Anxiety: causes, symptoms, and treatment approaches

Adolescent Anxiety

Adolescence is a time of uncertainty and change in a person's life. Things are happening on a number of levels. They experience physical changes, emotional changes, and changes in their social roles. They are not still children, yet not quite adults. It is not surprising that my adolescents experience anxiety with comorbidity for depression in varying degrees. The following will explore academic literature as it relates to this transitional stage of life and adolescent anxiety.

Sources vary as to the exact age that is considered adolescence. This creates differences in academic research that could affect the results. A majority of the studies found considered adolescence to begin anywhere from 12-14 years of age and end at age 18. These differences are due to differences in the timing of physical changes within the body. Stretching the limits of this age group to younger children can have an impact on the study results, as some of the research subjects may not be clearly established adolescents. On average, the adolescence is established by the ages of 13-14. This research will consider adolescence to be from the ages of 13-18.

Anxiety Disorders are the most common mental illness in the United States (Anxiety disorders association of America, n.d.). Anxiety disorders are subdivided into several major categories. They are generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, social anxiety disorder, and specific phobias (Anxiety disorders association of America, n.d.). All of these disorders can be present in adolescents. The prognosis of the disorder depends on many variables, including the root cause of the disorder, comorbidity, social support systems, and the self-image of the adolescent.

Anxiety disorders in adolescents can lead to other problems, such as substance abuse. In a study of patients being treated for anxiety disorders, an overwhelming percentage of patients had tried alcohol, cannabis, or other substances in an attempt to self-medicate and make themselves feel better (Connell, 2005). One of key common factors among this study group was the absence of a supportive father in their lives. Substance abuse, in conjunction with the primary anxiety disorder complicates the chances of treatment success. Anxiety disorders can lead to other symptoms and disorders in the adolescent, complicating treatment and having a devastating impact on their lives and on the lives of those around them.

Untreated anxiety in adolescents can be determinant in the development of adult depression (Moran, 2004). The impact of adolescent anxiety on the rest of the patient's life is a key concern in the development of effective treatment strategies. Treating the adolescent for anxiety has become a primary concern for psychologists, school counselors and other who work with adolescents.

Current Treatment Strategy

Currently there are a number of treatment protocols and techniques being evaluated for the treatment of adolescent anxiety and its various forms. In a recent study involving OCD adolescents, an intensive five-day treatment consisting of two cognitive-behavioral therapy sessions over a five-day period was administered. This treatment strategy was affective in all of the patients studied (Whiteside, Brown, & Abramowitz, 2007). However, the study makes no mention of how long the affects of the treatment lasted. The goal of treating anxiety disorders in teens is to produce long-term affects. Like this study, many treatment programs were only assessed shortly after the treatment was administered. Therefore, it is difficult to determine if the treatment had lasting affects. However, in a longitudinal study that measured clinical outcomes over a 7-year period found that a 16-week cognitive-behavioral treatment program for primary anxiety disorders results in a low reoccurrence rate for the sample population (Phillip, Safford, Flannery-Schroeder, & Webb, 2004). However, one must be cautious not to apply these results to other sample population or treatment methods.

The most common forms of treatment for adolescent anxiety utilize Cognitive-behavioral therapy, antidepressants, or a combination of these therapies. In a study by the National Institute of Mental Health (NIMH), three different treatment methods were studied. It was found that a protocol that combines cognitive-behavioral therapy, psychotherapy, and an antidepressant were effective in treating children and adolescents with anxiety (Baker & Lower, 2008). A majority of psychologists prefer to try non-pharmacologic treatments for anxiety before resorting the drug therapy. Only if the child does not respond to non-drug based therapy ill the therapist prescribe a selective serotonin reuptake inhibitor (SSRI) (Schneider, 2008).

Cultural elements can affect the development of adolescent anxiety (Joshua, 2008). Culture can also have a dramatic affect on the outcome of treatment (Joshua, 2008). Culture must be considered in the type of treatment chosen and the social factors involved in that particular case. Studies also indicate that parents can transmit anxiety disorders to their children through environmental factors, such as modeling, behavior, and family conflict (Dixon, 2007). This same study indicates that the role of genetics in this transmission is not yet clear. Cultural and environmental elements must be considered in developing an appropriate treatment protocol for the individual adolescent. These elements represent case-specific conditions that could affect the outcome of treatments.

Due to the cultural and familial associations of anxiety disorders in adolescents, family focused interventions are becoming a popular treatment option (Saavedra & Silverman, 2008). Parenting significantly affects the outcome of any treatment strategy chosen and can have a significant impact on the long-term effectiveness of the treatment strategy. The most effective treatment strategies were found to be those that involve cognitive-behavioral therapy with all of the family members. This technique enhances other therapies that the individual may receive. Family-focused therapy was found to be an effective intervention in treating anxiety in adolescents (Saavedra & Silverman, 2008).

Choosing an Appropriate Intervention Strategy

Treating anxiety in teens differs from treating similar disorders in adults. The adolescent has many social pressures that will have resolved themselves by the time they reach adulthood. In addition, their bodies are undergoing mental change. From a clinical perspective, natural changes in the adolescent psyche and physiology can mean that the therapist must be flexible and willing to change strategies to meet the current needs of the teen client.

The therapist may be treating a major condition with other underlying conditions that complicate the case. For instance, they may be treating major anxiety that is the root cause of substance abuse, as the teen attempts to alleviate their own symptoms. Current thought among researchers is that due to the unpredictable nature of pharmacological therapies in the teen-age body, it is better to attempt to resolve the issues using behavioral and psychotherapeutic approaching. Only if these techniques do not work, should pharmacological approaches be used.

Current treatment philosophy takes into cultural and familial considerations into the factors affecting treatment protocols for a particular patient. Many individual factors can affect the appropriateness of a treatment method for a particular patient. Research reveals that there are many different treatments and treatment combinations that have proven effective in the treatment of anxiety disorders in adolescents. The clinician has a wealth of resources and treatment procedures at their disposal.