend with was the weekly magazines or TV channels. However, the advancements in technology have not only influenced the use of air brushing but brought with it the use of filters, snap shot moments of lives and an imagery of ‘perfection’ which for the majority is unobtainable. ‘Overnight sensations’ arrive on social media channels with the perfect imagery of life displayed but without the acknowledgement that many of these platforms have been building over years and many have teams of social media specialists generating the content/marketing and presentation of said channels.

The issue for the adolescent generation (and many adults) is that the reward based system of the brain which is activated on the response of a ‘like or comment’ on a social media post. Whilst in the early development of social media those individuals who deleted posts with underachieve engagement were labelled ‘narcissistic’ it is becoming apparent that this may be linked to a decline in mental health and well-being in which the limbic brain system is not receiving the rewards that it has become addicted to. Coupled with disproportionate images of the ‘overnight social media sensation’ the gap between reality and expectation can lead to anxiety and depression in many adolescents. Twenge (2017) identified that ‘heavy users of social media increase their risk of depression by 27 percent’ – if we look at this in reality an adolescent using social media for a few hours each day can easily be using social media for 10-20 hours a week quite easily and being overstimulated by this imagery and the false entities of a social media show case and develop a distorted sense of reality and themselves, considering themselves inadequate and therefore developing anxiety.

Immediate gratification

For every post uploaded to social media the subsequent ‘likes’ and ‘comments’ crate a sense of reward and gratification for the individual, this in turn releases dopamine. Dopamine, a neurotransmitter, is responsible for the sending signals between the neutrons in the brain. Dopamine is the response that is activated in relation to unexpected rewards and is believed to be related to the addictive qualities of such behaviours. Social media, in essence, is a reward centred response to the reassurance and attention of those watching us on social media.

The very nature of dopamine means that social media can quickly become addictive to individuals, particularly if other areas of life are stressful or not going to plan. The reassurance of the dopamine response to our social media posts means that individuals behind them are given an instant buzz. it is interesting (although still being explored and not definitive) that research has shown that in negative situations the dopamine response is not activated and as such raises a question that when an individual is struggling with an aspect of life (and thus has no dopamine response) that the impact of social media buzzes would fuel this addictive nature?

Regardless we can see that a lack of engagement on social media posts (and thus no dopamine release) can trigger anxiety in adolescents reliant on such a buzz to feel that they ‘fit in’ or are accepted.

Reduced connection to people

It seems incongruent that with multiple social media platforms which lend themselves to connection that loneliness, depression and anxiety are at their highest levels for 25 years in the UK (Parentzone, 2016). The impact of typed conversation versus emotional connection has regularly come into play in this debate. In a generation where the majority of young people carry a mobile phone we know that cyberbullying is affecting increased numbers of young people. The Annual Cyberbullying Survey 2013 found that ‘7 in 10 young people aged between 13 and 22 have been a victim of cyberbullying’. The NSPCC report that ‘over the last three years there has been an 87 % increase in the number of Childline’s counselling sessions about online bullying’.

So, whilst we are better connected than ever before the quality of connections is, in many cases, poorer than ever. Many young people reporting feelings of anxiety discuss feeling that they cannot talk to anyone about this, and it could appear that the reduction in emotional connection and awareness, instead relying on the interpretation of written status’ or texts may be a contributing factor to this. Prior to the inception of mobile phones and social media individuals would write, phone or visit, whereas now many parents will report concern that their teenagers spend large quantities of their time ‘behind screens’.

The perception of some people that individuals use social media for ‘attention seeking’ behaviour e.g. oversharing, ranting, sharing personal information seen as inappropriate can also lead to a risk of us overlooking the cry for help of an individual person who has previously overused social media. As such this raises questions about the use of social media and the way that we interact, as feed algorithms begin to only show us those who we interact with regularly are we at risk of missing the important support services that may help someone in emotional distress or need? And could we ‘miss’ the individual who is screaming for help because we do not regularly ‘like their post’? Perhaps our most important questions is how do we rebuild our ‘real life’ connections?

Increased expectations

It has been found that a quarter of students report experiencing a mental health disorder. YouGov (2016) report ‘Anxiety and stress are commonplace among students, and the effects are often obstructive. Six in ten (63%) students say that they feel levels of stress that interfere with their day to day lives. Additionally, 77% of all students report that they have a fear of failure, with one in five of these saying that this fear is very prevalent in their day to day life.’ So how does our education system affect this?

Changes in education grading systems, earlier school transitions and the pressure of exams have all been reported in various articles as affecting the mental health of children within the education system. When we refer to the earlier reviews of the fast acting development of the limbic system and the need to support neural pathways development it is important to look at how we can best support anxiety related symptoms. As the brain is developing efficient systems and coping mechanisms offering children and adolescents safe spaces to explore and refine their skills is imperative, as is the role of consistent carers who can work with the adolescent and the families. If we can support the anxious teenager appropriately they are able to re-programme their own responses to old triggers.

Foremost ensuring suitable support in transitions, the implementation or realistic expectations and the installation of firm boundaries and key workers for children and adolescents all lend themselves to this support. Inevitably we see much news footage given to attendance, exams and parental involvement and it should be examined that placing young people under tremendous pressure to obtain consistent grades through all subjects may be unrealistic and stress triggering. A holistic approach to supporting core planning systems, individual goals and expectations can all contribute to reducing anxiety around school and education.

What can you do?

So, what are the next steps as a parent or carer? Whilst the statistics can make for concerning reading all is not lost and help is in place, though sometimes hard to find. We are all in the same boat with this generation, we need to TAKE POSITIVE STEPS to support our adolescents as they navigate their next steps. Which is why I created my ‘5 Steps to Supporting Teen Anxiety‘ guide. Exploring teen anxiety and offering my professional advice as a therapist and from my 14 years as a lecturer to college and university students to create simple first steps you can use with you teenager at home in relation to their personal, social and intellectual development.

One of the greatest things I have found is that when I meet many parents they are at their wits end with worry about their child and desperately seeking support and simple resources that they can put in place to feel that they are aiding their child as they navigate anxiety. Which is why my ‘5 Steps to Supporting Teen Anxiety‘ guide offers 5 steps to help you navigate, support and engage with you teenager without feeling like you put your foot in it. You can get your copy of my guide by clicking HERE.

You can additionally speak with your child’s pastoral support department within their school/college who will have in-house support available for them.

There is also a wealth of online support through Anxiety.Uk and Mind.org.uk who offer information, advice and fact sheets about anxiety. Knowledge is, as with most things, power and being able to engage with your teenager and understand their anxiety will allow you to open communication and move forward.

I hope that you have found this information helpful, if you know a parent, carer or even a teacher who would benefit from it please do share it with them (one click of a button may be a life saver in this situation for a parent at their wits end), and if you would like a copy of my ‘5 Steps to Supporting Teen Anxiety‘ guide you can find it in the shop area.

Further help

For more articles about mental health visit – https://dandeliontraininganddevelopment.com/articles-resources/

To learn more about child and adolescent mental health visit – https://dandeliontraininganddevelopment.com/courses/

For resources to support child and adolescent mental health visit – https://dandeliontraininganddevelopment.com/shop/

References:

Annual Cyberbullying Survey 2013 – http://www.ditchthelabel.org/downloads/the-annual-cyberbullying-survey-2013.pdf

Childline Review Under Pressure (2014) – http://www.nspcc.org.uk/globalassets/documents/annual-reports/childline-review-under-pressure.pdf

Children and young people’s mental health —the role of education, Education and Health Committees – https://publications.parliament.uk/pa/cm201617/cmselect/cmhealth/849/849.pdf

Newton, P (2009) What is dopamine, PsychologyToday – https://www.psychologytoday.com/blog/mouse-man/200904/what-is-dopamine

Parentzone 2016 – Child Mental Health and the Internet – https://parentzone.org.uk/article/children-mental-health-and-internet-2016

Smith, M (2016) – YouGov Uk – https://yougov.co.uk/news/2016/08/09/quarter-britains-students-are-afflicted-mental-hea/

State of Child Health Report, 2017 – https://www.rcpch.ac.uk/system/files/protected/page/SoCH%202017%20UK%20web%20updated.pdf

Steinberg, L. (2008). A Social Neuroscience Perspective on Adolescent Risk-Taking. Developmental Review : DR, 28(1), 78–106. http://doi.org/10.1016/j.dr.2007.08.002

The Fundamentals Facts of Mental Health 2016, Mental Health Foundation – https://www.mentalhealth.org.uk/sites/default/files/fundamental-facts-about-mental-health-2016.pdf

Watts, T (2016), BrainWorking Recursive Therapy Training Level 1

2017 Children’s Mental Health Report, Child Mind Institute – https://childmind.org/downloads/2017-CMHR-PDF.pdf