Our world can be a very stressful place. Kids are hardly immune to worrying. In fact, it is arguable that they worry now more than ever before because of all the violence in schools, natural disasters and pollution problems. So, it’s not surprising to learn that recent studies conducted by the Centers for Disease Control and Prevention (CDC) estimate that 30% of teens and children with ADHD experience anxiety disorders of some sort. These are often exacerbated by their youthful impulsivity, fidgeting and forgetfulness. Also, constant reminders (or reprimands) to sit still, stop talking, or do their work can raise stress levels – and lower self-esteem.

But let me get personal for a moment. Moreover, my grandson worries about asking girls out on dates, getting parts in his school plays, and (continuously) how to make friends. Over and above all this is the ADHD. The fact is that many times he can’t find his work to turn in; and it’s hard for him in general to stay on track and finish the work. All that is a recipe for an anxiety disaster – or a bona fide panic attack – for teens as well as for younger children.

Disclaimer

It’s important to note that I am not a counselor or psychologist. I cannot diagnose or treat any mental-health condition. The recommendations and other information in the post are merely offered as-is as research leads. If you suspect that you or a loved one is suffering from an anxiety disorder, then you should seek professional assistance.

Background: What is ‘anxiety’?[1]

From the standpoint of psychology, “anxiety” denotes often overwhelming feeling of nervousness or worry about life’s problems. One could argue that anxiety just is the way that humans naturally respond to stressful situations.

For example, the first day of school (or, for that matter, a job interview) can produce actual fear in us and make us feel uneasy or anxious. Truly, these feelings are a normal part of everyday life. However, if the fearful feeling is with you all the time and is interfering with your life, it can be serious. This is what doctors call an anxiety disorder.

Symptoms to Watch for

• “Fidgety” behaviors such as finger tapping or hair twirling.
• Withdrawal from friends and other social activities that they enjoy.
• Sleep disturbances.
• Especially argumentative behavior – more than seems normal for your teen.
• Increased irritability and other emotional changes.
• Physical changes – complaining of stomach problems or headaches (particularly when these are nonspecific or diagnostically idiopathic).
• Panic attacks. (This one is pretty much a dead giveaway.)

Could It Just Be ADHD?

It can sometimes be hard to tell the difference between ADHD and a bona fide Anxiety Disorder because they have a lot of commonalities.[2]

• Inattention – Obviously, this is a classic symptom of ADHD. However, a child with an anxiety disorder may be inattentive because they are brooding over their problem.
• Poor relationships with friends – Both disorders struggle with this, but the etiology is different. Teens with social anxiety worry about rejection and negative emotions while being with friends, while an ADHD teen has problems with impulse control and poor social skills.
• Slow work habits – Perfectionism makes it difficult for anxious kids while lack of organization skills and poor attention spans hinder kids with ADHD.
• Always moving – Both disorders display this symptom. But there is a need to try to control the excessive nervous energy that is found in anxious children as opposed to the low impulse control of the ADHD child.

Keep in Mind[3]

Teenagers with anxiety problems:

• Worry about the situation.
• Display perfectionist tendencies.

Whereas, teenagers with ADHD also:

• Lack organizational skills.
• And sometimes display impulsivity problems.

Main Types of Anxiety Disorders

Once you are reasonably sure that you’re contending with an anxiety disorder, the first step toward treatment would be to identify the sorts of fears that are giving rise to the problem. By way of general introduction – which is, as I previously stated, the only thing that I am able to provide – I think it is helpful to understand the psychological lay of the land (so to speak).

I will briefly sketch five of the top varieties of anxiety disorder described in the literature.[4]

• Generalized Anxiety Disorder – This is any worry that is unrealistic or excessive and exists for no discernible or good reason. The main worry: Here, there is no one, specific area of concern. Rather, the anxious feelings are rooted in matters that remain somewhat vague.
• Obsessive Compulsive Disorder – This occurs when a person develops idiosyncratic rituals that are habitually performed in order to dispel various worries. The fears themselves are focused on obsessively and the fear-elimination routines are said to be repeated compulsively. The main worry: Main worries could be things that verge on superstitions – e.g., fears that something bad will happen if you don’t wake up on the correct side of the bed, or brush your teeth for a certain time,[5]
• Panic Disorder – Panic “attacks” occur when someone is seized suddenly with paralyzing anxiety, fear or nervousness. They can mimic heart attacks and come complete with apparent chest pain or heart palpitations. The main worry: In this case, fears often (but do not always) revolve around personal health, hypochondria, etc.
• Social Anxiety Disorder – This is a fear of social situations in which you worry unduly about being judged or embarrassed. The main worry: Clearly, typical concerns include fear of criticism or humiliation.
• Specific Phobia – This can be any irrational and persistent fear – like fear of flying (aviophobia) or fear of being trapped in small places (claustrophobia). The main worry: For specific phobias, the main worry is obviously whatever is the focus of the phobia.

What Can Help?

Non-Medication Approaches

Anxiety can sometimes be tackled through non-pharmacological methods. Spring-boarding from the section, once a worry is isolated, you can begin to try to find ways to mitigate it.

• Keep track of how and when worries start. Certain situations probably recur and start the chain of worry, anxiety and more worry. Knowing what starts it can help you head it off. A personal journal can be an excellent – and cathartic – tool.
• Take small steps. Small steps help us to gradually learn to cope. For example, one of my students had an intense fear of public speaking (glossophobia). So, I let him present only to me the first time. The next time he presented to a few friends, then his small group of six and, finally, he felt confident enough to give a short presentation to the class.
• Stop those thoughts! There’s a comedy sketch featuring Bob Newhart as a therapist in which he listens to a woman articular her fear of being buried alive (taphophobia). She describes how dwelling on this thought is debilitating. Newhart, with characteristic deadpan delivery, simply snaps, “Well…stop it!” Easy said than done, perhaps. But the serious truth is that just as recognizing situational triggers can help you to learn to lessen your anxiety, so can knowing your own thoughts. Negative and highly emotional thoughts can totally overwhelm us. This makes it difficult to move on to more positive thinking. Learning how to say “no!” to the idea your brain is presenting you with and redirecting your own thoughts can take some practice. However, it’s very important to interrupt this cycle of destruction.
• Practice deep breathing. Breathe in for a count of five; hold for five; and exhale for five. It slows your heart rate and decreases tension. Deep breathing is also, in my opinion, an under-recommended technique for general relaxation and can assist you in falling asleep.

Other Natural Helps[6]

• Exercise – Daily exercise contributes to a healthy lifestyle. But even a little can help you to relax. This is especially true of aerobic exercise, because it stimulates endorphins that are natural mood elevators. Examples of aerobic exercises are walking, swimming, running and cycling. (“Aerobic” means with oxygen.)
• Go outside – This ties into the first one because aerobic exercise can be done outside in your neighborhood or park. You can lower your blood pressure, heart rate and level of tension just by walking out the door because being in a natural environment has a calming effect. But it’s been found to help even if a person merely looks at a picture of a favorite place! Though, being in the sunlight though has the added benefits of receiving vitamin D3 which can reduce depression (among other things).
• Garden – Gardening not only get you outdoors, but it’s also good exercise. Digging in the soil, smelling the delightful fragrances of flowers and herbs can put you (or your teenager) in a better mood.
• Use aromatherapy – The simple smells like lavender, rose or chamomile can also have a calming effect on the mind and body. These scents can be diffused or added to a warm bath.
• Meditate – Meditation helps to free your mind and control breathing by replacing anxious thoughts with quiet and serene thoughts.
• Practice yoga – This form of exercise strengthens, stretches and relaxes the body.
• Get more sleep – Sleep is so important for your heath. It can boost your focus, mood and energy level. Everyone should get at least seven to nine hours of sleep every night. This will recharge your brain and keep it healthy.
• Make a to-do list – Sometimes anxiety arises because of everything that a teen has to do. Making a list can eliminate the fear of forgetting something, but it can also highlight an item that is unimportant thus letting them let go of it and not worry.
• Keep a journal – Maintain your own diary or journal – especially a gratitude Every day I jot down two to three things that I am grateful for. These can be tangible items or events, but they can also try to include something that you have accomplished or learned that day. Or maybe a person that really helped you or inspires you.
• Eat healthy foods – This includes eating fruits and vegetables and lean proteins while eliminating processed and fast food that has too many chemicals and artificial additives in it. Also drink plenty of water to stay hydrated. Dehydration can cause headaches and other problems.
• Avail yourself of ‘art therapy’[7] – Art therapy is a kind of therapy that concentrates not on the product of other people’s creative processes, but rather on the patient’s own acts of creating. For example, a child might make an art piece because working with the materials relaxes him or her. This helps especially those children and teens that can’t (or won’t) communicate their feelings. Experiences that use our senses can promote peaceful feelings that replace the chaos in our lives.

Herbal Sedatives

This arguably lands somewhere in between the interventions named above and full-out prescription medications, sketched below. Herbal supplements can be helpful additions to your, or your teenager’s, dietary regimen.

Even though they may not be as potent as their pharmaceutical cousins, they should be treated with respect as they can have contraindications, negative interactions, or other unpleasant and possibly dangerous side effects. Consult with a knowledgeable medical practitioner or naturopath.

• Baizhu (Atractylodes macrocephala)
• Longan (Dimocarpus longan)
• Dorstenia (Dorstenia arifolia)
• Morning-Glory (Ipomoea purpurea, Ipomoea tyrianthina, etc.)
• John’s Wort (Hypericum montbretia, Hypericum perforatum, etc.)
• Kava Kava (Piper methysticum)
• Valerian (Valeriana officinalis)
• Jujube (Zizyphus jujuba)

Medication Approaches

This is not the space to exhaustively discuss pharmacological interventions. However, I will say something about them anyway.

First, you should realize that there are several different categories of drugs that can sometimes be used to treat anxiety. The decision of which category – if any – if appropriate in a given circumstance is, of course, up to a qualified medical professional (general practitioner, psychiatrist, nurse practitioner, other specialist, etc.).

Anti-Anxiety Drugs (Anxiolytics)[8]

Simply stated, an “axiolytic” is a compound that treats anxiety. Etymologically, the suffix “-lytic” comes from the Greek word lusis, meaning to “destroy or loose.” So, the idea is that an axiolytic is a substance that can free a person from anxious feels.

Chemically, most of these drugs are benzodiazepines (“benzos”).[9] Some of the most commonly prescribed anxiolytics are as follows.

• Klonopin (Clonazepam[10])
• Lectopam (Bromazepam[11])
• Librium (Chlordiazepoxide)
• Mogadon (Nitrazepam)
• Serax (Oxazepam)
• Tranxene (Clorazepate)
• Valium (Diazepam)
• Xanax (Alprazolam)

Not all are benzos, however.

• Buspar (Buspirone)

Selective Serotonin Reuptake Inhibitors (SSRIs)

Although they differ chemically, and are mainly known as antidepressants,[12] physicians sometimes prescribe SSRIs for anxiety.

• Celexa (Citalopram)
• Lexapro (Escitalopram)
• Luvox (Fluvoxamine)
• Paxil (Paroxetine)
• Prozac (Fluoxetine)
• Zoloft (Sertraline)

Sedatives

Sedatives are used to calm people or to bring on sleep. The word derives from Latin – for example, from sedamen, meaning an “allayment,” (and its cognates). Similarly to the anxiolytics, this category is composed of benzodiazepines and nonbenzodiazepines.

Benzos

• Prosom (Estazolam)
• Somnos (Chloral hydrate)
• Versed (Midazolam)

Non-benzos

• Ambien (Zolpidem)
• Lunesta (Eszopiclone)
• Sonata (Zaleplon)
• Zimovane (Zopiclone)

Final Words

Everyone gets anxious at times. This is a normal part of life. Anxiety, while a natural byproduct of living, can wreak havoc in a child’s or teen’s life if not dealt with. It’s how we deal with it that counts.

As we have seen, there are many ways to help our children deal with the pressures of school and life besides medication, although medication is sometimes warranted.

Notes

[1]“Relationship Between ADHD and Anxiety,” Healthline.

[2]See, e.g., Katie Hurley, “ADHD and Anxiety in Children,” PSYCOM, https://www.psycom.net/adhd-children-anxiety

[3] “What Are Anxiety Disorders?” WebMD.

[4] There is also Post Traumatic Stress Disorder. I will set this aside, presently.

[5] And we’re not thinking about the minimum amount of time that a dentist might recommend brushing to maintain good hygiene. Rather, I’m thinking about a person who superstitiously scrapes the brush in particular patterns because he or she is worried that not doing so will issue in some non-tooth-related disaster.

[6] “10 Ways to Naturally Reduce Anxiety,” Healthline.

[7] “3 Natural Ways to Calm Your Child’s Anxiety,” Heathline.

[8] Ativan (Lorazepam), Emandaxin (Tofisopam). There are also other sedatives – such as Dalmane (Flurazepam), Halcion (Triazolam), Restoril (Temazepam), and so on – that are chemically similar. These have largely replaced barbiturates (pentobarbital, phenobarbital, secobarbital, etc.).

[9] This means that their structure consists of both Benzene and Diazepine “rings.”

[10] Also sold under the name Rivotril.

[11] This is also known as Lexotan, Lexatin, and several other names.

[12] A few, like Priligy (Dapoxetine), are used for other conditions (in this case, male sexual dysfunction).