Signs of anxiety in teenagers: what parents should look for

Teenagers can be difficult to read at the best of times. They may become more private, spend more time in their room, change friendship groups, become more emotional or suddenly seem to communicate mainly through one-word answers.

So when something changes, one of the questions parents often find themselves asking is: “Is this normal teenage behaviour, or is something else going on?”

There is not always a simple answer.

In my work with young people, I think one of the most useful things for parents to understand is that anxiety does not necessarily look like anxiety.

We often imagine an anxious young person as somebody who looks visibly worried, talks about their fears or tells us that they feel anxious. Some teenagers do. Others may not recognise what they are experiencing themselves, let alone know how to explain it to somebody else.

Instead, anxiety can sometimes appear through behaviour, emotions or physical symptoms.

Anxiety does not always look like worry

A teenager who is struggling with anxiety may become more irritable or frustrated. They might snap more easily, become upset over things that previously seemed manageable or appear disproportionately angry about something quite small.

From the outside, this can easily be interpreted as difficult behaviour. But behaviour is communication too.

That does not mean that every angry teenager is anxious. It means it can be useful to stay curious about what might be happening underneath the reaction rather than focusing only on the reaction itself.

I often encourage parents to ask themselves: “What has changed?”

That can be more helpful than asking whether a particular behaviour is a recognised symptom of anxiety.

Avoidance can be easy to miss

Avoidance is another pattern worth noticing.

Perhaps your teenager used to meet friends but increasingly finds reasons not to go. They may begin avoiding particular lessons, school days, activities, journeys or situations they previously managed.

One cancelled plan does not mean anxiety. But if the cancellations are happening more often, the list of things they feel unable to do is gradually getting longer, or their world seems to be becoming smaller, that tells us something important.

Avoidance can provide immediate relief from anxiety. If something makes us feel uncomfortable and we escape it, we usually feel better in that moment.

Unfortunately, that short-term relief can sometimes make it even harder to face the situation next time.

When doing well hides how difficult things feel

Perfectionism is something else I pay attention to.

A teenager may appear to be doing extremely well while feeling enormous pressure internally. They might spend excessive amounts of time checking work, become very distressed by mistakes, struggle to hand something in unless it feels perfect or feel that a good result still is not good enough.

This is one of the reasons it is important not to judge how somebody is coping purely by achievement.

A teenager can be attending school, completing work and achieving good grades while still finding the experience emotionally exhausting.

Parents sometimes wonder whether encouraging them to “stop worrying” or reminding them that their work is already good enough should help.

Usually, the issue is not that the teenager has simply forgotten they are capable. The anxiety may be telling them that making a mistake has much greater consequences than it realistically does.

“Are you sure?”

Repeated reassurance-seeking can also become part of anxiety. It might sound like:

• “Are you sure I’ll be OK?”
• “Do you think they’re annoyed with me?”
• “Are you definitely coming back?”
• “What if I’ve done something wrong?”

Of course, everybody asks for reassurance sometimes. What may stand out is when the same question keeps returning even after it has been answered.

Reassurance might make the young person feel better temporarily, but the uncertainty soon returns, and they need reassurance again.

Parents can understandably become frustrated by this. You may feel as though you have answered the same question ten times and nothing you say seems to stick.

Recognising that pattern can help you understand that the repeated questioning may be connected to difficulty tolerating uncertainty rather than your teenager simply not listening to you.

Anxiety can be physical

Young people do not always describe anxiety emotionally. Sometimes they describe their body. They may complain about stomach aches, nausea, headaches, dizziness, feeling shaky, feeling unusually hot or experiencing a racing heart.

They may also seem exhausted, struggle to sleep or find it difficult to concentrate.

Physical symptoms can have many causes and should not automatically be assumed to be anxiety. New, persistent or concerning symptoms may need appropriate medical assessment.

But when physical symptoms appear alongside worry, avoidance or changes in behaviour, they can form part of the wider picture.

So how do you know when to be concerned?

There is no single behaviour that tells you a teenager has anxiety.

Moodiness can be normal. Wanting privacy can be normal. Cancelling a plan can be normal. Being nervous before an exam can certainly be normal.

What I would look at instead is pattern, change and impact.

Consider:

• Has this changed from how they usually are?
• Is it happening more frequently?
• Is it becoming more intense?
• Has it continued rather than passing?
• Is it beginning to interfere with school, friendships, family relationships, sleep or everyday activities?

You know your teenager in a way that a symptom checklist does not.

Sometimes a parent's first indication that something is wrong is simply: “They just don't seem like themselves.”

That observation matters.

How should I talk to my teenager about it?

Parents can sometimes become so worried about saying the wrong thing that they avoid starting the conversation altogether.

You do not need a perfectly constructed therapeutic question.

Something simple can be enough: “I've noticed you haven't seemed quite yourself lately. How have things been for you?”

Try to notice without immediately interpreting.

There is a difference between: “You're avoiding your friends because you're anxious.” and:“I've noticed you've cancelled a few plans recently. How are things with your friends?”

The second leaves space for their experience rather than deciding what it is for them. 

And if they do talk, you do not necessarily need to solve the problem immediately. Young people often need to feel heard before they are ready to think about solutions.

Responses such as: “That sounds really difficult.” or “I can understand why that has been worrying you.” can be more useful than immediately explaining why they should not feel the way they do.

What if they won't talk?

This is another concern I hear from parents. A teenager not wanting to talk does not mean you have failed to reach them. You can keep the door open without repeatedly questioning them.

You might say: “You don't have to talk about it now. I just want you to know I'm here when you are ready.”

Sometimes knowing that a conversation is available, without feeling pressured into having it, is important in itself.

If the changes you are seeing are persistent, increasingly affecting your teenager's daily life, or you remain concerned about how they are coping, it may be helpful to seek professional support.

Counselling can give a young person a confidential space to begin understanding what they are experiencing at their own pace.

Most importantly, try not to reduce your teenager to a collection of symptoms. Look at the young person you know. Notice what has changed. Stay curious about what might be happening underneath the behaviour. And remember that you do not have to diagnose anxiety in order to recognise that your teenager may be finding things difficult.