Adolescence

Adolescence is traditionally known as the developmental time between childhood and adulthood (Millstein et al., 1994). The period of adolescence can be an influential one when an individual gains physical, emotional, cognitive and social abilities that culminate and provide a foundation for their future (Beyond Blue, 2022c). This period is when young people go through biological changes reaching both physical and sexual maturity. These changes along with both cognitive and psychosocial changes enable adolescents to either make risks or alternatively lead to healthy lifestyle choices (Millstein et al., 1994). Due to the uniqueness of each individual, the adolescent period can be quite varied with some young people moving through this period quicker than others. Additionally, this time period may be more tumultuous for some compared to others who may have better coping mechanisms (Geldard et al., 2019).

Anxiety

Anxiety is a mental health condition that involves a person’s future-oriented emotion which is defined by an increased level of apprehension and lack of control. Anxiety can occur in many forms such as social anxiety disorder, separation anxiety, generalised anxiety disorder, panic disorder, agoraphobia and obsessive-compulsive disorder control (Wicks-Nelson & Israel, 2015). When a person experiences anxiety they experience anxious symptoms in reaction to situations they perceive as a threat to them, rather than actual danger (Wicks-Nelson & Israel, 2015). Considering there are several types of anxiety disorders, they vary amongst teenagers. Anxiety during the adolescent period can typically be based on the way their body is changing throughout the period of puberty, how their body is looking and feeling. It can also centre on being accepted by peers and conflicts they are experiencing about independence (American Academy of Child & Adolescent Psychiatry, 2022).

The impact on a young person’s daily functioning can be significant and varies according to the form of anxiety disorder they have. Adolescents who experience social anxiety disorder experience significant anxiety when exposed to social situations and subsequently this leads to avoidance behaviours with peers and the school environment (Geldard et al., 2019). Additionally, young people with generalised anxiety disorder, experience long periods of persistent worry, with the source quite often unknown. Their symptoms can often impact their ability to concentrate which again impacts their ability to engage in required school work (Geldard et al., 2019). Adolescents who experience obsessive-compulsive disorder often experience intrusive thoughts which are difficult to manage. These thoughts often lead to repetitive rituals which can be isolating when socialising with peers as well as providing a strain on family members in the home environment (Geldard et al., 2019). Overall the avoidance behaviours displayed by young people experiencing anxiety can impair relationships and can increase the likelihood of further mental health problems such as depression (Geldard et al., 2019). According to studies, this can impact a young person’s physical, psychosocial and cognitive functioning (Herbert et al., 2009).

Evidence of symptoms 

Young people during the adolescent developmental period experience not only biological changes but also cognitive changes. This occurs during the process of changing from more concrete thinking experienced during childhood to dealing with more abstract ideas enabling them to make independent decisions (Geldard et al., 2019). Additionally, during this period egocentric thinking traits develop, which can have a direct impact on the cognitive thought process of a young person experiencing anxiety. The individual differences this person identifies with such as physiological symptoms of social anxiety disorder include excessive blushing, sweating and stomach aches. These symptoms can prove to be isolating as the adolescent believes that no-one else is capable of understanding them (Geldard et al., 2019; Wicks-Nelson & Israel, 2015).

As a young person starts to form their personal identity during aolescence, anxiety disorder can take its toll on their cognitive functioning. Anxiety symptoms such as excessive fear of a perceived threat, catastrophising or obsessive thinking which is commonplace for obsessive compulsive disorder can affect the formation process of identity which is a central characteristic of this period (Beyond Blue, 2022a; Geldard et al., 2019). Overall these challenges can affect the quality of day-to-day functioning of an adolescent.

Impact on the Individual and Interactions

Behavioural and social implications of anxiety can be profound for young people. Behaviours that are commonplace for generalised anxiety disorder include excessively worrying about their competence in certain areas which leads to perfectionist behaviours, displaying nervous habits, restlessness and sleep deprivation (Wicks-Nelson & Israel, 2015). Additionally, youths who experience anxiety can suffer from physiological symptoms such as rapid heart rate, shaking, quick breathing, fear of losing control and even fear of dying (Beyond Blue, 2022c; Wicks-Nelson & Israel, 2015). These dramatic behavioural symptoms can impact a young person’s ability to maintain friendships during a period when closeness to friends remains a high priority, more so than to their parents (Millstein et al., 1994). Youths who experience social anxiety disorder often make mention of feelings of loneliness and lesser self-worth, leading them to avoid everyday activities such as attending school or eating in public places (Wicks-Nelson & Israel, 2015).

According to the DSM-5 (APA, 2013) a variety of assessment tools to assist in the identification of anxiety include self-report instruments, taking part in direct observations of the young person in question and interviews (Wicks-Nelson & Israel, 2015). The most favoured assessment tool is the self-report instrument as it provides accurate reports assessing behavioural, physiological and cognitive anxiety traits (Wicks-Nelson & Israel, 2015).

Suggested Interventions

Cognitive behaviour therapy (CBT) is known as one of the most widely used therapies to treat young people experiencing anxiety. There are many different approaches to CBT but all of them share similar characteristics which include attributes, such as: collaborative relationships between counsellor and client; the knowledge that the clients’ issues stem from cognitive processes; a plan to change cognitions in order to change behaviour and affect; and an active and direct approach lead by the counsellor (Corey, 2021). CBT involves exposing a young person to a feared situation in which they perceive is dangerous and through this changing their process of cognition through modifying their thinking patterns and avoidant behaviours (Gordon et al., 2014).