How do you know if your teen’s anxious behaviour is “normal”, or they have anxiety that needs professional attention?

Dr Thabo Mogotlane, a specialist psychiatrist at Mediclinic Legae, explains the difference.

Being a teenager is difficult at the best of times – hormonal changes, trying to fit in socially, schoolwork, pressure to look and act in a certain way, and the effects of social media. So, it’s no wonder your teen sometimes gets anxious and moody in response to these kinds of stressors. But when their anxiety becomes ongoing, and there’s no apparent reason, your child may need help.

"Normal” anxiety in teens

Anxiety means fear and worry and it’s natural to experience both emotions in response to uncertain life events. Most teens will show signs of these emotions before a big exam, for example, or if they’re moving schools.

Natural anxiety goes away when the triggers are removed. If your child is starting a new school, for example, anxiety should disappear within about three months. If they’re anxious before a big test, sports match, or presentation, they should be okay afterwards.

But when your teen is anxious almost all the time without any obvious triggers, it becomes a concern. When there’s no trigger it’s called pathological fear and worry.

Signs and symptoms of pathological anxiety in teens

  • Panic attacks – symptoms include a racing or pounding heart, sweating, trembling, difficulty breathing, dizziness or weakness and chest pain.
  • Social anxiety disorder – fear of social situations and becoming anxious about going to school, a birthday party, or even to the mall. If your teen is suddenly displaying anxiety about the very thought of social interactions, it could be a concern.
  • Change in sleeping patterns – either sleeping too much or too little.
  • Change in eating habits – either overeating or avoiding food.
  • Decline in academic performance – when a good student shows a noticeable drop in grades and attitude to study and schoolwork.
  • Irritability – when no clear reason exists.
  • Frequent complaints of physical maladies – such as headaches, back pain, or stomach aches.
  • Apathy – a general lack of interest in life.

How you can help

Speak to your GP about getting a referral to a mental health professional. Psychotherapy is usually the first option – therapy can help to determine the underlying cause of anxiety and give your child the tools to cope.

Cognitive behaviour therapy (CBT) is a good technique to help an anxious teen. A therapist trained in CBT will help them identify their fears and teach them to replace irrational, catastrophic thoughts with rational ones. This helps your child realise that the situation they fear is not so scary after all and gradually gives them the tools and confidence to be exposed to it.  

If therapy doesn’t help, or as an adjunct to therapy, they may need medication. Because anxiety and depression often go hand in hand, doctors will often recommend an antidepressant.

The most prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs). Serotonin is a chemical that carries messages between nerve cells in the brain and throughout the body. It plays a key role in mood, sleep and digestion. SSRIs treat depression by increasing levels of serotonin in the brain. They also block the reabsorption of serotonin into the neurons – the fundamental building blocks of your brain and nervous system.

Why treatment is vital

Anxiety in teenagers can be debilitating, robbing them of enjoyment in this formative period of their lives, affecting their performance at school, leaving them feeling isolated and afraid all the time – and failure to deal with these feelings can have lasting effects, even in adulthood.   

Having an anxious teen can affect the whole family too. They may not want to go out with you anymore, or participate in activities, inventing all sorts of reasons why they can’t. This behaviour, when ongoing, can be upsetting for parents and any other siblings. This is why it’s vital not to wait for it to “blow over”.

If you are concerned about your child, trust your instincts as a parent, and seek expert help now.

To find a mental health professional at your nearest Mediclinic, visit

Disclaimer: The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.