What if My Teen Struggles With Anxiety and Depression Together?

Anxiety and depression are common illnesses for teens. Although anxiety is more prevalent among adolescents (31.9%) compared to depression (14.3%), both illnesses can have a severe impact on the functioning of a teen’s day to day life. But what if your teen struggled with both?

Anxiety Disorders

There are a variety of anxiety disorders that teens can experience, all of which can interfere with their ability to do well in school, have healthy relationships, or function day to day. Essentially, anxiety disorders are a group of psychological illnesses that include symptoms of anxiety and fear. The following is a list of types of anxiety disorders:

Generalized Anxiety Disorder – This illness is characterized by chronic and excessive feelings of nervousness or stress which seem to arise without cause. One of the major symptoms of this illness is an experience sometimes referred to as floating anxiety – a feeling of stress or tension that has no cause or trigger. It’s important to point out that teens with this illness experience excessive feelings of anxiety.

Social Anxiety Disorder – This is a psychological illness in which individuals have an extreme fear of social situations and being around others. A person with this illness commonly fears being evaluated and judged by others, to the point where it is debilitating. Frequently, this fear prevents them from being able to participate and engage in healthy activities and relationships. Those with Social Anxiety Disorder typically feel self-consciousness in an extreme way. They often also feel a fear of being embarrassed or humiliated. Sadly, even average, every-day interactions can feel overwhelming.

Panic Disorder – This illness involves the consistent experience of attacks as well as a persistent concern about having additional attacks. Typically, teens with this disorder are extremely anxious and fearful, primarily because of the inability to predict when the next attack will occur. Attacks are often accompanied by a feeling of being out of control and include uncomfortable physical sensations, such as a pounding heart, sweating, weakness, dizziness, and numbness. An intense worry about the next attack is a common symptom that makes Panic Disorder difficult to manage.

Phobias – A phobia is an irrational or persistent fear of an object, situation, or social activity. Most teens with specific phobias, such as claustrophobia – the fear of small spaces, have several triggers. When they are in the presence of a trigger, or sometimes just by thinking of the trigger, they experience anxiety. Depending on the type of phobia and the number of triggers, a phobia can become debilitating for a teen.

Obsessive Compulsive Disorder – This illness is characterized by repeating (obsessive) thoughts and images that might cause teens to behave compulsively in certain ways, such as performing the same rituals over and over again. These may include washing hands, locking and unlocking doors, or counting money. A teen typically cannot control the unwanted thoughts but they may experience some relief through the compulsive rituals they engage in.

Post Traumatic Stress Disorder – This is a mental illness experienced by a teen who has endured a traumatic event, and who is experiencing symptoms of anxiety as a result. These symptoms may include flashbacks, bad dreams, and frightening thoughts. An adolescent might also exhibit symptoms of avoidance, such as staying away from certain places to avoid reliving the traumatic experience or forgetting the experience entirely.

It’s important to note that in previous years, the last two illnesses above (OCD and PTSD) were considered to be subtypes of anxiety disorders. However, in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these two illnesses are now categorizes as its own type of illness.

According to the National Institute of Mental Health (NIMH), there are about 8% of teens ages 13-18 who have an anxiety disorder. Sadly, it’s very common for teens to believe that their symptoms are a regular part of life. If adolescents (or their parents) are not aware that they can get help for their anxiety, they may continue live with those symptoms throughout their adolescence and even into adulthood. Often, it is when those symptoms become so debilitating that something if finally done about it.

Mood Disorders

Mood disorders are psychological illnesses in which teens experience a disturbance in their mood, such as with the illness of depression. And although it’s easy to believe that there is only one form of depression; there are actually many types of depression that a teen can experience:

Major Depression – This mental illness has symptoms that interfere with daily living such as eating, sleeping, school performance, and studying. Some teens with major depression might have one period of depression in their lifetime, while for others periods of depression may be ongoing or return periodically.

Persistent Depressive Disorder (PDD) – This is a milder form of depression, once known as dysthymia. It is a chronic but low-level experience of depression, usually accompanied by irritability and an inability to experience joy. It includes the above symptoms but in a milder form. It can last longer and episodes of PDD can range from months to years.

Minor Depression – This form of depression is less severe than the other two illnesses mentioned and its symptoms are less severe. However, symptoms are present enough to recognize a problem, and if untreated, it can lead to major depression.

Seasonal Affective Disorder (SAD) – This type of depression is characterized by experiencing sadness or low moods during particular seasons of the year, partly due to the lower levels of sunlight.

Bipolar Disorders – There are two major type of bipolar disorder. This illness includes depression as well as experiencing high states, known as mania. Experiencing a swing of moods between depression and mania is what characterizes this illness.

According to the 2014 Conference held by the Anxiety and Depression Association of America (ADAA), the following are rates of occurrence of depression in adolescents.

  • Major Depression or PDD – 11.7%
  • Bipolar Disorder (I or II) – 2.9%
  • Any Mood Disorder – 14.3%

Like with anxiety, many family members grow up with depressive symptoms and believe that they are a regular part of life. This is especially true of teens who were raised by a parent with depression. Furthermore, it can be difficult for a family member to admit they are depressed, further exacerbating a teen’s desire to keep their symptoms hidden.

Anxiety and Depression Together

It’s common for teens to feel both depressed and anxious. For instance, at the start of the day, a depressed teen may feel anxious about the way he or she looks (hoping not to get rejected by peers). If during the day, a peer was rude or made a sneer comment or made a face, that teen may take that as evidence for being worthy of rejection. And throughout the day, that teen might also feel anxious about being rejected by other peers. In one day, a teen can easily experience depressive symptoms as well as anxiety.

In fact, depression disorders often coexist with illnesses of anxiety. For instance, a teen might have experienced a recent trauma, triggering feelings of anxiety around the event. And that event might have also triggered depression, especially if that event meant the loss of a loved one. A teen might have social anxiety as well as major depressive disorder, such as in the example above.

The following are illnesses that can co-occur with depression:

  • Generalized Anxiety Disorder
  • Social Anxiety
  • Panic Disorder
  • Post Traumatic Stress Disorder
  • Addiction
  • Eating Disorders

Both anxiety and depression are illnesses that are commonly experienced by teens. But according to the 2015 Child Mind Institute Children’s Mental Health Report, only 80% of children under the age of 18 who have a diagnosis of anxiety receive treatment for their disorder. Similarly, only 60% of youth with a diagnosis of depression actually get treatment.  If you are a parent seeking professional mental health support for your teen, it’s important that the mental health provider is aware of the full scope of symptoms your teen is experiencing so that one or more illnesses can be identified.

Treatment for Coexisting Anxiety and Depression

Fortunately, when a teen has both anxiety and depression, treatment can often address both illnesses. For instance, antidepressants can help with both symptoms of depression as well as symptoms of anxiety. Despite this, as mentioned above, the mental health provider needs to be aware that both illnesses exist. Typically, teen co-occurring disorder treatment would include:

  • psychological evaluation
  • individual and/or family psychotherapy
  • support groups
  • medication
  • relaxation techniques
  • regular exercise
  • other wellness practices

Furthermore, strong communication is needed among the psychiatrist, psychologist, family members, social workers, teachers, and other professionals in a teen’s life. Ideally, there would be an integration of services between the psychiatric and the counseling professionals in order to best treat a teen with a co-occurring disorder.

Seeking Support for Anxiety and Depression

If you recognize that your teen is struggling with symptoms of anxiety and/or depression, call a mental health professional in your community. They can often provide a diagnosis, and the appropriate treatment plan can then be developed. However, without call for professional help, your teen may never get a proper diagnosis, which in turn can lead to the right treatment.