Teen Anxiety: Front-Page News, Still in the Shadows

Benoit Denizet-Lewis has a detailed and compassionate story in the New York Times this week about teen anxiety that gives a voice to a group of kids we know well: those whose fears have stopped them in their tracks, made it unbearable to go to school, and put their promising futures in doubt.

Much of Denizet-Lewis’ article focuses on adolescents receiving intensive treatment for anxiety disorders (and OCD and PTSD) at a residential center in New Hampshire called Mountain Valley. It sounds like a wonderful and transformative place for these young people, and utilizes many of the treatment approaches Child Mind Institute clinicians use, including real-world (“in vivo”) exposure therapy and anxiety peer groups.  We were reminded strongly of the work of Jerry Bubrick, PhD, the senior director of our Anxiety Disorders Center.

Here’s Denizet-Lewis on Jake, whose anxiety led to extended time away from school and suicide attempts. “On a group outing to nearby Dartmouth College, for example, Jake’s therapist suggested he strike up conversations with strangers and tell them he didn’t have the grades to get into the school…The hope was that he would learn that he could talk about college without shutting down — and that his value as a person didn’t depend on where he went to school.”

These individual stories are inspiring and hopeful — but the young people who are lucky enough to be at Mountain Valley or the Child Mind Institute are just a part of a national problem that is stubbornly ignored and misidentified. Denizet-Lewis’ article is called “Why Are More American Teenagers Than Ever Suffering From Severe Anxiety?” There are some plausible reasons: the rise of smartphones and social media, on the one hand, or an increase in awareness and identification of anxiety disorders. But apart from a rise in teen anxiety or treatment, far too many teens don’t get identified as having an anxiety problem at all, particularly when they are poor and they demonstrate disruptive or antisocial behavior.

[fbshare “Too many teens don’t get identified as anxious, particularly if they are poor or disruptive.”]

Anxiety is the most common mental health disorder in childhood and adolescence, affecting around one-third of young people under 18. And yet, Denizet-Lewis writes, “kids who ‘act out’ are often labeled defiant or aggressive, while those who keep to themselves — anxiety specialists call them ‘silent sufferers’ — are overlooked or mistaken for being shy.”

Denizet-Lewis quotes Dr. Philip Kendall, a psychologist and anxiety expert at Temple University. “If you go to a public school in a struggling urban area, teachers will talk about drugs, crime, teen pregnancy, violence,” Kendall says. “When you start to talk about anxiety, they’re like, ‘Oh, those are the kids we like!’”

Whether teen anxiety is on the rise or we are more aware of it, or both, these treatable disorders affect millions of kids and keep them from growing and thriving. We have gotten very good at helping individual children and adolescents in need; we need to get a whole lot better at helping the vast majority that never get help, or even know to ask for it.