5 Things You Need to Know About Teen Anxiety
Anxiety is like fire: It can keep us safe and warm, or completely devastate our property and our lives. It's good to be a little anxious at times. When walking down a deserted street at night, anxiety keeps us on alert and ready to fight or take flight should a dangerous situation arise.
But for many people, especially adolescents, anxiety can become the norm instead of the exception. Just walking into a classroom or being with a group of people they don't know can become crisis situations. And, the more they experience these scary events, the more anxiety becomes a chronic condition.
I first wrote this post in 2017, not long after opening Aspire, when most of my caseload was kids and teens. The five things below are still true. What I've added, almost nine years later, is the part I wish I'd explained better back then: the cycle that keeps teen anxiety going, how parents get pulled into it without meaning to, and what our therapists actually do about it with CBT and exposure.
5 Important Things to Know About Teen Anxiety
Here are 5 things parents and teachers should know about adolescent anxiety.
1. Anxiety Refers to Physical Symptoms Associated with Negative Thoughts
Negative thoughts such as, "No one will like me," or "Everyone is going to think I'm stupid" come first. These thoughts are then followed by physical symptoms such as a stomach ache, diarrhea, or shaking, and shallow breathing. Young people need to learn how to not only shift their thinking ("This will feel awkward but I'll be okay") but also cope with the physical stress (take slow, deep breaths). This will help kids know without a doubt they can handle uncomfortable feelings instead of avoiding them.
This is the CBT piece, and it's still where we start with most anxious teens. Thoughts, body, and behavior feed each other. The thought "everyone will think I'm stupid" sets off the body. The body's alarm makes the thought feel truer. And both of them push the teen toward the one move that seems to help: getting out of there.
So in session, we teach teens to catch the thought and check it. Not to argue with it all day, but to notice it, name the trick anxiety is playing, and decide whether to believe it. We wrote a whole post on how a teen's anxiety lies to them and the common patterns to listen for.
One important thing when it comes to breathing techniques….Breathing helps, but the goal isn't to make the anxiety go away before your teen does the hard thing. The goal is to stay in the situation long enough for the body to settle on its own, which it will. If a teen only ever breathes their way out of a feeling, their brain learns the feeling was dangerous. If they breathe and stay, their brain learns it wasn't. That difference is the whole game, and it's why our therapists pair CBT with exposure instead of picking one. If the physical side of anxiety is what scares your teen most, we also explain why anxiety feels so physical and why that's not a sign something is medically wrong.
2. Dealing with Anxiety Requires Problem Solving Skills
Life is full of uncertainties and gray areas. Parents of very young children help them navigate through these situations. But adolescents must be equipped with problem-solving skills so they may tolerate uncertainty instead of avoiding it, as avoidance only makes things worse and gives anxiety more power.
That last sentence is the one I'd underline today. Tolerating uncertainty isn't a skill you can explain to a teen. It's one they have to practice, the same way they'd practice free throws. Sending the text without rereading it five times. Walking into the party without knowing who's there. Turning in the paper without asking you if it's good enough.
Each one of those is small. Each one teaches the brain something: I didn't know how it would go, and I handled it. That's what we mean by exposure. Not forcing a kid into the scariest thing on the list, but choosing something uncomfortable and doable, doing it on purpose, and letting the brain learn from what actually happens instead of what anxiety predicted.
If your teen has learned a lot of coping skills and is still stuck, this is usually why. Skills that help a teen calm down are useful. Skills that help a teen avoid feeling anxious at all are a trap. We wrote about why coping strategies alone often don't fix anxiety, and the same logic holds for teens.
3. The Teenage Mind is More Sensitive to Environmental Stress
The adolescent mind is a jumble of chemical changes that can make any situation seem like time spent in a funhouse. These hormonal changes make adolescence a particularly challenging time to cope with anxiety.
I'd add one thing to this now, because it's changed since I first wrote it. The environment itself is different. When I was a teenager, the school day ended when I got home. For today's teens it doesn't. The group chat, the friend who's upset, the thing someone posted, all of it follows them into their bedroom. A brain that's already extra sensitive to stress is getting stress with no off switch.
Ashley Elder, one of our teen therapists in Lee's Summit, put it to me this way: "They don't really get a break when they go home, because they're still so connected to their peers." If your teen seems wound tight after an evening alone in their room, that may be why. We wrote more about this in a short post on why "I was a teenager once too" doesn't land with today's teens.
4. Anxiety is a Vicious Cycle
When young people are anxious, it's easy for the adults around them to become anxious as a response. But, the more anxious parents and teachers are, the more controlling and inflexible they may become.
As adults, it's important we manage our own anxiety around our kids and students so we can manage the overall situation much more effectively.
All of that is still true. But when I wrote it, I only described half the cycle, the adult half. Here's the whole thing, because once you can see it, you'll see it everywhere.
What the anxiety cycle actually looks like
Something comes up. A party, a test, a presentation, a text that didn't get answered.
Anxiety makes a prediction. "This will go badly. I can't handle it." The body sounds the alarm: racing heart, stomach, shaky hands.
Your teen does something to feel better right now. They skip the party. They ask you if it'll be okay, then ask again. They study until 1am even though they knew the material at 9. They go, but they stay glued to their phone so they don't have to talk to anyone.
It works. The anxiety drops. Relief.
And that's the problem. The brain just learned two things. The situation really was dangerous, because look how bad I felt. And the only reason I'm okay is that I escaped, or got reassured, or overprepared. So next time, the alarm is louder and the escape comes faster.
Round and round. Each loop makes the feared thing a little scarier and the teen's world a little smaller. That's why avoidance feels so helpful and is so costly. Relief in the moment, more fear tomorrow. We wrote about what this looks like when it's gone on a while in When Anxiety Starts Shrinking Your Teen's Life.
Where parents get pulled in
Here's the part that's hard to hear, and I say it as someone who loves a lot of anxious kids. Step 3 often runs through you.
You answer "are you sure it'll be okay?" for the fourth time. You email the teacher so they can skip the presentation. You drive them to school because the bus is too much. You let them stay home from the family thing. Every one of those is an act of love. And every one of them is step 3 of the cycle, with you doing the escaping for them.
Therapists call this accommodation. It's not a criticism. It's the most natural thing in the world to take away your kid's pain when you can. The trouble is that it takes away the practice, too. I wrote a longer post for the people who love someone with anxiety, including parents, called When Love Feeds Anxiety. If you read one link in this post, read that one.
The short version: you can validate the feeling without doing the avoiding. "I know this feels awful, and I think you can do it anyway, and I'm not going to help you get out of it." That's two true things at once. It's the hardest sentence in parenting an anxious teen, and the most useful.
5. Anxiety is treatable
The good news is that your teen doesn't have to live with anxiety symptoms. Panic attacks, constant worry, or fear don't have to rule their life. Anxiety responds very well to counseling. It often requires coming on a weekly basis, sometimes homework between sessions, and motivation. So, your teen needs to be ready to get their anxiety under control. But truly, we have several different counseling techniques that can really make a difference and help your teen find some relief!
Since I wrote that, I've gotten more specific about what "several different techniques" means, because parents deserve to know what they're signing up for. With anxious teens, our therapists work from two directions at once.
The CBT side. We help your teen catch the anxious thought, name the trick it's playing, and check it against what's real. Not endless debate, just enough to loosen anxiety's grip on the steering wheel.
The exposure side. We help your teen practice the things anxiety has been telling them to avoid, one doable step at a time, and drop the safety behaviors that quietly keep the fear alive. That's how the brain actually learns the thing was survivable. For teens with OCD, this becomes a specific treatment called ERP, and reassurance is one of the first things we work on.
The homework I mentioned is usually the exposure part. A teen who only practices in our office once a week gets better slowly. A teen who practices between sessions, with a parent who knows how to support it without rescuing, gets better a lot faster.
One honest change in how I'd say it now: the goal isn't a teen who never feels anxious. That teen doesn't exist, and chasing it keeps the cycle going. The goal is a teen who can feel anxious and still go to the party, take the test, send the text. Anxiety comes along for the ride. It just doesn't get to drive.
We measure whether this is working. Kids and teens under 18 who come to us for anxiety fill out a short questionnaire at intake and as they go, and the pattern is consistent: not much movement in the first few months while trust and skills are building, then real change around the four-to-five-month mark. The actual numbers are in our guide to knowing if your teen needs therapy, and they're why we ask families to plan on months, not weeks.
Begin Teen Counseling for Anxiety
If your teen is struggling with anxiety and is ready to begin anxiety treatment in Mid-Missouri, we have several teen therapists who would love to help. We have teen therapists both in our Columbia office and our Lee’s Summit office that can meet with your teen in person. Many teens also respond well to online counseling and that can help reduce missed school sessions-we’ve had a number of schools provide a private room that a teen can go into for their counseling session then rejoin class right after. And even though our offices right now are both on the Missouri side, we have teen therapists licensed in both Missouri & Kansas so we can see your teenager online in either state.
To begin counseling start with these steps:
Contact our counseling clinic to speak to our care coordinator,
Schedule a free in-person consultation meeting with one of our teen therapists
Begin learning new ways to cope with and conquer your anxiety
Other Counseling Services Offered at Aspire Counseling
At our Mid-Missouri mental health clinic, we believe healing begins when you look past hurts, current obstacles, and future worries directly in the eye and can confidently say, “I’ve got this.” Our counselors & therapists provide a variety of counseling services to give our clients the tools they need to cope with their challenges and achieve emotional wellness. Our therapy services include counseling for caregivers, counseling for chronic illness, postpartum counseling, grief counseling, counseling for teens, counseling for college students, trauma and PTSD therapy, EMDR therapy, counseling for sexual assault and rape, anxiety therapy, counseling for depression, LGBTQ-affirming counseling services, and Dialectical Behavior Therapy (DBT). Additionally, our therapy team contributes to our blog on a regular basis to provide you with interesting information on a variety of mental health topics.
About the Author
Jessica Oliver, MSW, LCSW (formerly Jessica Tappana) is the founder and Clinical Director of Aspire Counseling, with offices in Columbia and Lee's Summit and online therapy across Missouri. She has more than fifteen years of clinical experience treating trauma and anxiety, with advanced training in EMDR, Cognitive Processing Therapy, Prolonged Exposure, ACT, and Exposure and Response Prevention. She wrote the first version of this post in 2017, when most of her caseload was kids and teens, and still keeps a few anxious teenagers on her schedule because she loves that work. She primarily works out of our Lee's Summit office serving the KC metro area.
This post was originally published on November 11, 2017 and updated on October 14, 2026 to add the anxiety cycle, parental accommodation, and how Aspire's therapists treat teen anxiety with CBT and exposure. The quote from Ashley Elder, LCSW, a teen therapist at our Lee's Summit office, is from Jessica's interview with her on October 13, 2026.
