Adolescence

The development stage of adolescence is known for the changes in cognitive processes in the brain.  During puberty the impact of serotonin and dopamine on the cerebrum and additional stress hormones impact the body’s responses, processing ability and behavioural functionality.  According to Eysenck et al. (2007), cognitive processing begins to become impaired when anxiety affects the perceptive and reasoning areas of the brain, beginning to distort working memory.  These distortions affect the regularity of general processing when recall, retention, and storage components are applied.  The cognitive-developmental processing parts of the brain are still developing from the ages of ten years to young adult, making this time frame accurately reflect the four stages of adolescent development than previously estimated.  According to Sanci et al. (2018), the four stages of development are biological and sexual maturation, personal identity formation, engagement in intimate sexual relationships with an appropriate peer, and establishment of social independence and autonomy.  According to the Department of Health (2017), around 8.8% of adolescents aged 12 to17 years and 28.2% of young adults aged 18–24 years reported illicit drugs in cannabis, methamphetamines, ecstasy, and cocaine.  These alter brain functionality, altering perception and the regulation of behaviour.  According to the Centres for Disease Control and Prevention (CDC, 2021a), the prevalence of certain sexually transmitted infections is highest, especially among adolescents and young adults, with chlamydia, gonorrhoea, and young adolescent females infected with the HPV virus.  All these stressors are due to adolescents being at an age where risk-taking activities of unprotected sex and substance use are all impacted by changes within the body, altering brain functionality and distorting the individual’s perception of self and notion of reality.

Anxiety

Anxiety is an aversive emotional and motivational state occurring in dire circumstances (Eysenck et al., 2007).  It is a debilitating condition that manifests in several forms.  Some Anxiety disorders are more common than others, while some are triggered by a trauma or a situation that creates the manifestation due to conditions within the individual.  The individual has an overwhelming, uncontrollable fear and dread about every aspect of their life.  Anxiety impedes the individual’s mental health capacity to function; it affects the individual work-life or finances and disturbs the family dynamics.  The repetitive negative self-talk and elements of paranoia where internalisation, self-focus are intensified, debilitating the individual, mentally, physically and socially, leading to depression if left untreated.  According to Health Direct (2019), Generalized anxiety disorder (GAD) is an extreme and overwhelming worry about mundane daily life.  According to Beyond Blue (2019), generalized anxiety disorder (GAD) is when an individual is constantly experiencing anxious emotions, not in specific stressful situations but continuously affecting all aspects of daily life.  The constant cyclic fears in all aspects of everyday life, from health, family, and work.  Every slight daily aspect of their lives becomes a focal point of the attention within the anxiety, from being late to an appointment to simple household chores; these can spiral an individual with a generalized anxiety disorder to overwhelming emotion that something dreadful will transpire, a form of predictive catastrophe.

Social anxiety disorder (SAD), also known as social phobia disorder, is an incapacitating condition that causes individuals to circumvent social situations of fear of being ridiculed or rejected.  According to Brook and Schmidt (2008), it is a chronic illness categorized as the constant dread of social situations.  Its prevalence is 7% to 13%, with the last two decades depicting a rapid increase as social media and technology become staples and extensions of society. Panic disorder is another disorder under the anxiety umbrella.  An individual must have had two panic attacks to be diagnosed with panic disorder.  A panic attack manifests as an unexpected intense occurrence of illogical fear, shortness of breath, dizziness and other physical symptoms.  Individuals have described it as an internal separation of senses as though the internal body was speeding at high velocity.  However, the outside appeared to move in a painfully slow motion.  According to Richmond (2003), one in 10 individuals between the ages of 15 and 25 usually begin with panic attacks.  About 3% of adults have it, and it is more common in women than in men.

Specific phobias are among the most common anxiety disorders as most of the population has a couple, to a culmination of very specific phobias. According to the Mayo Clinic (2016), Specific Phobia is not seen as a problem unless it becomes an impediment to the individual’s way of life.  Specific phobias are illogical fears targeting one area, such as a fear of people, places, animals, or insects.  Common fears generally are Acrophobia, the fear of heights, Claustrophobia, the fear of confined spaces, Coulrophobia is the fear of clowns and Arachnophobia, the fear of spiders.  For example, if an individual were to see a spider, they would become highly anxious, and their body would start to show signs of becoming highly stressed.

Characterized by obsessions and compulsions, obsessive-compulsive disorder (OCD) is the undesirable feelings, compulsions, and fixations that cause a habitual compulsion to repeatedly repeat a routine, action, or behaviour to soothe the anxious feeling of dread.  According to Better Health (2012b), individuals with obsessive-compulsive disorder are acutely embarrassed by their repetitive, routine behaviours and compulsions.  In addition, the condition and ritualistic elements of the illness retain them housebound and isolated.

Post-traumatic stress disorder (PTSD) is a disorder of reliving fear or trauma in individuals who have experienced or witnessed a traumatic life event.  According to the National Institute of Mental Health (2019), an individual with post-traumatic stress disorder cannot deal with or move past the circumstances of that situation or traumatic incident.  Instead, they are stuck in a loop and relive that moment and situation, and anything can trigger or instigate the recall of that experience and trauma.  Post-traumatic stress disorder according to Health Direct (2019), manifests in reliving the traumatic memories in the form of flashbacks, nightmares affecting sleeping and general daily life.

Evidence of Symptoms

Anxiety is a multifaceted mental health condition that affects all levels of society.  There is a notion that biology and genetics influence the condition and their response mechanisms. It begs to consider how previously generations in the past managed the world and coped with the additional contributing factors of human resilience.  According to Lukasik et al. (2019), Anxiety and trauma produced by severe life-changing events like emotional, physical and mental distress and stressors have revealed the detrimental effects and deterioration of cognitive development within the working memory.  Cognitive performance affects numerous elements, including the non-cognitive emotional state.  According to Wang et al. (2015), their study on anxiety strongly demonstrated that Generalized anxiety disorder is related to cognitive deficiency and impairment, specifically in the attention and working memory area.  When ranked in order of cognitive debilitation, anxiety disorders, according to Nyberg et al. (2021), ranked second among all mental disorders.  The complexity and severity of range within the condition and the impact the disorder has on executive functions and working memory, independently of comorbid major depression and cognitive function.

According to Volel et al. (2018), anxiety disorders’ high prevalence and significance within the community are essential due to the negative impact on the quality of life and the associated physical symptoms and neurological impairments present in the patients.  The cognitive and social development during puberty affects the behaviour response during anxiety episodes.  According to Blaker (2019), anxiety disorder has common symptoms.  However, the less common symptom experienced by adolescents can go undiagnosed until it becomes severe and diagnosed.  Some of the unusual anxiety symptoms are indigestion, heartburn, nausea, and any stomach related symptom.  Another is phantom ringing in the ear, from buzzing or humming.  Symptoms of burning on the skin, lips, mouth, and eyes, to prickly sensation on the skin, or sharp shooting pain over the body.

Anxiety disorder has been associated with palpitations, but heart irregularities are also an undiagnosed part of the condition, with misdiagnosis due to the difficulty to distinguish between heart irregularities caused by anxiety versus a heart attack (Blaker, 2019).  Other symptoms are phantom smells, tremors, eye problems, physical numbness and tingling, excessive yawning, globus hystericus, a lump in the throat and derealisation, the sensation of not experiencing reality, to a feeling of losing touch with reality.

Impact on the Individual and Interactions

Adolescents’ perception and processing of stress conditions outside their comfort zone is demonstrated as fight, flight, or freeze response mode.  According to the American Academy of Child and Adolescent Psychiatry (2019), teenagers develop an overload of stress leading to manifesting neuroticism when exposed to stressful conditions.  They exhibit and display forms of anxiety, mood irregularity, aggression, irrationality in behaviour, and physical illness and can turn to substance abuse as coping mechanisms.  Stress factors take the form of difficult or painful changes in the adolescent mind and the body begins to prepare for the response to danger.  The physical symptoms manifest as fast racing heart, rapid breathing, increased blood to muscles in the arms and legs, becoming physically cold or rise in body temperature with clammy hands and feet, sensations of upset stomach including nausea and a sense of dread and panic. According to Headspace (2021a), adolescents fear the future and the impact of their place within the environment.  The worry and anxiety referred to as ‘climate anxiety’ being that it is a new concept affecting adolescence and youth culture generation.  The increased level of anxiety based on a future generation that will be most affected by climate change affects the psyche of adolescents today.  Therefore, the sense of urgency to create direct change for future generations adds to the stress and non-compliance from older generations. All these factors and perceptions create additional anxiety for the current generation, who feel that they must cope and deal with a resistance of outdated ideologies and mindsets.

Suggested Interventions

The following suggested intervention allows for the development of cognitive restructuring and cognitive executive functioning skills to manage anxiety and modify the development of depression as a secondary condition.  Moodgym is an interactive program introduced in 2001 that has applications to assess emotions like anxiety and depression. It allows individuals to reformulate their thinking from negative tendencies into positive thought patterns. It retrains the individual to consider how thoughts can alter perception, mindsets and emotions. It aims to develop the individual the learning skills to manage and work through these emotions.  According to Moodgym (2021), several research trials globally have been performed within settings from schools, workplaces, crisis support services, and mental health care services.  As a result, diverse individuals have used the program (especially adolescents), with students able to access it at their own pace with and without therapist guidance.

Moodgym requires the individual to register and is a free service. However, it has proven to have various secondary benefits.  According to Powell et al. (2012), studies demonstrated that moodgym was an effective tool in improving wellbeing. It allowed the individual to be aware of the automatic tendency of thought patterns and behaviours and tools to modify negative responses by illustrating options of considerations. Moodgym models and simulates examples and activities with a pre-test that is a prerequisite at the start before starting the modules. This gauges the individual’s mindset and depressive, anxious or other sever thought patterns. In addition, studies suggested that moodgym was the feasible choice for individuals who could not access face-to-face therapy and treatment due to distance, location, or other circumstances. It was also available to reexplore once the program was completed and individuals could practice key activities, explore the characters, modules and activities again for further practice and enforcement of learnt skills.