Finding steady ground when anxiety takes over
Teen anxiety can creep into a family’s life in quiet, everyday ways. A teen who used to bounce out the door now freezes before school. Homework takes hours because it has to be “just right.” Club sports and travel teams that once felt fun now feel like pressure. Social media, friendships, and college planning add even more weight.
Anxiety can start in small ways at first, until one day it hits you as a parent: “Oh wow, we have to do something about her anxiety.”
Parents are under a lot of pressure to “fix” things for their teens. Remember that anxiety is not a personal failure, and as a parent your job isn’t to fix the anxiety right away. But it can help to get some support from a seasoned professional.
At Bloom Psychology Group in Apex, we help teen girls, youth athletes, and families who are trying to keep up with high expectations and busy schedules. With AP exams, finals, graduations, tryouts, and schedule changes, spring and early summer can be a natural time to reset, and get support before the next school year ramps up again.
What does teen anxiety actually look like in real life?
Teen anxiety is not always obvious – it doesn’t have to be a full-blown panic attack to be serious. Often, anxiety shows up in small signs that add up over time.
Normal anxiety is a healthy, temporary reaction to a specific stressor (like a big test or game). A small-to-moderate level of anxiety can give you a boost of energy or help you focus. But anxiety can turn into more of a problem (think an anxiety disorder) if the worry is excessive, persists for months, becomes difficult to control, or doesn’t ease once the stressor is over.
In teens, anxiety can look like moodiness or irritability. That’s why it’s important for parents to pay close attention to determine if anxiety is above “normal.”
Parents should watch out for these common emotional signs of anxiety:
- Internal noise: Constant or racing thoughts, and “what if”-type worries about school, health, how they’re perceived by others, or the future
- Irritability: Feeling on-edge, snappy, or moody, even tearful seemingly out of nowhere
- Pressure to perform: An intense fear of letting down coaches, teachers, peers, or parents
Teens might not always directly say, “I’m feeling anxious/worried.” Instead, parents might see changes in their physical habits or schedule.
- Unexplained pain: Frequent stomachaches or headaches without a medical explanation
- Avoidance: Skipping practice, pulling back from friends, or avoiding social events they used to enjoy
- Increased scrolling: More social media use as a way to “numb out” or withdraw from the real world (and you might see increased irritability after screen time)
- Changes in eating: Low appetite, nausea, or even dieting disguised as “eating for performance”
- Sleep changes: Difficulty falling asleep, staying asleep, or early morning waking
For teen girls and youth athletes, anxiety can hide behind perfectionism. Your teen might appear to be highly driven and motivated, with high expectations for their own achievement in sport, school, socially, and in life. This in itself isn’t a problem, unless your teen is internally stuck in a classic cycle of perfectionism, characterized by:
- Unrelenting standards: They set goals that are demanding and inflexible. If they hit the goal, they don’t feel successful – they just assume the goal was too easy and set a harder one.
- Fear of failure: Because their self-worth is on the line, any mistake feels like a threat. They dread any form of perceived failure, instead of viewing mistakes as ways to learn and grow.
- Performance checking: You might see them constantly checking grades, re-reading emails multiple times before hitting send, obsessing over film, or obsessing over food and their body weight/shape.
- Fragile self-worth: They base their self-worth on their ability to achieve these demanding and inflexible goals. If they fail to meet the standards, they view it as a personal failure and engage in self-criticism, until it slowly erodes their self-esteem. If they meet the standards, they still aren’t satisfied – instead of attributing it to their own ability and effort, they externalize it by deciding the original standards weren’t demanding enough, and continue to set harder standards.
As a parent, seeing these cycles play out in your teen can be hard to watch. The good news is that treatment, particularly cognitive-behavioral therapy (CBT) is highly effective for reducing anxiety and improving quality-of-life (Carpenter et al., 2018). Early support can help teens cope with harder milestones for teens, like harder classes, college applications, new teams, or more travel.
What happens in teen anxiety therapy sessions
Starting therapy can feel intimidating for both parents and teens. There is a lot of vulnerability in talking about your deepest challenges with a new person. Knowing what actually happens during the first phase of therapy can take a lot of the pressure off.
The first few sessions: Understanding their story and mapping a plan
At Bloom Psychology, we start with a conversation. We do ask questions, but the overall goal is to pull the pieces together to understand your teen’s unique story. We look closely at what they are experiencing right now, how they got to this point, and where they want to go.
In this first phase, our focus is on:
- Hearing their story: We look at how anxiety is currently impacting their day-to-day life. We help them explore how it started, and what it currently looks like now – what are the things that are important to them that they’re missing out on because of anxiety? We also help them map out their values, and identify what they want out of life, even in spite of anxiety.
- Gathering the whole picture: We talk about everything that makes up their world – school, sports, friendships, family dynamics, sleep patterns, social media use, and physical health – to understand how it all connects.
- Collaborative goal setting: We work together as a team to figure out what meaningful progress looks like for them. We help your teen set clear, realistic goals for therapy based on what they want to accomplish, not just what others expect of them.
- Establishing safety and privacy: In our first session with each client, we establish basic components of mental health care. We clearly lay out rules of confidentiality, their rights in therapy, and what to expect from the process. This helps your teen feel safe to show up as their authentic, honest self. And as a parent, you can feel secure knowing that your teen has a safe adult to talk with about their inner world.
unknown for both parents and teens. Knowing what to expect can take some of the pressure off.
Mid-Treatment: What an actual session looks like
Once we understand your teen’s story and have our goals locked in, we move into the middle phase of therapy. We are not the kind of therapists who just listen and take notes while your teen talks. Our sessions are collaborative, active, and very conversational. Your teen takes an active role in their own healing.
Throughout sessions, we use what we call a non-judgmental stance, meaning your teen is met with total understanding, paired with growth strategies. This helps them feel validated in their feelings, while also stretching and challenging them to grow. We teach evidence-based skills, and discuss ways to use them in real-life situations.
Some examples of things we can work on:
- Building a concrete toolkit: We learn and practice tangible coping strategies to manage physical panic and high-stress moments in real-time. Therapy is aimed to actually change their life outside of sessions.
- Rewriting the inner critic: We help teens spot their perfectionistic “rules” and practice self-compassion, swapping a harsh inner voice for one that is realistic and supportive.
- Performance resilience: We practice how to navigate mistakes during tests, games, or auditions, without letting those moments dictate their entire self-worth.
If the anxiety is tangled up in body image issues or perfectionism, we don’t treat them as separate problems. We weave together strategies that help across multiple problems, so your teen can get the most out of sessions.
The end goal: Graduating and generalizing skills
Therapy is not meant to be forever. The ultimate goal of our working together is to get your teen out of therapy and back into their life. As we head into the final phase of treatment, the focus shifts from learning new skills to maintaining and generalizing them – meaning, your teen can apply these tools out in the real world when the pressure is on.
When therapy is successful, parents will start to see shifts like:
- Flexibility over perfectionism: Your teen might still strive for the “A” or the win, but a mistake won’t cause total emotional collapse.
- Stepping into the challenge: Instead of avoiding the game, social event, or hard class, they use their tools to approach those situations, even when they feel nervous.
- Emotional resilience: When big feelings or stressful seasons hit, teens have the self-awareness to say, “I’m feeling overwhelmed right now – and I know what I need to do to take care of myself.”
As a parent, this phase is where you really get to see the impact of the work. Ending therapy doesn’t mean your teen will never feel stressed or anxious again (anxiety is a normal, human emotion). But it does mean that your teen can notice the anxiety mindfully, and take steps to cope well.
Putting it all together: An inside look at teen anxiety therapy in Apex, NC
Teens in Apex and across the Triangle live very full lives. Between AP/honors classes, club sports, showcase weekends, and college prep, the pressure to always be “on” is really loud. It’s common for high-achieving teen girls and youth athletes to look perfectly fine on the outside, while quietly drowning in overwhelm on the inside.
Therapy is a collaborative, three-part process designed to give teens their life back when anxiety threatens to break them. At the start, we sit down together to understand their unique story, and set clear and collaborative goals and expectations. The work of therapy then involves helpful weekly sessions to build a concrete toolkit to build resilience. All of this aims to graduate from therapy so your teen can get back to their lives, without the weight of so much anxiety.
Take the next step
Don’t wait for a total breakdown or crisis to get your teen the support they deserve. Addressing perfectionist and anxious patterns (before they become unmanageable) helps give teens the tools they need to handle the hard stuff.
If you’re ready to help your teen find steadier ground, contact us today. We are happy to schedule an initial session or answer questions. Your teen is working hard to build a great life – let’s make sure they have the resilience and emotional freedom to actually enjoy it!