Your Teenager Is Not Crazy

by Jerusha Clark

  Classes were harder, and he felt anxious about his grades. The kids were meaner, and Jared, who was nicely called a “late bloomer” by adults and cruelly termed lots of unprintable things by other teenagers, had been the subject of some vicious online teasing—not quite cyberbullying, but ugly and hurtful nonetheless.

  Now, about to start his freshman year of high school, Jared felt stressed all the time. He hadn’t been able to enjoy the summer, even though his parents had done everything they could to make it fun. Even going to a local water park had been worrisome. What if a tube broke open while he was sliding down? What if he got caught in the drain beneath the gigantic wave pool? What if he saw one of the guys from school who hated him for no reason? Jared knew on an intellectual, rational level that these thoughts shouldn’t paralyze him with anxiety, but fear gripped him anyway.

  At least once a day, something happened, and his breathing became shallow, his heart rate spiked, and his body went on high alert with every muscle tensing, every nerve tingling. He couldn’t tell if he wanted to puke, run, scream, or hit something as hard as he could.

  Tonight was the fifth night in a row Jared awoke at 2:00 a.m. in a cold sweat. He was sure it had something to do with starting school this morning. This morning. How was he going to make it?

  Bio 101

  Anxiety is one of the most common health concerns experienced by today’s adolescents. Depending on the intensity, frequency, and symptoms that characterize it, anxious teens may be described as stressed out, worried, afraid, nervous, freaked out, prone to panic, or throttled by obsession and compulsion. These labels all point to a nearly universal experience for teens: adolescent life is full of uncertainty, and there’s always a reason to “flip out.”

  For many parents, it’s difficult to discern between typical stress or worry and the kind of anxiety that needs medical attention. If you’re in that position, take a deep breath. (Don’t forget, a deep breath really does work to renew brain cells and change your thought processes!) The more anxiety you feel about your son’s or daughter’s experience, the less able you’ll be to see clearly, sort through the facts and fears, and tackle this teenage trial head-on.

  Approximately forty million Americans, including 25 percent of the youth population,1 battle a clinical anxiety disorder, defined by “marked distress and functional impairment in the short-term, [which] can derail the normal developmental trajectory and place youth at risk for a host of poor outcomes over the long term. . . . When left untreated, youth with these conditions are at risk for diminished school performance, compromised family functioning, and increased rates of psychiatric disorder in adulthood.”2

  Using this definition, parents can separate a clinical disorder from relatively normal levels of anxiety. If worry inhibits daily functioning, the development of social skills, and academic advancement, or if fears—like Jared’s—are manifesting in physical symptoms, it’s time to get help.

  Tragically, as is true with depression and other mental health concerns, only a small percentage of sufferers seek treatment. Because adolescents usually aren’t proactive in asking for assistance, the numbers are grimmer for this population. We use the word tragic to describe this, not to be melodramatic but because anxiety is a highly treatable condition that responds well to a variety of treatments.

  Don’t dismiss concerns that are impinging on your child’s daily life. Assuming “this is just a phase” or hoping “things will get better after . . .” will only delay the important first step of admitting there’s a problem. Fearing that the diagnosis of an anxiety disorder condemns your child to a life of mental health struggles or that your teen will have to take medicines that “make him or her a zombie” are unhelpful and untrue suppositions. There’s great hope and help available for adolescents with anxiety. If your adolescent has been struggling with anxiety for longer than a couple weeks, be brave; your child needs you to wade into this complexity unafraid and unashamed.

  As we’ve previously noted, the neural remodeling that occurs during adolescence can uncover genetic or chemical vulnerabilities. The teenage brain appears more susceptible to a variety of psychiatric conditions. Knowing this need not increase our worry. Instead, it should inform our awareness and direct our intentions.

  In the spirit of these goals, and in order to best confront the anxiety our teenagers face, we must understand a bit about the brain structures that control our experience of fear and worry. Chief among these structures are the left and right basal ganglia. An intricate set of neurological networks, the basal ganglia (BG) play an essential role in the processes of thinking and learning. The BG also help other areas of the brain turn experience and emotion into action.3

  According to Change Your Brain, Change Your Life Before 25 author Dr. Jesse Payne, the basal ganglia maintain a healthy body’s “idle,” integrate feelings and thoughts, make movements smooth by tuning fine motor skills, modulate motivation, and mediate pleasure. When the BG are impaired, either temporarily or for an extended time, the body’s “idle” runs too high; hypervigilance, muscle tension, conflict avoidance, and excessive fear of being judged by others result. An adolescent with poor basal ganglia functioning often assumes the worst, “freezes” when nervous, appears shy and timid, engages in self-injurious activities (e.g., biting fingernails or picking skin), and/or complains of headaches and stomachaches. Some teenagers manifest BG problems by exhibiting panic or unhealthy drive, which keeps them from being able to relax or slow down.4 A variety of anxiety disorders can develop.

  In adolescents, generalized anxiety disorder (GAD) usually manifests in excessive concern related to family, school, work, extracurricular activities, and social interactions. Those with GAD may be overly anxious about performance, punctuality, or the ability to deal with potential problems.

  Social phobia, or social anxiety disorder, in teenagers goes beyond normal worries about fitting in. In a battle with this condition, the fear of being judged, rejected, or abandoned, along with an insatiable need to be affirmed, becomes so unbearably weighty that teens may feel physically ill in social situations and lack the skill to “talk themselves down” and “go with the flow.” Telling an adolescent fighting this to “just chill” is not only unhelpful, it may in fact increase anxiety, causing a young person to obsess about his or her inability to relax.

  Panic disorder is often identified by the dramatic and arresting “attacks” that accompany it. Adolescents experiencing a panic attack may complain of a pounding or racing heart, feeling unable to breathe, tightness in the chest, tingling or numbness in the limbs, excessive sweating, feeling excessively hot or cold, or intense stomach pain. Panic attacks can occur at any point, although many experience them during particularly stressful situations (e.g., a big test at school or participating in a major sporting event) or are awakened by them at night.

  Initially identified in soldiers exposed to brutal combat, post-traumatic stress disorder is now associated with trauma of many kinds, either experienced or observed. A teenage victim or a witness of physical, sexual, verbal, or emotional abuse may suffer from flashback memories of the trauma. A serious accident, natural disasters, and being threatened physically (e.g., mugging, rape, etc.), can also trigger PTSD. Symptoms associated with PTSD fit into three categories:

  Re-experiencing the trauma (through flashbacks, dreams, or frightening thoughts, accompanied by vivid physical sensations)

  Avoidance symptoms (staying away from people, places, or things that remind a victim of the trauma; heavy guilt, fear, or depression; memory disturbance; feelings of apathy/numbness)

  Hyperarousal symptoms (being easily startled, feeling tense or edgy, angry outbursts/rage, and sleep disorders)

  Adolescents—particularly early adolescents—who experience trauma may struggle with problems characteristic of much younger children (e.g., bed-wetting, fear of strangers, excessive clinginess to parents or other “safe” adults). Older adolescents may display disruptive, disrespectful, or destructive
behaviors. They may express guilt for not preventing the trauma or the desire to exact revenge against those who have hurt them or those they love.

  Obsessive-compulsive disorder (OCD) in adolescents looks very similar to the profile we associate with adults. Sufferers may excessively wash hands to prevent the spread of germs, check and recheck things (e.g., locks, homework answers, or technology) in an effort to self-soothe, or perform tasks in a rigid and ritualistic way because the fear of not doing so is debilitating.

  In outlining these forms of anxiety disorder, we hope to empower you with knowledge. For many parents, it’s helpful to see in print what their teenager has been doing or expressing for a long time. It may make things more “real,” but it also identifies the struggle as something that can be addressed and treated. Once you acknowledge what your teen is facing, you can move toward freedom and wholeness.

  Psych 101

  If your teenager suffered a serious head injury and doctors told you an area of his or her brain was damaged, I imagine you’d do everything possible to help in the recovery process. Discovering that the neural networks that mediate anxiety in your teen’s brain are over- or underactive is no different. Your anxious teenager’s brain needs real, tangible help, and you can provide that. Undoubtedly, he or she will also need to make personal decisions to pursue health and continue to do so after the initial healing begins, but as a parent, you are a huge piece in the puzzle. Let’s look at some specific ways you can help your teen battle anxiety.

  Change the statistic. If only 1 in 3 sufferers pursue help, that means 66 percent get no treatment. Anxiety, like other mental health conditions, is powerfully impacted by lifestyle changes, therapy, medication, or a combination thereof. With treatment, there is great hope for a bright future!

  You’ve got to move it. Intense aerobic exercise combats anxiety in dramatic ways. As Dr. Jesse Payne notes, “When worry or negative thoughts take over, exercise can provide a welcome distraction. Research shows that high-intensity physical activity can even reduce the incidence of panic attacks.”5 If your child is stressing out, activities like going for a run, setting up a punching bag in the garage, or playing a pickup game of basketball can diffuse anxiety. When we recommend this, some parents dismiss the suggestion out of hand: “My kid won’t even come out of his room. How am I supposed to get him to exercise?” The answer is, you can’t. You cannot control your child any more than you can control the weather. But if you are a person of faith, you know the One who can direct your child’s behavior and motivation. Why not ask God—the blessed controller of all things (see 1 Tim. 6:15)—to help your child get moving? If you move with your teen, the benefits will extend even further.

  Take what goes in seriously. The food teens consume matters; the hours they sleep (or don’t) and the amount of caffeine they drink do too. Limiting if not eliminating caffeine, eating from the rainbow (see chapter 21), and establishing healthy sleep habits (see chapter 20) will make a huge difference in your adolescent’s level of anxiety.

  Kill your own ANTs, and help your teen do the same. Dr. Daniel Amen coined this phrase, and coming from Southern California, where hideous, shockingly massive armies of black ants can invade a home at any point, we think it paints a vivid picture. ANTs refer to automatic negative thoughts, and they can take numerous forms, from overgeneralizing (“I’ll always be a loser”) to the fortune-telling variety (“I’m going to fail this test and then I’ll never get into college”) to guilt-beating ANTs (“I should have done this; if I would have done this, I wouldn’t be in this stupid situation”). We cannot outline every variety of ANT in this chapter, but for comprehensive help, we refer you to Dr. Amen’s excellent books (Change Your Brain, Change Your Life is a great place to start). Killing your own ANTs and helping your adolescent do so is a practical way to obey the biblical command to “take every thought captive” (2 Cor. 10:5). Getting serious about killing ANTs reestablishes brain and soul health for you and your adolescent.

  Mirror healthy reactions to stress. Your level of worry, fear, and anxiety directly impacts your teenager. If anxiety floods your life or your spouse’s, your adolescent may marinate in the same. Learning to control your own anxiety is essential if you want to help your adolescent.

  Choose to unwind. I (Jerusha) recently asked a friend what she liked to do. She actually laughed at the question. She couldn’t remember the last time she chose to do something just because she liked it. This is a problem, not only because it revealed an undue amount of stress in her life, but also because it’s virtually impossible for our teens to learn to relax and unwind if we don’t know how to do it ourselves. And I don’t mean just flipping on the television. Modeling healthy ways to relax—listening to music, going to a beautiful place, reading a novel, taking a bath or shower—will not only help you process the tensions of the teen years, it will teach your teen as well.

  Faith 101

  There are over three hundred references to fear in the Bible, which amounts to almost one per day. If you ask us, this is no random coincidence. Life overflows with things that trigger anxiety and worry. Over this reality we have very little control. Whether we live in panic or peace, however, is largely our choice.

  In Philippians 4:6–8, the apostle Paul exhorts, “Don’t worry about anything; instead, pray about everything. Tell God what you need, and thank him for all he has done. Then you will experience God’s peace, which exceeds anything we can understand. His peace will guard your hearts and minds as you live in Christ Jesus” (NLT).

  There are several important elements to this passage, but an oft-overlooked one involves the connection between letting go of worry and giving thanks for what God has done. On the surface, it’s certainly a nice idea: don’t worry; instead, thank God; then you get peace. That sounds great, but is it really practical?

  Yes! Brain research clearly shows that anxiety and gratitude are mutually exclusive neural pathways. Physiologically, you cannot be anxious and grateful at the same time. In his book What Happy People Know, Dr. Dan Baker writes, “During active appreciation, the threatening messages from your amygdala (fear center of the brain) and the anxious instincts of your brainstem are cut off, suddenly and surely, from access to your brain’s neocortex, where they can fester, replicate themselves, and turn your stream of thoughts into a cold river of dread. It is a fact of neurology that the brain cannot be in a state of appreciation and a state of fear at the same time. The two states may alternate, but are mutually exclusive.”6

  Don’t allow this life-changing truth to pass you by: choosing to give thanks instead of giving in to fear changes more than just your momentary thoughts. It literally changes the structure of your brain! When confronted with worry, you have a choice; so does your teenager. Share this important information with your adolescent.

  Also, keep in mind that giving thanks doesn’t have to be directly related to your present situation. Right after receiving a cancer diagnosis isn’t usually the best time to try thanking God for the way sickness will help you and those around you grow. Instead, try thanking God for something little (salted caramel mochas come to mind). It may sound like a simple step, but it’s actually an incredibly powerful one.

  Reading the stories of Jesus’s life, we see that thanksgiving always preceded his miracles.7 The same is true of the everyday miracle of you and me and our adolescents being released from worry and fear. Our brains literally cannot be grateful and anxious at the same moment. This knowledge is God-given power to be transformed by the renewing of your mind.

  Try It Today

  Have you ever asked your teenager what he or she fears most? Find a time to ask, and listen carefully. Simply giving your child the space to name his or her fears can be incredibly helpful. Many parents have given up asking their teen straightforward questions. If he or she answers, “I don’t know,” “Everything,” or with an angry, “Why?” don’t settle. Another time may be better, but pushing a bit may also be in order.

  If you do get a clea
r response, offer to pray for your child right then. Go back later—perhaps in a couple days—and tell them you’ll keep praying. Ask a while later how things are going and whether there’s anything specific you can do to help. Again, this may seem simple, but it’s actually quite profound. You don’t need to be a therapist in order to listen and pray.

  Clinicians used to warn parents not to address anxiety for fear of reinforcing it. Current research reveals, however, that gently helping people process the irrationality of their fears can equip them to talk back to their thoughts and move forward. Whatever the concern, let your teen know that he or she can always trust you to empathetically listen, without fear of being rejected or judged.

  You can also show understanding by reminding adolescents that anxiety is connected to a highly active brain, a powerful mind which can serve them well, now and in the future. Remind them (and remember yourself) not to give up hope. Overcoming anxiety is not an overnight process, but it is possible.

  Appendix A

  The Truth about Substance Abuse

  Note: This section provides basic information about substance abuse, but it does not outline intervention strategies or enumerate specific treatment approaches. For parents facing crisis situations, we recommend seeking professional help from a pastor, youth worker, or counselor.

  For many, adolescence follows a “best of times, worst of times” pattern. Undoubtedly, the teen years are full of stress and strain. Ironically, people also expect high school and college students to have the “time of their lives,” to “live it up” before settling into adult life. When you add powerful mood-altering substances like alcohol and drugs to the mix, all of this easily spells disaster.