Free Parenting Workshop! December 9th @ 5:30pm

“Help! My teen is stressed, anxious and/or showing OCD tendencies.”   

Anxiety disorders are the most common mental health disorders of adolescence. Different kinds of anxiety affect young people at different times in development. 

Join us on December 9th at 5:30pm at Doorways to learn more about tools and strategies to support your teen during this time in their life.  The one hour workshop will be led by Megan Schwallie, MSW, LCSW, Licensed Clinical Social Worker.   She specializes in treating OCD and anxiety disorders as well as frequently co-occurring conditions such as Body Focused Repetitive Behaviors, Tourette Syndrome, and other tic disorders.  Megan received her Masters in Social Work from the School of Social Service Administration at the University of Chicago in 2009. She has completed substantial post-graduate training in her areas of expertise with the International OCD Foundation, the Trichotillomania Learning Center, and the Tourette Association of America.

Anxiety Disorders in Teens and Young Adults

Did you know that an estimated 31.9% of adolescents suffer from some kind of anxiety disorder? And while the condition enjoys a high treatment success rate, the percentage of those who actively seek professional help for anxiety disorders is very low. In fact, only 1 in 5 teen sufferers actively seek professional help for their condition.

Characterized by intense and excessive amounts of nervousness, worry, and fear, anxiety disorders can affect the day-to-day workings and functioning of the sufferer.

However, given that anxiety disorders are highly treatable, it is indeed unfortunate that the level of awareness about the condition is very poor among the general population.

Which means, most sufferers of anxiety disorders, of which adolescents form a substantial percentage, continue to suffer through most of their childhood, and well into their adulthood, in silence.

Causes of Anxiety Disorders

Genetics can be a contributing factor in developing an anxiety disorder. This is especially true if the condition runs in the family. On top of this, some teens are more prone to developing the condition after undergoing a stressful event.

The divorce of parents, the loss of a loved one, a traumatic accident, or too much pressure to excel in academics or sports can lead to anxiety.

anxiety disorders in teens and young adults

Different Forms of Anxiety Disorders Among Young Adults

Anxiety disorders among young people can be classified under different types. Primary among these include the following:

Generalized Anxiety Disorder (GAD)

Teens and young adults often face a lot of pressure at school, from their parents, or within their immediate social group. Sometimes it is about excelling in a particular arena, or it could be over their actions and behaviors. This can lead to excessive worrying—even about the smallest of issues.

Common symptoms to watch out for:

  • High-strung and restless.
  • Unable to focus or concentrate.
  • Highly fatigued.
  • Difficulty in sleeping or suffering from disturbed sleep.

Panic Disorder

This condition is characterized by unexpected yet reoccurring panic attacks which cause the sufferer to experience sudden and intense episodes of fear or a feeling of doom. Panic disorder, if left untreated, can cripple the social and relational life of a young person.

Common symptoms to watch out for:

  • Elevated heart rate.
  • Feeling of choking or experiencing chest pain.
  • Excessive sweating and trembling as well as having difficulty in breathing.
  • Dizziness, a numbing or tingling feeling in the arms and legs.
  • Gastric distress (abdominal pain, cramping, gas, nausea, indigestion, etc.).
  • Unexplainable fear of dying.

Separation Anxiety

Separation anxiety is more common among young children and teens. The fear of separating from a parent or caregiver or someone with whom they enjoy a strong emotional bond can trigger separation anxiety.

Common symptoms to watch out for:

  • Excessively worrying about losing the parent, caregiver, or loved one.
  • Excessively worrying about an impending departure of the loved one.
  • Avoiding activities which require separating from the parent or loved one.
  • Headache, nausea and vomiting, sweating.

Social Anxiety Disorder

Social anxiety disorder is characterized by a strong and often crippling fear of being embarrassed or humiliated when in social events or gatherings.

An adolescent might fear saying or doing something which could cause them embarrassment. An estimated 15 million people in the US suffer from this condition and the onset age is during the early teenage years.

Common symptoms to watch out for:

  • Avoiding social gatherings, which could include going to school, or other social events.
  • Fear meeting new or unfamiliar people.
  • Worry they will be judged or scrutinized by other people.
  • Worrying for days about attending an upcoming social event.
  • Nausea, excessive sweating, rapid heart rate, dizziness, and difficulty speaking in front of others.

Treatment is Available

Adolescents suffering from anxiety disorders don’t have to suffer in silence. With timely intervention, including professional counseling, medication management, and dialectical behavioral therapy (DBT), an anxiety disorder can be effectively treated.

How Doorways Can Help

The world we live in today is ever changing. The pressures and challenges that young folks undergo as they carve out their individual identity can leave them vulnerable. Here at Doorways, our aim is to help our patients overcome some of these difficulties and to help them live strong and healthy lives.

We understand the degree of distress can be different for everyone. The best way to address individual triggers and symptoms of different forms of anxiety disorders is to create customized programs for every young person who comes to us. Some of the programs we offer include individual and family counseling for teens and young adults between the ages of 13-25.

We also offer an Intensive Outpatient Program for OCD and Social Anxiety. This program provides counseling in a small group setting and is open to adolescents between 13 and 18. This approach is very helpful in alleviating symptoms of anxiety, especially when these symptoms are interfering with school attendance and/or daily functioning. To find out more, visit our IOP page HERE.

If your child or someone close to you is suffering from an anxiety disorder, please connect with us at Doorways. We can help to identify the underlying cause of the condition and provide professional counseling and help. You can always give us a call at 602-997-2880.

Help Your High-Schooler Manage Stress with these 4 Easy Tactics

High school is full of challenges, academic and otherwise, that can add up to some serious stress for your teen. They’re tackling homework and navigating complex social dynamics, all while balancing time spent with friends, family, and on activities. The demands and schedule might start to feel overwhelming. As the parent, helping your teenager navigate these rough waters is crucial.

Here are some tactics to keep your high schooler from feeling overly stressed when they’re swamped with school work and obligations:

1. Tackle tough homework incrementally.
A large project can sometimes feel like an impossible hurdle, especially if your teen struggles with organization or focus. Instead of jumping straight in, encourage your teenager to break the assignment down into more manageable pieces. Start with a brainstorming session one day, research the next, and so on. This will help the project seem much more achievable. Then, your high schooler can keep a To-Do list of the various steps and check things off as they get completed. Each time he or she gets to tick a box they will feel less stressed about the impending deadline.

2. Familiarize before diving in.
The unknown or unfamiliar can leave teens feeling uneasy. If your high schooler is diving into a new opportunity – a part-time job, an internship, a new club or group — help them to familiarize themselves with what is to come. Check out websites, visit the location, or meet with someone already involved. If their new venture feels familiar it can cut back on your teenager’s nerves about the unknown.

3. Keep things organized at home.
Returning home to a disorganized environment with little structure can have a snowball effect on a teen already stressed after a jam-packed day of high school. Help your teen to create order in his or her room and the rest of the house as well. Make sure your high schooler has a neat and tidy space to work on assignments. Display a calendar with activities and obligations in the kitchen. Establish a predictable framework for after school hours and weekends, too. Disorganization and lack of a clear plan can cause many teenagers to feel apprehensive and distressed.

4. Offer stress relief opportunities.
If your teen needs to relieve some stress, give them the space to do so. Encourage them to tap into activities that make them feel better when school and responsibilities become overwhelming. They might love playing an instrument or writing poetry or riding horses. Whatever gives them a release and brings them joy is worth exploring. And while your teen may not be a varsity athlete, consistent exercise is a wonderful antidote to stress. Help them find an exercise outlet they enjoy. If team sports aren’t their thing, they could always try swimming, dance, or long walks around the neighborhood.

If your high schooler needs additional help with stress management, we encourage you to speak to the staff at Doorways to find out if our services might be the right fit for your family. We provide counseling and psychiatric services exclusively for teens, young adults, and their families in the Phoenix, Arizona area. Each of our staff is dedicated to the specialized needs of high schoolers and committed to the compassionate understanding of their struggles.

Managing Back-To-School Anxiety And Pressure

For teenagers returning to high school, or young adults beginning college, starting a new school year often comes with a lot of stress and anxiety.

Gone are the days of a relaxing summer spent with friends outdoors and easy-going vacation time. With today’s competitive society, many teens and young adults feel pressure to find an internship, practice for standardized tests, or continue to study through the summer. Add to that the pressure of social media, with many experiencing the feeling of FOMO (Fear Of Missing Out) when seeing all the fun things their peers are doing during the summer. It can lead to feelings of self-doubt and worry.

A parent might begin to see some troubling patterns emerge from their anxious teen. Patterns of anxiety can be internalized or externalized. Internalized anxiety may include insomnia, excessive headaches or stomachaches, changes in eating, moodiness, and lashing out. Externalizing anxiety can include partying, consuming alcohol, doing drugs, playing hours of video games, or watching TV excessively.

When should a parent be concerned? It’s the duration of the behavior that can be troubling. A headache from stress is normal. When it is days or weeks of headaches, or other troubling behavior, it’s time to intervene. Here are some suggestions to help guide your teen with stress:

  • Make sure your teen or young adult is getting the sleep they need. According to the National Sleep Foundation, teens need about 8 to 10 hours of sleep each night to function best. Most teens do not get enough sleep — one study found that only 15% reported sleeping 8 1/2 hours on school nights. Getting the right amount of sleep will help with their mood and agitation level.
  • Manage your own expectations and stress. It’s okay if your teen doesn’t make the team or get the lead in the play. Don’t allow your own stress to become theirs. Being a parent means helping your teen overcome failure and disappointment. They will face many challenges going forward in life, so this is the time to help them cope with issues as they arise.
  • Keep the lines of communication open. Help them navigate their feelings of being happy, sad, disappointed, frustrated, etc. Don’t just ask them about their studies or grades. Ask them how they felt about their day. Ask leading questions that will encourage dialog and sharing.
  • For teens still living at home, limit their digital time. Being connected at all hours to social media, or the internet, can compound the feelings of stress or inadequacy. It can also lead to “digital insomnia”, whereas the light from televisions, phones, and computers is processed by our bodies is similar to the way we process daylight. This leads back to teens not getting the sleep they need to be healthy and less stressed.
  • Set your teen up for success with goals and achievements they can accomplish. This will help build their self-esteem and guide them through the feelings of inadequacy. Creating mini-goals that are not time consuming, but affirming their skills and knowledge, will help them feel good about their achievements.
  • If your teen has turned to drinking or drugs to deal with the stress and anxiety, it may be time to get professional help. According to The National Center on Addiction and Substance Abuse (CASA), the studies found that highly stressed teens, compared to low-stressed teens are much more likely to become involved in substance abuse. If you see troubling behavior that suggests problems with alcohol or drugs, get help immediately.

Going back to school, or starting a new one, is never easy for teens and young adults. As with any new beginning, it can lead to stress and worry, which are expected. By guiding your teen, being alert to their behavior, and keeping the lines of communication open, it can be the start of a whole new adventure on the path to success.




What is Social Anxiety

Our providers often get asked about social anxiety and so we thought it would be helpful to put together a primer, so to speak.  If you are a parent of a teenager who refuses to go to school, isolates themselves and is exhibiting other forms of anxiety, feel free to give us a call at Doorways, 602-997-2880.

Getting to Know Social Anxiety

Because social anxiety can often seem unwieldy or even overwhelming to understand, it is often helpful to view it in terms of three separate components that are interrelated and can strengthen one another, leading to a cycle of anxiety:

Anxious sensations in our bodies, such as:

  • Blushing
  • Sweating
  • Racing heart
  • Shaking or tremor
  • Dry mouth
  • Shortness of breath
  • Feeling faint

Anxious thoughts about ourselves, others, and the situation:

  • “Everyone is staring at me.”
  • “They’ll think I’m a loser.”
  • “I don’t belong here.”
  • “I won’t have anything to say.”
  • “People will see how nervous I am.”
  • “They won’t want to talk to me again.”
  • “I will keep looking more and more foolish.”

Anxious behaviors, which can be triggered by anxiety, but can also make the anxiety worse over the long term:

  • Avoiding entering social situations
  • Leaving situations
  • Only entering “safe” places or with “safe” people
  • Using mobile phones, MP3 players, or other devices to avoid
  • being in conversations
  • Apologizing excessively
  • Asking for reassurance from others
  • Preparing excessively (memorizing what to say, extreme grooming)
  • Trying to direct people’s attention away from one’s performance (e.g., by making jokes, dressing in a particular way, etc.)
  • Watching for signs that people are judging us

Social anxiety can emerge in a wide range of situations – essentially, whenever we are in contact with other people or believe we may become a focus of others’ attention. While the possibilities are infinite, the following list outlines some of the more common situations in which people experience social anxiety:

  • Going on a date
  • Starting a conversation with a stranger
  • Asking for directions
  • Starting a conversation
  • Keeping a conversation going
  • Attending a party
  • Being interviewed for a job
  • Holding eye contact
  • Performance situations – our anxiety is triggered by potentially or actually being the focus of attention.
  • Public speaking
  • Public singing
  • Eating at a restaurant alone
  • Dropping something in a public place
  • Spilling a drink
  • Reading in front of others
  • Voicing an opinion during a class or meeting

Is Social Anxiety Always a Bad Thing?

No! Anxiety is a normal and healthy part of being human. It mobilizes our bodies and minds to take action in dangerous or unhealthy situations. Without anxiety, we would probably not be alive – it is what tells us to get out of the way of the bus heading right toward us or to get that 3-week-old cough looked at. Social anxiety is no different. Social anxiety helps us to remain sensitive to the feelings and needs of others, which is a core foundation of cooperation and building relationships. Even strong social anxiety can occasionally be useful; for that job interview, we’ll likely do better if we’re extra careful in choosing our words and our outfits.

When Does Social Anxiety Become a Problem?

Social anxiety becomes a problem only when it is so severe that it is excessive or outside the “norm,” and when it causes major problems in our quality of life. When our social anxiety leads us to consistently avoid social situations, to be very distressed when exposed to them, to have excessive fears of being negatively judged by others, or to miss out on things that we otherwise strongly want or need to do, mental health professionals may consider a diagnosis of Social Phobia (also known as Social Anxiety Disorder). 

How Common is Social Anxiety?

Quite common. While the exact prevalence of social anxiet remains to be determined, approximately 12% of the general public will experience social anxiety at some point during their lives. 

Do I have Social Anxiety

Maybe…or maybe not. If you find that your social anxiety is above and beyond what you would consider “normal” or appropriate and it significantly interferes with your quality of life, you may have Social Phobia.

The next page contains a list of several common symptoms of social anxiety.  Please take the next few minutes look through the lists on the next page and mark each item for how that situation affects you. Each item should have two scores, first rate how much anxiety that situation causes you and second mark how often you avoid that situation.  Later, one of the therapists will review your list with you.  


Depression and Anxiety

While this group specifically focuses on treating OCD and Social Anxiety, people who experience one or both of these conditions often suffer from difficulty in other areas of life as well.  For example, your feelings of anxiety may not be limited to only OCD or social situations. It might feel like everything leaves you feeling anxious.  Other times our conditions can cause us to miss out on important parts of our lives.  It can impact our family relationships, our friendships, or it can halt our progress in school or our hobbies.  It is very normal for people who experience this much difficulty to feel down or sad.  Sadness, frustration and anxiety are all normal experiences that we should not feel embarrassed about.  Sometimes, however, our feelings can become so strong and last so long that they become their own problem. 

Taking your life back

Now that we have a better idea of how your symptoms affect you, it is time to get started fighting back.  The good news is that OCD and Social Anxiety can be effectively treated.  While there is no such thing as being “cured” from anxiety, this treatment program can help to eliminate some problems, reduce others and learn to effectively live with the rest.

How are OCD and Social Anxiety treated?

The best treatment for most people should include one or more of the following three things: A type of therapy called Exposure and Response Prevention (ERP), medicine, and family support.

Most studies show that, on average, about 70% of patients with OCD will benefit from either medicine or therapy. Patients who respond to medicine usually show a 40 to 60% reduction in OCD symptoms, while those who respond to therapy often report a 60 to 80% reduction in OCD symptoms.

However, medicines have to be taken on a regular basis and patients must actively participate in CBT for the treatments to work. Unfortunately, studies show that at least 25% of OCD patients refuse CBT, and as many as half of OCD patients don’t take their medication as directed.

What are CBT and ERP?

There are many types of therapy out there that use different techniques to help people find relief from their mental suffering. One type of therapy is Cognitive Behavioral Therapy (CBT).  CBT focuses on changing the way people think in order to change emotional and behavioral responses to those thoughts. There are many types of CBT.  The most important strategy in CBT for people with OCD is called “Exposure and Response Prevention” (ERP).

“Exposure” refers to confronting the thoughts, images, objects and situations that make you anxious. At first glance, this sounds backwards. You have probably confronted these things many times only to feel bad over and over again. It is important to keep in mind that you have to do the second part of the treatment as well – Response Prevention. Once you have come in contact with the things that make you anxious, you make a choice to not do the compulsive behavior. Again, this might not seem correct to you. You may have tried many times to stop compulsive behavior only to see your anxiety skyrocket. The last point is key – you have to continue to make the commitment to not give in to the compulsive behavior until you notice a drop in your anxiety. In fact, it is best if you stay committed to not doing the compulsive behavior at all.

When you stay “exposed” and “prevent” the compulsive “response” you will start to notice a drop in the feeling of anxiety. This might be a new idea for you – your anxiety will start to decrease if you stay in engaged with the things you fear and resist the compulsive behavior.

A False Alarm

When you feel anxiety, what is your brain trying to tell you? That you are in danger – or more accurately, that you might be in danger. “Might be” in danger is important to consider here. The experience of anxiety does not feel like a “might”, it feels like a fact: “I am in danger.” It has taken over your alarm system, a system that is there to protect you.

When you are facing an actual danger, like crossing a street and seeing a truck speeding toward you, your brain puts out information that you are in danger by making you feel anxious. The anxiety creates motivation to do something to protect yourself. The behaviors you do to protect yourself can actually save your life (getting out of the way of the oncoming truck!).

Unfortunately, your brain tells you that you are in danger a lot! Even in situations where you “know” that there is a very small likelihood that something bad might happen. Now consider your compulsive behaviors as your attempts to keep yourself safe when you “might be” in danger. What are you telling your brain when you try to protect yourself: that you must be in danger. In other words, your compulsive behavior fuels that part of your brain that sends the false alarm signals. In order to reduce your anxiety and your obsessions, you have to stop the behavior.

Teen Anxiety: How to Help Your Teen Cope and Stay Mentally Healthy

Anxiety is a feeling that virtually every teen will experience during their adolescent years in response to changes, pressures or stresses they encounter in life. While occasional anxiety is completely normal in teens, it is important to understand how you can help your teen cope with feelings of anxiety, and properly manage stress in a healthy manner. Learning how to handle occasional bouts of anxiety that will occur in life will help your teen cope better during hard times, and ensure their mental health stays strong.

According to WebMD, however, 13 percent of teens experience levels of anxiety that require professional intervention and treatment to remedy. For this reason, it is also vital for parents of teens to understand anxiety, and the role it plays in the life of their teenager. This understanding and attention will help you better identify how you can help your teen deal with occasional moments of anxiety, as well as understand what to do to help them if you think your teen suffers from an ongoing anxiety disorder.

Teen Anxiety: How to Help Your Teen Cope and Stay Mentally Healthy

What is an Anxiety Disorder?

According to the National Institute of Mental Health, anxiety is an emotional response to stress brought on by many aspects of life. Anxiety is normal for both adults and teens, and should typically subside naturally as you adjust to changes or eliminate stressors from your life. While anxiety is a normal part of life, particularly for teens, it should not linger or last for any substantial periods of time. If your teen is expressing anxiety frequently, it is possible they could be suffering from an anxiety disorder.

In order to differentiate between occasional anxiety and various anxiety disorders, you can use these indicators to identify if your teen is having issues handling anxiety over prolonged time periods.

Generalized Anxiety Disorder

  • Frequently restless, wound up, or on edge
  • Easily tired and frequently fatigued and worn down
  • Excessively worrying
  • Extremely tense muscles
  • Irritability
  • Suddenly changing sleep patterns, or having trouble sleeping

Panic Disorder

  • Repeatedly experiencing sudden attacks of fear or worry
  • Losing control, or feeling out of control
  • Worrying excessively about when another panic attack will happen

Social Anxiety Disorder

  • Feeling very anxious around people, and having extreme difficulty speaking to others
  • Worrying in advance about a future event where interaction with people will take place
  • Trembling, blushing, or sweating when speaking to others
  • Feeling inadequate and unworthy of others
  • Difficulty making friends

How Can I Help My Teen Cope With Normal, Occasional Anxiety?

Whenever your teen is under heightened stress, they will be more likely to experience feelings of anxiety. Tests, sporting events, oral reports, moving and changing schools, and going on dates are just a few of the many life events and occurrences that can lead to your teen having anxious thoughts and feelings. This type of anxiety is inevitable, and your teen can benefit greatly from being guided through their anxious moments, so they know how to handle them in the future where they are bound to occur again.

You can help your teen cope with occasional, normal anxiety by trying the following exercises:

Recognize and name the emotion as anxiety, as it occurs.

Ask you teen speak openly about what they are feeling, and what is causing them stress. This will help them both name and understand the feelings they are having, and help them cope more calmly in the future.

Admit a situation is stressful, and brainstorm ideas to resolve the cause of the stress.

Sometimes, just admitting that you’re under an abnormal amount of stress can cause great relief. Talk with your teen, and help them know it is okay to admit stress, and then help them think of some ways that they can resolve the stress and resulting anxiety they are feeling.

What Can I Do if I Suspect My Teen Suffers From a Serious Anxiety Disorder?

According to the Anxiety and Depression Association of America, 80 percent of teens with a diagnosable anxiety disorder are not being treated, so it is very important to get your teen the help they need if you notice they suffer from much more than just occasional anxiety.

If your teen is suffering from extended periods of anxiety, and you are unable to help them find relief and peace, then it is a great idea to consult a teen counselor who specializes in teen anxiety disorders.