“Sometimes anxious people fail to give themselves credit for what they have accomplished.”Anxiety can be described as conscientiousness run amuck. I once heard a corporate manager point out that anxious people make wonderful employees: they’re never late for work, they rarely make mistakes, and their work is immaculate. But anxiety can be crippling, causing your teen to miss school, experience insomnia, and hide from friends.
Putting Anxiety in Perspective
During an anxious episode, start by expressing sympathy for your teen’s anxiety. This can be difficult if it seems like they are blowing the situation out of proportion. Yet, a simple acknowledgement of their discomfort can significantly reduce the anxiety immediately. We all need to feel understood.
Now that you’ve been able to get your teen to relax and trust you, ask in a calm tone if they can isolate the specific triggers that are causing anxiety. There may be several. They may recognize on their own that one of them is not really a big deal. For the remaining issues, ask a few questions. If possible, have your teen sit down with you and write their answers on a piece of paper. Seeing the words on the page can provide clarity and reassurance. Ask these questions:
- What is the worst that can happen? If that happens, what can you do?
- Is there anything you can do about the problem now?
- Can you create a step-by-step plan of action?
- Can you forgive yourself in advance if you don’t achieve your goal?
The point of the exercise is to try to get your teen unstuck from the circular thinking typical of anxiety. Try to get them to step outside of the immediate worry by promising that every situation eventually has a resolution.
Evaluating and Reducing Anxiety
Another useful exercise for the teen who is either driven or a perfectionist, is to have them scribble down a list of their accomplishments at the end of each day. This should help them to realize that they are doing all they can. For example, if they are feeling overwhelmed about completing their college applications, have them list the things they have already finished. Sometimes anxious people fail to give themselves credit for what they have accomplished.
Help your teen learn to reduce big jobs into several small tasks. Make the first few tasks easy, and ask them to start with the first one. Note how long it takes and then tell them how quickly they completed the task. Ask f they will go through the list and assign to each task the number of minutes or hours it will take to complete. Then set up a realistic schedule for completing the entire job. If the job is going to take three days to finish, tell them to look at only the tasks for the current day. The next time they feel overwhelmed by a large job, remind them that they successfully handled it in the past, and they can successfully handle it now.
Getting Through the Worst Moments
During your teen’s most anxious moments, encourage them to take deep breaths. This advice may annoy them, but ask them to try it because it will refocus their energy. Another helpful exercise is to take a brisk, twenty-minute walk.
Ask your teen to come up with a mantra. For example, “I’m doing the best I can.” Ask them if they will allow you to say this to them when they are becoming overwrought. For example, you could say, “You’re doing the best you can” as they are getting out of the car for school. Remember, though, that you need to have their permission. Coming from you, the phrase could either soothe or irritate them, so ask in advance.
If a worry or a thought keeps intruding into your teen’s thoughts, teach them to put it on hold. They can do this by picturing a stop sign and silently saying, “Stop.” They may also choose to substitute a positive thought. For example, if they realize that they have been telling themselves, “I’m going to fail this test,” they can interrupt the thought by saying, “I’m well-prepared for this test.” The old message will pop back in, but if they keep halting it, the periods between episodes will lengthen and they will come to realize that they can control these intrusive thoughts.
Daily Pleasures
The anxious teen often neglects to indulge in a daily pleasure, preferring to torment themselves with the possibilities of future disasters. A daily pleasure means living in the moment. It might be watching a half-hour television show with you after dinner, playing a game of cards before bed, reading a mindless novel for an hour after school, or spending time each day on a craft project. As trite as it might sound to your teen, scheduling a routine activity that provides a pleasurable or creative outlet will add up to a big relief of stress.
Reducing Unstructured Time
If your anxious teen could see how many minutes a day she spends brooding, you might both be stunned. Unstructured time is an enemy to the anxious teen. If your teen is spending hours each day in their room and coming out looking stressed, it is time to take action. Get them involved in an activity outside of the house. This can include joining a club, getting a part-time job, volunteering at school, or taking lessons. At home, include a daily fun activity, chores, and some form of physical activity, such as walking the dog each day. They will probably not want to do any of these things, but start adding them one at a time. They can start dinner one afternoon a week, do their laundry another afternoon, and pick up their younger brother from football practice another day. All of these activities will keep their mind occupied with thoughts that force them to live in the present.
Anti-Anxiety Medicines
Your teen’s psychiatrist may prescribe an antidepressant or other medicine for their anxiety. Be watchful for side effects or an increase in their anxiety; if this occurs, report it to the doctor. If the doctor prescribes a quick acting, short-term medicine from the benzodiazepine family (for example, Ativan, Valium, Klonopin, Xanax), he is likely to monitor your teen closely because it can be habit-forming. If you are concerned that your teen may become dependent upon the drug, calculate how frequently they take it. For example, when you need to refill the drug, look at the date the prescription was filled and divide the number of days by the number of pills used. If they are using it once or twice a week, you can relax. If they are using it daily, you may want to bring it up to the doctor. Above all, do not have your teen quit a benzodiazepine cold turkey if they have been using it regularly because they are likely to experience serious withdrawal symptoms, including insomnia and temper outbursts. Your doctor can easily manage your teen’s titration of a benzodiazepine by gradually tapering it off. The same is true of antidepressants.
Anxiety tends to be a pervasive trait, even after the acute symptoms are under control. Help your teen recognize that their conscientiousness is a positive quality that will aid them in achieving their goals. To discern the difference, if they are fretting, they can stop and ask, “Is this helpful?” Eventually, they will learn to manage their thoughts so that they can benefit without suffering.
“In addition to providing an important history, the medicine log can also give you insight.”