Anxiety in teens: what it looks like and how to cope

This page is not medical advice or a diagnosis. Only a trained health professional can tell what is going on with your teen. Do Not Lose Hope is not a clinic or a crisis line.

Is this normal worry or anxiety?

Every teen worries. A big test, a new school, a fight with a friend, news about immigration raids. Worry before a hard thing is normal, and it usually fades once the hard thing is over.

An anxiety disorder is different. The worry does not go away. It shows up in many situations. It can grow over time. And it starts to get in the way of school, sleep, friends or family life.

You are not alone in this. The CDC reports that about 11 percent of children ages 3 to 17 had diagnosed anxiety in 2023 and 2024. In a 2021 to 2023 survey, 20 percent of teens ages 12 to 17 said they had anxiety symptoms in the past two weeks.

Ask yourself three questions:

1. How long has it lasted? Weeks and months, not days.
2. How much does it get in the way? Missing school, skipping things they used to enjoy, not sleeping.
3. Is it growing? More things to fear, more time spent worrying.

If the answer to any of these worries you, it is reason enough to get a check. You do not need to be sure first.

What does anxiety look like in a teen?

Teens do not always say "I am anxious." Many keep their worries to themselves, so the signs are easy to miss. Watch for:

In the body

• Stomachaches, headaches or tiredness with no clear medical cause
• Trouble falling asleep or staying asleep
• A racing heart, sweating, shaking or feeling out of breath

In feelings and mood

• Fear or worry that seems bigger than the situation
• Being irritable, angry or on edge
• Needing a lot of reassurance, asking "what if" again and again

In behavior

• Avoiding school, classes, parties, sports or places with people
• Grades dropping, or trouble focusing
• Using alcohol, vapes or drugs to calm down
• Pulling away from friends and staying in their room

Some of these signs also show up with depression. If your teen seems sad or hopeless, has lost interest in things, or talks about feeling worthless, read Signs of depression and anxiety too. The two often come together.

What kinds of anxiety are there?

Anxiety is a group of conditions, not just one. The CDC names these in young people:

• Generalized anxiety: worry about many everyday things that is hard to control and not tied to one situation.
• Social anxiety: strong fear of being judged or embarrassed around others. It usually starts in childhood or the teen years. Teens may avoid school, have trouble making friends, or get stomachaches before social events.
• Panic disorder: sudden waves of intense fear with a racing heart, trouble breathing or chest pain, again and again.
• Phobias: extreme fear of one thing or situation, like needles, animals or doctor visits.
• Separation anxiety: intense fear of being away from parents or of being separated from them.

What about OCD?

Obsessive compulsive disorder (OCD) means thoughts that keep coming back and will not stop (obsessions), repeated behaviors the person feels they must do (compulsions), or both. Examples are washing hands over and over or checking a door again and again. It usually starts between late childhood and young adulthood.

OCD and anxiety share a lot, but OCD is its own condition. It needs its own check and its own kind of treatment. The therapy that works best for many people is called exposure and response prevention (ERP), a type of CBT. If your teen spends a lot of time on rituals, or gets very upset when they cannot do them, tell the doctor exactly that. And please do not joke "you are so OCD." For a teen who lives with it, it is not funny.

Why is my teen so anxious?

There is rarely one cause. The CDC names things that raise the risk: trauma or stress, violence, abuse, bullying, being rejected by peers, and having a parent with anxiety or depression.

In immigrant families there can be extra weight. Fear that a parent will be detained. Translating for adults. Money worries. Being the first in the family to do high school or college here. These fears are real, and your teen is not overreacting by feeling them. But when the fear takes over daily life, it still deserves care.

If the stress comes from immigration fears, a family plan can help everyone feel steadier. See Make a family preparedness plan.

How do I help without making it worse?

This is the hardest part for loving parents. When a teen is scared, we want to take the fear away. So we let them skip school, we answer for them, we stay in their room until they sleep. Experts call this accommodation.

Accommodation helps in the moment. Over time it can keep a teen from learning that they can face the fear and be okay. An NIH funded study of children ages 7 to 14 found that a program teaching parents to slowly reduce accommodation, called SPACE, worked as well as therapy given to the child.

Here is how we suggest trying those ideas at home. These steps are our practical advice, not the study's own wording:

1. Name it with calm confidence. "I know this feels scary. I also know you can handle it. I am right here."
2. Pick one thing to change, not everything. If you have been calling the school every morning so they can stay home, start with going in for first period.
3. Do not argue with the fear. "There is nothing to worry about" rarely helps. Say what is true: the feeling is real, and it will pass.
4. Praise brave steps, even small ones. Going in late still counts.
5. Expect it to get harder before it gets easier. A teen may push back when you change the routine. That is normal.
6. Get a professional to guide you if the avoidance is big, like weeks of missed school. A therapist can build a step by step plan with you.

Other things that help:

• Talk about what is worrying them and help them keep perspective.
• Keep expectations realistic. Teens need time to rest, play and be with friends.
• Talk about social media and help them take breaks.
• Protect sleep, movement and meals. These help, but they do not replace treatment.
• Teach one calming skill together, like slow breathing. See Simple grounding exercises.
• Take care of your own worry. Teens notice how we handle fear.

How is anxiety treated?

Anxiety disorders are very treatable. The main treatments are:

• Cognitive behavioral therapy (CBT). Federal health experts call it the gold standard talk therapy for anxiety. It teaches new ways to think about fears and to cope.
• Exposure therapy. A part of CBT where the teen slowly and safely faces the things they fear, step by step, with support.
• Family involvement. Therapy can include the teen, the family, or both, and the school can be part of the plan.
• Medicine. Some teens also take medicine, such as an SSRI. A doctor will explain the benefits and risks. These medicines can take several weeks to work.

Healthy habits like exercise, sleep and mindfulness help, but they cannot take the place of treatment when anxiety is a disorder.

Where can my teen get help?

Start with the doctor. Federal experts recommend anxiety screening for children and teens ages 8 to 18. Ask at the next checkup, or call now if things are bad.

Use Medi-Cal. Children and teens up to age 18 can get full Medi-Cal in California no matter their immigration status, and children do not pay the premium. Mental health care is covered. See Where your child can get mental health help in California for how to apply and which door to knock on.

Ask the school. School counselors can help, and many districts have mental health staff. Under federal disability law (Section 504), an illness can count as a disability for a particular student when it limits them. If anxiety is keeping your teen from learning, ask the school about support and a 504 plan.

Teens can start on their own. In California, a teen 12 or older who is mature enough can agree to outpatient counseling without a parent's consent. The counselor will usually involve parents unless that would be harmful. Your teen can also use Soluna, a free state app with coaching for ages 13 to 25, in English and Spanish, whatever their insurance or status.

Will they ask about immigration status? In California, if a clinic learns your immigration status, the law treats it as private medical information. See Will my therapist share my information with immigration?

When is it urgent?

Get help this week if:

• Your teen has missed school for days because of fear
• They cannot sleep most nights
• They have panic attacks
• They are using alcohol or drugs to calm down

Get help right now if your teen talks about dying, wanting to disappear, or hurts themselves on purpose. Call or text 988. If a life is in danger, call 911. See When a teen hurts themselves on purpose.

What should I tell the doctor?

Questions people ask

Is my teen just being dramatic? No. Anxiety is a real condition, and a teen cannot simply decide to stop it. Calm, steady support works better than pressure.

Will my teen grow out of it? Some worry eases with age. An anxiety disorder often does not go away on its own and can grow. Getting help early makes the path shorter.

Should I let them stay home when they panic? Once in a while is human. Often is a sign that avoidance is growing. Talk to the school and a therapist about a plan to get back step by step.

My teen does not want to talk to anyone. Start with the doctor for a body check. Or let them try Teen Line or Soluna first. Some teens find it easier to talk to another young person.

Is anxiety a lack of faith? No. Anxiety is a health condition. Prayer and your church can walk beside care, not replace it. See When to talk to your pastor and when to see a counselor.

Who can help

These are public programs, clinics and free lines. Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• San Mateo County BHRS ACCESS Call Center: for residents with Medi-Cal or no insurance. (800) 686-0101, 24 hours, TTY 711. English, Spanish and Chinese, with free phone interpreters. smchealth.org
• Santa Clara County Behavioral Health Services: (800) 704-0900, then press 1, 24 hours. bhsd.santaclaracounty.gov
• Ravenswood Family Health Center: counseling for children and adults, by self referral or through your doctor. 1885 Bay Road, East Palo Alto. (650) 330-7400. ravenswoodfhn.org
• allcove: youth centers for ages 12 to 25 with mild to moderate needs, free or low cost, most services without parent consent. San Mateo (650) 226-7030; Palo Alto (650) 798-6330. allcove.org
• Teen Line: for young people up to age 19. Call (800) 852-8336, 6 to 10 p.m. Pacific, or text TEEN to 839863, 6 to 9 p.m. English only. didihirsch.org/teenline
• Soluna: free California app for ages 13 to 25, English and Spanish. DHCS page
• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. Free and confidential, available 24/7/365.

Anxiety can make a teen feel trapped. It is not a trap. With the right help, most teens learn to face their fears and get their life back. We are holding hope for your family.