When to Be Concerned about Your Anxious Teen

Even a little anxiety can have a big impact

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Adolescence is commonly acknowledged as a stressful period of change and transition. In addition to the physical changes that kids undergo in their teen years, there are psychological changes that occur as well. These changes may occur in the context of biological (e.g., hormonal) or environmental (e.g., increased responsibility at home, higher expectations at school, more complicated peer relationships) stressors.

Some teens become more impulsive, outspoken or rebellious, and others more private, quiet, and even withdrawn. And of course, many teens begin to experience anxiety (or experience it more intensely than before) and express it in ways that look more or less familiar to adults.

Knowing that anxiety is a natural part of both the adolescent and adult life experience, it can be hard to determine how much is too much. Certainly, the agreed-upon criteria for anxiety disorders (established by mental health specialists), such as those for generalized anxiety disorder (GAD), can be a helpful guide.

But what if the anxiety that your teen is experiencing does not quite meet the watermark established for a condition like GAD? What if it has not been going on for a full 6 months? What if it’s only been a few months, or the symptoms wax and wane? What if your teen isn’t describing physical anxiety as you or other adults would?

Perhaps, for example, he or she does not complain of muscle tension or restlessness. Is it really a problem then?

Reports from studies of GAD in teens suggest that yes, it just might be a problem worthy of some attention.

The National Comorbidity Survey-Adolescent Supplement is a nationally representative survey of adolescents in the continental U.S. As part of this survey, over 10,000 teens completed a face-to-face, standardized diagnostic assessment of psychiatric problems which included questions corresponding to each criterion of GAD.

In addition, a parent (or guardian) was asked to complete a questionnaire about their child’s mental health, physical health, and home and community environment.

The findings from this study, published in 2014, highlight several important features of GAD in teens:

  • Though only 3% of teens surveyed met strict criteria for GAD, the prevalence increased to 5% when the criterion for duration of symptoms was relaxed from 6 months to 3 months. There were very few differences between threshold and subthreshold cases, meaning that teens endorsing generalized anxiety symptoms lasting even just a few months, were just as likely to describe their condition as interfering in day-to-day life or to have symptoms of other mental disorders.
  • Teens with subthreshold forms of GAD were less likely to be in treatment, despite being similarly impacted by their symptoms as teens with full-blown GAD. To learn more about GAD treatment for young people, see our treatment guide for parents.
  • Similar to adult cases of GAD, teens girls are disproportionately affected by full-syndrome and subthreshold GAD.
  • An increase in prevalence of full-blown GAD was noted from the youngest to the oldest teen age groups studied; this pattern was also observed for subthreshold forms of GAD. These findings suggest that the late teen years, sometimes thought of as the beginning of emerging adulthood, may be a time of particular risk for early onset GAD symptoms (with usual onset being in adulthood during the early 30s). For additional information on the management of GAD symptoms in high school and college, check out these strategies to “stay ahead of the curve.”
  • The most commonly described physical symptoms of GAD by teens included poor concentration, irritability and restlessness; the least commonly endorsed physical symptom was muscle tension. Of note, younger teens and those with subthreshold GAD were less likely to describe the symptom of restlessness than older teens or those with threshold GAD.
  • The presence of full-blown or subthreshold GAD was associated with the presence of other anxiety disorders (most commonly specific phobia and separation anxiety) and mood disorders.

This research confirms the impact that subthreshold anxiety symptoms can have on a young person and underscores the need for early intervention. Parents naturally have questions about what treatment for anxiety involves and what they can do to help at home; for the answers to some commonly asked questions, consult this related post by a child and adolescent specialist.

To further assess your teen’s situation, talk to them directly about the symptoms. Through conversation, observation and consultation (perhaps with your spouse, teachers, coaches or your teen’s siblings), evaluate how distressing the anxiety is and how much of a problem it is creating from day to day. Using this information, engage your teen in conversation about the next best steps to take to help him or her to feel better, sooner rather than later.

To find a qualified clinician, check out referral resources including Psychology TodayThe Association for Behavioral and Cognitive Therapies, The American Academy of Child and Adolescent Psychiatry, or The Anxiety and Depression Association. Or, speak with your current physician about seeking a psychiatric evaluation with a recommended mental health provider. 


Beesdo-Baum K, Winkel S, Pine DS, Hoyer J, Hofler M, Lieb R, & Wittchen HU. (2011) The diagnostic threshold of generalized anxiety disorder in the community: a developmental perspective. J Psychiatric Res, 45:962-972.

Burstein M, Beesdo-Baum K, He J-P, & Merikangas KR. (2014) Threshold and subthreshold generalized anxiety disorder among US adolescents: prevalence, sociodemographic, and clinical characteristics. Psychol Med, 44(11): 2351-2362.

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