Anxiety and the Parent-Teen Bond
Everyone worries about things.
The common way to say it is “I’m stressing.”
Some of us stress over the small stuff – ignoring the adage don’t sweat the small stuff every day – while some of us stress over the big stuff.
Small stress or worries include things like focusing on a clean and tidy house, finding the perfect accessory for an outfit, wondering whether the garden gnome you ordered from Amazon will arrive in time for your first summer barbecue, when you want everyone to be impressed with your cute yard, or spending time wondering if that last text you sent as a joke was received as intended.
We can all relate.
Big stress or worries include things like focusing on whether your teenager will go to college, being scared about global warming, and thinking constantly about the size and state of your retirement account. We should also keep it real, as it were, and recognize that any stress and worry over survival – i.e. paying rent, putting food on the table, neighborhood safety, and chronic illness, for example – is legitimate stress that is, as another saying goes, as real as it gets.
In a roundabout way, that kind of stress is also directly related to why teens get anxiety, why young kids get anxiety, and why young kids or teens who develop an anxiety disorder might need specialized treatment at a mental health/anxiety treatment center that specializes in adolescents.
The Source of Anxiety
Most of us can relate to those big picture stressors, as well as the small stressors that don’t do much more than bug us a little. If we can’t relate to those big picture stressors, at the very least, we understand.
Which brings us to an important point, which we hinted at above. Survival stress is at the root of what we call anxiety. If you’ve never thought objectively about anxiety before, then this is an important thing to wrap your mind around:
Anxiety over safety in the present or future is a positive survival trait. It developed over time and gave us an advantage.
For instance, when our distant ancestors heard a twig snap behind them in woods, accompanied by the growl of an animal, stress hormones would kick in, and they’d run for safety. Or when they looked at the sky and saw storm clouds, they’d get to shelter before the rain arrived. That kind of anxiety, which causes us to take proactive steps to ensure our safety now or in the future, is something we need in our lives.
That’s not the kind of anxiety we’ll talk about in this article, though. We’re spending time talking about it because it’s crucial to understand, since it explains why stress and anxiety are so powerful. It also explains the type of anxiety we will talk about in this article: stress or anxiety related to the safety associated with the parent-child bond.
That kind of anxiety is called separation anxiety. Alongside generalized anxiety disorder (GAD) and social anxiety disorder, it’s one of the three most common anxiety disorders in the world. We’ll review the specifics of separation anxiety – including signs, symptoms, and common treatments – in a moment. First, we’ll offer a clear definition of anxiety, list the different types of anxiety disorders, and review the prevalence of anxiety disorders among teens in the U.S.
A Clinical Definition of Anxiety
The National Association on Mental Illness (NAMI) indicates that all the various anxiety disorders recognized by mental health professionals have one distinguishing feature in common:
“A persistent, excessive fear or worry in situations that are not objectively or inherently dangerous.”
Most people know about clinical-level anxiety, but not everyone knows there are several types, each with its own specific set of characteristics. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines seven distinct anxiety disorders that occur in children and adolescents:
- Generalized anxiety disorder (GAD)
- Separation anxiety
- Social anxiety disorder
- Panic disorder
- Agoraphobia
- Specific phobia
- Selective mutism
Now let’s move on to how many teenagers have anxiety that meets the clinical criteria for an anxiety disorder diagnosis.
Here’s the data, according to the National Institutes of Health (NIH), the Centers for Disease Control (CDC), and the Child Mind Institute:
Prevalence of Anxiety Disorders: Adolescents in the U.S
Any Anxiety Disorder
- Age 13-14: 31.4%
- Ages 15-16: 32.1%
- Age 17-18: 32.3%
- Females age 13-18: 38%
- Males age 13-18: 26.1%
- Age 13-18, female and male: 31.9%
- With severe impairment, female and male, age 13-18: 8.3%
By Anxiety Type
- Specific phobia: 13%
- Social anxiety disorder: 9%
- Separation anxiety: 8%
- Panic disorder: 2%
- Generalized anxiety disorder: 2%
Let’s attach numbers to those percentages.
Overall, 31.9% of teens age 13-18 works out to around 7.5 million teenagers. That’s how many teens in the U.S. have any type of clinical anxiety. With regards to separation anxiety, which we’ll discuss next, 8% of teens works out to around 2 million teenagers.
Those numbers tell us two important things. First, if your teenager has an anxiety disorder, they’re not alone. Millions of teens and families share your experience. Second, if your teen has separation anxiety disorder, they’re also not alone. There are at least two million teens and families that share a similar experience.
We bet they’ll want you to know that treatment for anxiety works. But we’re getting ahead of ourselves. First, we need to clarify what we mean by separation anxiety, and how it relates to the parent-teen bond.
What is Separation Anxiety?
Separation Anxiety Occurs in Almost 8 Percent of Adolescents In The U.S. – That’s About 2 Million Teens.
Separation anxiety occurs when teens become extremely anxious or fearful of being away from people to whom they’re emotionally attached. This is not the same as the developmentally appropriate separation anxiety infants and toddlers experience between 12 and 18 months. Separation anxiety – as a clinical disorder – typically begins around preschool age. Separation anxiety is less common in teens than other types of anxiety, but – as the data above shows – it’s not as rare as panic disorder or generalized anxiety disorder.
To meet clinical criteria, symptoms must last for four months or more, and may include the following general symptoms:
Common Emotional Symptoms of Anxiety
- Excessive fear of regular daily situations
- Excessive irritability
- General restlessness
- Assuming negative outcome for any future event
- Extreme agitation
- General nervousness
Common Physical Symptoms of Anxiety
- Rapid heart rate
- Hyperventilating
- Sleep problems: too much or too little
- Excessive fatigue
- Frequent headaches
- Twitching or tremors
- Excessive sweating
- Frequent nausea/stomachaches
- Frequent trips to the restroom
Those symptoms appear in most anxiety disorders. To meet the criteria for separation anxiety, teens will display extreme and disruptive fear or worry related to:
- Spending the night at a friend’s house
- Going to school
- Going to summer camp
- Any trip that involves leaving family or home
Additional symptoms of separation anxiety include:
- Excessive fear of losing loved ones to illness or accident
- Fear of being home alone
- Nightmares about separation from parents or loved ones
- Worry that something bad will happen – like getting lost or being kidnapped – that will result in being separated from parents or loved ones.
We think you can anticipate how we’ll describe the relationship between separation anxiety and the parent-teen bond, as well as the link between separation anxiety and survival stress.
Anxiety and Parent-Teen Bonds: What’s the Connection?
Both separation anxiety and survival stress revolve around one thing that everyone can relate to:
Feeling safe.
A teenager with a strong bond with their parents may develop separation anxiety in response to significant life trauma. Life stressors that can trigger separation anxiety include things like losing a loved one, a loved one developing a serious illness, losing a pet, moving, changing schools, or experiencing a natural disaster that involves losing, or the potential to lose, a friend or loved one.
On that note, an event like the coronavirus pandemic qualifies as a significant stressor, and may trigger separation anxiety in your teen. If your teen was in virtual school most of the year, but resisted returning to school when and if it reopened, or expresses hesitancy about returning to in-person school in the fall, please pay attention to this insight from the American Academy of Child and Adolescent Psychiatry (AACAP):
“Separation anxiety is often behind a teen’s refusal to attend or remain at school. School avoidance can follow a significant change. It may also be triggered by something unrelated to school, such as a divorce, illness, or a death in the family.”
Or, as we mention, separation anxiety may be triggered by a significant event such as a global pandemic that lasts over a year and disrupts virtually all facets of life, from school to socializing to participating in sports and doing simple things like going out to eat or going to a movie.
Therefore, if your teen shows any of the symptoms of separation anxiety listed above – and developed those symptoms over the past year – then we recommend arranging for a full psychiatric assessment with a licensed mental health professional. They can determine whether your teen meets the criteria for an anxiety disorder and recommend an appropriate level of treatment and support.
Evidence-Based Treatment for Teens with Anxiety Disorders
We’ll now discuss the most effective treatments and therapies for anxiety disorders in teens.
Research shows the best way to treat anxiety disorders in teens is with a combination of therapy and medication:
- The most widely used mode of therapy include:
- Cognitive-Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Exposure Response Prevention Therapy
- The most common medications for anxiety include:
- Anxiolytics, a.k.a. anti-anxiety medications
- Anti-depressants
In addition to these two traditional approaches, many adolescent treatment centers for anxiety also offer complementary and experiential therapies. In the context of evidence-based, integrated treatment, clinicians use these techniques to augment a treatment plan. Evidence shows these complementary approaches work best when delivered by licensed clinicians in order to support more traditional therapeutic approaches:
- Mindfulness-Based Stress Reduction (MBSR)
- Meditation
- Yoga
- Tai Chi
- Chi Kung
- General Exercise
Studies indicate that untreated clinical anxiety disorders are typically chronic and progressive. What this means is that, without professional support, they can last a long time and get worse the longer an individual goes with treatment. In addition, the symptoms of anxiety may go into remission for long periods of time – think months or years – and return in response to traumatic or stressful life events.
That’s why clinical anxiety often requires long-term treatment. That’s also why parents of teens with an anxiety disorder – especially one that developed recently – need to understand this:
Clinical anxiety rarely resolves on its own.
Treatment works – and in the case of an anxiety disorder – the sooner a teen gets treatment, the better.
Treatment Now Means Hope for The Future
Your teen can learn the skills and techniques they need to manage their anxiety. In some cases, they may need medication. In almost all cases, a teen with an anxiety disorder – including separation anxiety – can get their symptoms under control. Your teen can resume things like going to school, going to camp, and going on sleepovers with friends. They can restore balance to their lives and get back to all the fun parts of being a teenager. They may experience stress or anxiety in the years to come, but they’ll be ready to handle it. Treatment can give them the tools they need to live on their terms, rather than those dictated by any recurring symptoms. Once your teen has those tools, they can use them at will, for the rest of their life – and that’s a legitimate reason for confidence, hope, and optimism.
